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Programming Cochlear Implants

Programming Cochlear Implants

          
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About the Book

Cochlear implants offer significant benefits for children and adults with severe to profound hearing loss; however, to realize these benefits, the device must be carefully and correctly programmed. With current information on cochlear implant technology, Programming Cochlear Implants, Third Edition, a volume in the Core Clinical Concepts in Audiology Series, is a valuable guide for clinicians providing services to cochlear implant users or as a teaching tool for graduate-level students Programming Cochlear Implants, Third Edition introduces the basics of cochlear implant hardware and programming and continues through advanced programming techniques, with manufacturer-specific information and case studies. The text reviews clinical protocols for cochlear implant management; programming considerations for bilateral cochlear implant; troubleshooting during the programming process; device-specific programming techniques; use of objective measures to set cochlear implant programs; use of assistive listening devices with cochlear implants; and providing support to difficult-to-program users, such as infants, individuals with cognitive impairment, persons with disabilities, and so forth. New to the Third Edition The latest hardware innovations in modern cochlear implant systems Advancements in software and programming approaches for cochlear implants New content on methods used to code sound intensity in cochlear implant systems Updates on the latest signal processing and input processing schemes and technologies used in cochlear implants Expanded discussion of programming considerations related to electric-acoustic stimulation and bimodal use Recent developments in hearing assistive technologies used by cochlear implant recipients New and updated information on objective measures in cochlear implant programming

Table of Contents:
Contents Preface Introduction Acknowledgments Contributors Chapter 1. Basic Components and Terminology of a Cochlear Implant Jace Wolfe and Erin C. Schafer Basic Operation of Cochlear Implants Basic Components of Current Cochlear Implant Systems Basic Terminology of Cochlear Implant Programming Parameters Affecting Signal Coding in the Intensity Domain Stimulation Levels Threshold of Stimulation Upper Stimulation Levels Current Amplitude and Pulse Width Mapping Acoustic Inputs Into the Electrical Dynamic Range Parameters Affecting Signal Coding in the Frequency Domain Electrode Contact Versus Channel Virtual Electrodes (Current Steering) Frequency Allocation Parameters Affecting Signal Coding in the Time Domain Stimulation Rate Basic Cochlear Implant Terminology Electrode Coupling Strategy/Stimulation Mode Sequential Versus Simultaneous Stimulation Interpolation Sweeping Loudness Balancing Radio Frequency Telemetry Impedance Voltage Compliance Mixing Ratio Basic Cochlear Implant Signal Coding Strategies Continuous Interleaved Sampling HiResolution Sound Processing n-of-m Strategies Spectral Peak (SPEAK) Advanced Combination Encoder Fine Structure Processing Simultaneous Analog Stimulation Intensity Coding in Cochlear Implants Intensity Coding in Advanced Bionics Cochlear Implants Input Dynamic Range Automatic Gain Control-2 Effect of T and M Levels on Intensity Coding Volume Control Sensitivity Channel Gain Intensity Coding in Nucleus Cochlear Implants Input Dynamic Range, Instantaneous Input Dynamic Range, T-SPL, C-SPL, Automatic Gain Control, Sensitivity, and Autosensitivity Control Volume Control Intensity Coding in MED-EL Cochlear Implants Input Dynamic Range, Electrical Dynamic Range, and Adaptive Sound Window Dual-Loop Automatic Gain Control Maplaw Key Concepts Chapter 2. Basic Principles of Programming Jace Wolfe and Erin C. Schafer Preactivation Procedures Realistic Expectations Prior to Activation Reviewing Logistics of Cochlear Implantation Familiarity With Cochlear Implant Hardware Setting the Stage Programming After Implantation Physical Evaluation Selecting a Signal Coding Strategy Streamlined Versus Comprehensive Programming Measuring Stimulation Levels Setting Threshold Levels for Adults Special Considerations for Setting Threshold Levels for Children Additional Measure to Ensure Adequate T Levels and Confirm Audibility Setting Upper Stimulation Levels for Adults Setting Upper Stimulation Levels for Children Additional Considerations in the Measurement of Stimulation Levels Adjustments to Special Parameters Stimulation Rate Pulse Width Channel