Cochlear Implants
Cochlear implants (CIs) have been widely studied to vast aspects that enhance its
performance as well as foster its challenges. Cochlear implants bear the definition of prosthetic
technology that allows the deaf to experience hearing and spoken language. Cochlear implants
(CIs) are electrically bypassed to the nerve endings in the ear and the implant transmits sounds to
the brain through the auditory nerve. The aim of this paper is to analyze vast aspects that
concerns cochlear implants. The paper will begin by discussing the effects of behavior problems
in children with cochlear implants in order to define whether the cochlear implants affect their
behavior. Secondly, the paper looks at how children with cochlear implants showed ease or
difficult voice and emotion recognition compared to their normally-hearing peers (Chao et al,
2014). On a third note, the paper will review the bilateral cochlear implants in relation to the
perception and interaural time differences coding. In simpler terms, the paper will define the
coding and perception reliance of bilateral cochlear implant on its users. On a different note, the
paper will further analyze the challenges that the research community has experienced defining
and applying vast aspects of cochlear implants (Zhou et al 2014). Thus, the nerve conditions and
stimulation aspects in relation to the importance of cochlear health for implant function fosters
difficulties to the pioneers of cochlear implants. Lastly, the paper discusses the benefits of deep
electrode insertion as well as sound coding techniques in cochlear implants. This section further
depicts that cochlear implants through the deep insertion electrodes are extremely beneficial
because the insertion improves the speech understanding and sound quality to its users especially
when they are exposed in noisy areas. Therefore, the paper will review numerous topics that
relate to cochlear implants by depicting its positive impact and the negative aspects that affect its
Behavior Problems in Children with Cochlear Implants
Children behave differently due to various factors that contribute to their upbringing.
However, when it comes to disabilities like hearing correspondence, children with deafness
defect tend to behave differently from their hearing counterparts. The most challenging aspect
concerning such children is that the cochlear implants do not grant the much difference in terms
of improving the children’s behavior. For this reason, a research was carried out to determine the
difference of behavior between normal hearing children and children with cochlear implants. The
research was carried out on sixty patients aged 6-18 years (Chao et al, 2014). The research
monitored these children for a period of eight years.
The results of the research depicted that many children had normal internalizing and
externalizing behaviors. However, children with cochlear implants had high rates of social and
attention related behavior problems compared to the behaviors of the normal hearing children.
The survey also depicts that such children are withdrawn, have social problems, thought
problems, attention problems and aggressive behavior (Chao et al, 2014). Experts argue that
these behaviors could be contributed by various factors that are enhanced by the inability to
naturally hear or recognize emotions. However, language delay seems to be the main cause of
these behaviors because language mediates social relations and enhance behavioral control.
Therefore, since children with sensor neural hearing loss depict delayed language, their behavior
control becomes a problem. The fact that they do not have a normal conversing platform also
makes them confused because they cannot adhere to the environments that surround them or
freely mingle with people around them. This explains why they are drawn back and behave
differently as a means of keeping off. Prior to keeping off, these children’s behavior deteriorates
and goes out of control, an aspect that increases parental stress (Chao et al, 2014). In order to
curb this situation, a hearing and behavior performance follow up is essential in order to allow
suitable treatment plans and customized rehabilitation programs.
Voice Emotion Recognition by Cochlear-Implanted Children and their Normally-Hearing
The ability of children to correctly hear and recognize the mood and the intention of the
speaker is an essential aspect in their development both socially and linguistically. Earlier
research clarifies the fact that children with cochlear implants have difficulties recognizing
voices and emotions (Chatterjee et al, 2014). More so, the study depicted that younger children
had difficulty processing degraded speech. This was derived at after various studies of speech
perception were carried out under numerous conditions like sine wave speech noise vocoding,
reverberation as well as background noise. The results showed that the reason why there was no
developmental effect in cochlear implant population is because various factors contributed to the
vice. These factors are electrode insertion depth, etiology of hearing loss, the rehabilitative
services received, nerve survival among other factors. Therefore, cochlear implants are effective
because they have elements that help children to detect and recognize voices as well as emotions.
The survey carried out clarifies this fact because it depicted a great achievement in voice and
emotion recognition in children, but only if their hearing aid is not disrupted by the afore-
mentioned factors (Chatterjee et al, 2014). This means that an in-depth survey is needed and it
should include a larger database of stimuli, a more comprehensive acoustic analysis and multiple
talkers that include both children and adults.
Perception and Coding of Interaural Time Differences with Bilateral Cochlear Implants
The clinical treatment of profound deafness has taken a new dimension since the
introduction of bilateral Cochlear implants. This is the case because there emerged reasons of
implanting Cochlear implants in both ears in order to grant users an experience of normal
hearing. This is because binaural Cochlear implants allows sound sources along both the right
and the left dimension. Therefore, bilateral Cochlear implantation aims at granting its users with
access to binaural signals, which are essential for localizing the sources of sounds and speech
understanding in diverse environments where there are interfering sounds (Laback, Egger &
Majdak, 2014). Despite the aid granted by Cochlear Implants, another crucial concept called
interaural time difference (ITD) matters because they determine the characters of low frequency
sounds as well as spatial release. However, the challenge emerges because Interaural Time
Differences (ITD) are not frequently represented by clinical based Cochlear implants systems.