Gain Frequency Allocation Input Dynamic Range Maxima Key Concepts Chapter 3. Advanced Bionics Hardware Jace Wolfe and Erin C. Schafer Advanced Bionics Sound Processors Naida CI Marvel and Sky CI Marvel Sound Processors Sound Processor Microphones Digital Signal Processing Processor Controls Marvel CI M AquaMic Naida Marvel CI LED Light and Internal Alarms Naida CI Marvel Connectivity AutoSense OS 3.0 Phonak Link Hearing Aid and Adaptive Phonak Digital Bimodal Fitting Formula Adaptive Phonak Digital Bimodal Fitting Formula Advanced Bionics AB Remote App Advanced Bionics Chorus Sound Processor Advanced Bionics Universal and AquaMic Headpieces Naida CI Q Sound Processors Naida CI Q Battery Module Neptune Sound Processor Advanced Bionics Internal Hardware HiRes Ultra Cochlear Implant Mid-Scala Electrode Array HiFocus SlimJ Electrode Array HiRes 90K Advantage Cochlear Implant HiRes 90K Implantable Cochlear Implant Key Concepts Chapter 4. Programming Advanced Bionics Implants Jace Wolfe and Erin C. Schafer Advanced Bionics Programming Interface Advanced Bionics CI Target Programming Software Step 1: Client Section-Enter Patient and Implant Information/Telemetry Measures Home Page and Training Mode Workspace Tabs Implant Settings Audiogram Step 2: Instruments Section Impedance Measurement Fitting Section Mapping Signal Coding Strategy Pulse Width and Stimulation Rate Filter Type Radio-Frequency Lock Step 3: Setting Stimulation Levels Maps Versus Programs in Target CI Software Creating Multiple Maps Fine-Tuning Programs Manual Programs Additional Considerations for AutoSense OS 3.0 and Manual Programs Span Progressive Levels Program Manager Maps and Programs in the Marvel Sound Processor Bilateral Maps Data Logging Device Options Save and Close Presenting Programming Stimuli Measuring T Levels Measuring M-Level Stimulation Electroacoustic Stimulation-Marvel Acoustic Earhook Programming Advanced Bionics Bimodal Recipients in Target CI Advanced Bionics Active Insertion Monitoring System Programming in Advanced Bionics SoundWave Software Step 1: Create or Select Recipient Step 2: Connect Sound Processor and Conduct Electrode Impedance Measurement Step 3: Create a MAP in the SoundWave Software Select Sound Processing Strategy Pulse Width and Stimulation Rates ClearVoice SoftVoice Stimulus Units and Measuring T Levels Measuring M-Level Stimulation Channel Clipping and Span Input Dynamic Range and Automatic Gain Control Microphone Sensitivity Lock Extended Filtering Channel Gains Load MAPs Onto Sound Processor as User Programs DuoPhone ZoomControl StereoZoom Mic Mode WindBlock, SoundRelax, EchoBlock Audio-Mixing Ratio Internal Telecoil Volume Minimum and Volume Maximum DirectTouch Clear Slot and Stimulate Audible Alarms and QuickSync Additional User Options Loading Programs Into Advanced Bionics Sound Processors Data Logging Ground (Return/Reference) Electrode Key Concepts Chapter 5. Cochlear Nucleus Cochlear Implants and Sound Processors Jace Wolfe and Erin C. Schafer Introduction Nucleus Sound Processors Nucleus 7 Sound Processor Nucleus 7 Features Nucleus 7 Microphone Technology Nucleus 7 Electronics Nucleus 7 User Options Nucleus 7 Acoustic Component Nucleus 7 Accessories Nucleus 7 Wearing Options Nucleus 8 Sound Processor Nucleus Kanso 2 Sound Processor Nucleus Kanso 2 Microphones Nucleus Kanso 2 Electronics Nucleus Kanso 2 Wearing Options Nucleus Kanso Sound Processor Nucleus Kanso Microphones Nucleus Kanso Electronics Nucleus Kanso Wearing Options Nucleus 6 Sound Processor Wearing Options Battery Options Processor Buttons and Lights Processor Direct Auditory Input Port Wireless Remote Assistants Nucleus Cochlear Implants The Nucleus Profile Cochlear Implant Nucleus Profile Plus Cochlear Implant Nucleus Freedom Internal Device Nucleus Electrode Arrays Nucleus Slim Modiolar Electrode Nucleus Contour Advance Electrode Nucleus Slim Straight Electrode Nucleus Slim 20 Nucleus Straight Electrode Array Nucleus Double Array Nucleus L24 Hybrid Electrode Array Nucleus Slim 20 Electrode Array Key Concepts Chapter 6. Programming Nucleus Cochlear Implants Jace Wolfe and Erin C. Schafer Programming Nucleus Implants Programming Nucleus Sound Processors Creating Recipient Files The Programming Process Dashboard Measure Impedances Transimpedance Matrix Measurement AutoNRT Adjust Opening or Creating MAP Master Volume Four Options for Creating New MAPs in Custom Sound Pro AutoNRT Population Mean Other Measures Thresholds Initial Activation in Custom Sound Pro Custom Sound Pro-Follow-Up Programming Sessions Parameters Strategy Stimulation Mode Channel Rate (Hz) Maxima Pulse Width (Microseconds) Power Level Setting Tone Level (%DR), Tone Channel, Low Tone Channel Volume Adjustment Manufacturer's Settings Frequency Table T-SPL and C-SPL Loudness Growth Set Levels Screen Adjusting Default Parameters Determining Stimulation Levels for Nucleus Cochlear Implants Optimizing T Levels Optimizing C Levels Optimizing the Electrical Dynamic Range Channel Gains Voltage Compliance Prediction of Stimulation Levels From Other Programs Progressive MAPs Double-Channel Mapping Channel-to-Electrode Assignment Finalize Adjust and Configure Programs and Input Processing Input Processing Nucleus Input Processing Technologies and Considerations for Use Autosensitivity Control and Autosensitivity Control Breakpoint Adaptive Dynamic Range Optimization Beam and Focus Zoom Forward Focus SCAN SCAN 2 SCAN 2 FF SNR-NR-Signal-to-Noise Ratio-Noise Reduction WNR - Wind Noise Reduction Whisper Processor Settings Power Level and Battery Life Neural Response Telemetry Measurement and AutoNRT Programming Previous Generations of Nucleus Implants Cochlear CR120 Remote Assistant Nucleus SmartNav System Key Concepts Chapter 7. Cochlear Implant Hardware Jace Wolfe, Sharon Miller, and Erin C. Schafer MED-EL Corporation SONNET 2 Sound Processor SONNET 2 Wearing Options DL-Coil With Magnets SONNET Sound Processor OPUS 2 Sound Processor Battery/Wearing Options RONDO 3 RONDO 3 Cover Battery Options RONDO 3 Magnets RONDO 2 Battery Options AudioLink Wireless Accessory FineTuner Echo Remote Control FineTuner Additional Features in MED-EL Systems MED-EL Speech Processor Test Device MED-EL Microphone Test Device SYNCHRONY Cochlear Implant SYNCHRONY 2 Cochlear Implant MED-EL Electrode Array Options MED-EL FLEX Series MED-EL FORM Series Classic Electrode Array Series Additional MED-EL Electrode Arrays MED-EL Auditory Brainstem Array Additional MED-EL Cochlear Implants MED-EL CONCERT Internal Device SONATA TI100 Internal Device PULSAR CI100 Internal Device SONNET 3 Audio Processor Key Concepts Chapter 8. Programming MED-EL Cochlear Implants Jace Wolfe, Sharon Miller, and Erin C. Schafer Programming MED-EL Implants Patients Programming Interface Telemetry-Impedance and Field Telemetry Measurement Creating a MAP in MAESTRO Setting Stimulation Levels to Create a MAP Measuring MCL Setting MCLs With a Flat-MAP in Live Speech Electrically Evoked Stapedius Reflex Threshold Measurements Sweeping, Balancing, and Interpolation Set Levels Grid/Table Measuring THR Shift & Tilt, Pivot, Interpolation Strategy Section Stimulation Rate Channel-Specific Sampling Sequence Channels Compliance Level Control Volume Mode Channel Interaction Compensation Pulse Characteristics Frequency Bands Maplaw Indicators Loading Programs Onto MED-EL Sound Processors ASM 3.0 Input Processing Parameters Adaptive Intelligence Microphone Directionality Ambient Noise Reduction, Transient Noise Reduction, Wind Noise Reduction Compression Ratio and Sensitivity Additional Considerations for ASM 3.0 Settings Additional Programming Options Settings Menu Electroacoustic Stimulation of MED-EL Recipients MED-EL-Specific Troubleshooting Additional Considerations Auditory Response Telemetry, AutoART, ARTFit, and Electrically Evoked Auditory Brainstem Response MED-EL OTOPLAN Chapter 9. Clinical Considerations: Putting All of the Pieces Together Jace Wolfe Collaboration With the Cochlear Implant Surgeon/Medical Evaluation Programming Schedule Initial Activation Session Initial Activation Realistic Expectations Measuring Stimulation Levels at Initial Activation One-Week Postactivation Appointment One-Month Postactivation Programming Session Remainder of Programming Schedule The Role of Electrically Evoked Potentials in Programming Additional Habilitative/Rehabilitative Considerations Considerations for Bilateral Cochlear Implantation The Benefits of Binaural Hearing Programming Considerations for Bilateral Cochlear Implant Recipients Considerations for Bimodal Users Programming Considerations for Bimodal Users Considerations for Individuals With Single-Sided Deafness and Cochlear Implants Key Concepts Chapter 10. Troubleshooting and Managing Patient Complaints and Complications Jace Wolfe and Erin C. Schafer Introduction Patient Complaints and Complications Managing Recipients Who Experience Disappointing Outcomes External Hardware Determine Wear Schedule and Facilitate an Auditory Lifestyle Evaluate the Appropriateness of the Cochlear Implant Program Assessment of Internal Hardware Identifying "Ref Flags" Cochlear Implant Programming Tips to Address Common Recipient Complaints Insufficient Audibility for Low-Level Sounds (Poor Understanding of Soft Speech/Aided Thresholds Poorer Than 25 to 30 dB HL) Poor Speech Recognition in Noise Facial Nerve Stimulation/Other Nonauditory Side Effects Associated With Stimulation From the Cochlear Implant Chapter 11. Hearing Assistance Technology and Cochlear Implants Erin C. Schafer, Jace Wolfe, and Sharon Miller Basic Description of Personal Systems Optimal Systems for Use With a Cochlear Implant Description and Programming for Personal Hearing Assistive Technology and Cochlear Implants Frequency Modulation and Digital Radio-Frequency Transmitters Frequency Modulation, Radio-Frequency, and Induction Loop Receivers Programming Considerations for Frequency Modulation/Radio-Frequency Receivers and Sound Processors Programming and Fitting Remote Microphone Receivers Sound Processor Programming and Hearing Assistive Technology Audio-Mixing Ratios Input Dynamic Range Microphone Sensitivity Fitting Procedures for Personal Remote Microphone Systems Monitoring and Troubleshooting Personal Frequency Modulation/Radio-Frequency Systems for Cochlear Implants Hearing Assistive Technology to Improve Telephone Conversations Telecoils Telecoil Accessories Streaming Devices Summary of Hearing Assistive Technologies for Cochlear Implants Key Concepts Chapter 12. Programming Recipient Using Electroacoustic Stimulation Jace Wolfe and Erin C. Schafer Introduction Electroacoustic Stimulation Hardware Electroacoustic Stimulation Sound Processors Electroacoustic Stimulation With the Advanced Bionics Marvel Sound Processor Electroacoustic Stimulation With the Cochlear Nucleus 7 Sound Processor Electroacoustic Stimulation With the MED-EL SONNET 2 EAS Sound Processor Programming Considerations for Electroacoustic Stimulation Recipients Clinical Protocol for Programming Electroacoustic Stimulation Devices Audiometric Assessment Fitting of the Acoustic Component Provision of Electric Stimulation for Electroacoustic Stimulation Recipients Additional Considerations Regarding Spectral Allocation of Electroacoustic Stimulation Additional Consideration: Acoustic Coupling The Future of Electroacoustic Stimulation Key Concepts Chapter 13. Case Studies Margaret Dillon, Jourdan Holder, Lisa R. Park, Jace Wolfe, and Erin C. Schafer Case Study 1: Spatial Hearing Abilities With Default Versus Place-Based Maps Take-Home Points Case Study 2: Programming a Child With Normal Low-Frequency Residual Hearing Take-Home Points Case Study 3: Electroacoustic Stimulation and Unilateral Hearing Loss-Place-Based Programming Take-Home Points Case Study 4: Optimizing Hearing Performance for a Bimodal User Case Study 5: Addressing Poor Hearing Performance and Sound Quality Complaints for a Bimodal User Take-Home Points Case Study 6: Basic Example of Creating Programs for an Adult Recipient Take-Home Points Case Study 7: Establishing a Program for an Adult via Objective Measures Take-Home Points Case Study 8: Creating Programs for a One-Year-Old Implant Recipient Take-Home Points Case Study 9: Creating a Program for a Young Recipient Using the Advanced Bionics HiRes 90K Advantage Cochlear Implant Take-Home Points Case Study 10: Inadequate Stimulation Levels and Narrow Electrical Dynamic Range Take-Home Points Case Study 11: Using Objective Measures to Set Upper Stimulation Levels Take-Home Points Case Study 12: Creating a Program for a Recipient With Multiple Disabilities Take-Home Points Case Study 13: Use of Objective Measures as a Guide to Avoid Overstimulation Take-Home Points Case Study 14: Addressing Speech Recognition Difficulties That May Be Associated With Excessive Stimulation Take-Home Points Case Study 15: Utilizing Behavioral Information to Create a Cochlear Implant Program and Address Recipient Difficulties Take-Home Points Electrode Impedance Case Studies Case Study 16: Sawtooth Electrode Impedance Pattern Managed With Programming Take-Home Points Case Study 17: Flat Low Common Ground Impedances With Performance Decrease Take-Home Points Case Study 18: Physiological-Related Electrode Impedance Changes Take-Home Points Case Study 19: Impedance Changes Secondary to Excessive Stimulation Take-Home Points Case Study 20: Programming for a Teenage Recipient Who Had Significant Residual Hearing After Implantation Key Concepts References Index


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Product Details
  • ISBN-13: 9781635501766
  • Publisher: Plural Publishing Inc
  • Publisher Imprint: Plural Publishing Inc
  • Height: 279 mm
  • No of Pages: 630
  • Width: 216 mm
  • ISBN-10: 1635501768
  • Publisher Date: 15 Sep 2025
  • Binding: Paperback
  • Language: English
  • Spine Width: 30 mm


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