Therefore, to determine coding and perception of Interaural Time Differences (IRD) sensitivity
of Cochlear implants (CIs) and how its users depended on stimulation parameters, an analysis
was carried out (Laback, Egger & Majdak, 2014). The stimulation parameters included
stimulation place, rate, modulation rate and other vast aspects.
The results of the survey depicted that many bilateral Cochlear implants users had worst
performance compared to NH listeners. The result also depicted that ITD sensitivity varied
across bilateral Cochlear implants listeners. More so, Interaural Time Differences perception
showed beneficial factors in electric hearing. Among these beneficial factors are that the
stimulation of the neural pathways possess high temporal acuity. The other beneficial factor is
that the match between temporal properties of AN responded to electric stimulation (Laback,
Egger & Majdak, 2014). In addition, a low degree of channel interactions was attained due to the
spread of electric current. Another benefit the interaural match grant is the place of electric
stimulation takes place and the fact that a user receives binaural auditory input in the first five
years both electrical and acoustical. Therefore, since bilateral Cochlear implants do not grant the
much-needed coding and perception reliance, there is a need for future research, which will
provide a better understanding of the presented factors as well as other factors that affect ITD
and its perception in electric hearing. Thus, improved access to salient ITD cues depicts an
improved future performance of Cochlear implant listeners (Laback, Egger & Majdak, 2014).
Importance of Cochlear Health for Implant Function
Electrophysiological and psychophysical studies in human subjects depicted that the
patterns of implant function varied from one stimuli site to the next due to varying conditions
near the electrodes and scala tympani (Zhou et al 2014). Thus, the functions of implants are
determined by conditions like the health of the neurons, the distance of the neurons to the
electrodes, the presence of fibrous tissue or bone in the path from electrodes to neurons. These
functions measures positively guide processor fitting, an aspect that help in improving speech
recognition in humans who use cochlea implants. However, despite that the pioneers of Cochlear
implants have helped millions of hearing impaired individuals; they have also presented the
research community with vast interesting challenges (Zhou et al 2014). Among the challenges is
that the research community experience difficulties dealing with a partially degraded auditory
nerve, which is the aim of Cochlear implants stimulation. Thus, the challenge arises in the sense
that the research community finds it hard comprehending how the nerve’s condition impacts the
function of Cochlear implants, and how this understanding might be used to enhance the
perception quality experienced by patients using the implant (Zhou et al 2014). The challenge
intensifies further because results derived from earlier research, which related neural status
performance with the implants challenged the perception that the auditory nerve condition is
extremely crucial for speech recognition with Cochlear implants.
More so, a study of ganglion neurons (SGNs) in cadaveric temporal bones derived from
deceased patients depicted little relationship with Cochlear implant functions in life. In addition,
the auditory nerve condition at the time of death differed from the condition when the subject’s
ability to use the implant was assessed. The other puzzle that the study depicted was that the
anatomical status of the auditory nerve that are observable under the light microscope was
inadequate to represent the health of the neural population because the result might not grant the
needed changes in the sensitivity properties of the nerves in the pathological state (Zhou et al
2014). Therefore, the cochlear health for implant function depicts several difficulties that
challenge its importance. This calls for further research in order to determine the relationship
between electrophysiological and psychophysical measures of speech recognition, cochlear
health and the function of the implant.
Deep Electrode Insertion and Sound Coding in Cochlear Implants
Present day cochlear implants depict remarkable speech understanding performance
especially with the invention of deep electrode insertion. This is because the deep electrode
insertion allows a deep insertion that reaches the required apical region (Hochmair et al, 2014).
This insertion has numerous advantages that include access to minimal frequency information,
minimize channel interaction due to the separation fostered by a wider contact, several channels
and coverage of a wider range of cochlear locations. This means that the insertion covers a wide
range of cochlear locations, which turn out to occupy a large space; hence, reducing disruption
form noise. The goal of inserting super flexible straight electrodes through the round window
membrane is to attain hearing and structure preservation that possess deep insertion electrodes
and average insertion length. More so, the goal of this insertion is to reach the epical area of
cochlea, where there is an effective rate pitch that carries out low pitch fine frequency
information (Hochmair et al, 2014). These applied strategies integrate with the better placer pitch
mach and it acts as an outcome of the complete cochlear coverage. This fosters an intrinsic with
long electrodes that foster a more natural hearing that end up allowing greater enjoyment of
music as well as improved communication capabilities. For this reason, the advantage of deep
insertion electrodes is that it has greatly improved the speech understanding and sound quality
especially in noisy areas.
Cochlear implants (CIs) have achieved tremendous success because prior to aiding
hearing capabilities on profoundly deaf individuals, Cochlear implants deliver speech
information to individuals who are severely impaired. Statistics depict that more than three
hundred thousand patients all over the world now use Cochlear implants. Most of these patients
are children who were born deaf, while others lost their hearing capability within the first few
years in life. Cochlear implants have undergone vast challenges that foster its functionality.
These challenges include high rates of social and attention related behavior problems in children
with cochlear implants compared to the behaviors of the normal hearing children (Chao et al,
2014). Another challenge is that bilateral Cochlear implants do not grant the much-needed
coding and perception reliance. However, the overall performance has provided positive results.
Among the progresses granted by cochlear implants is that it supports high levels of speech
understanding in many post-lingual deaf adults, who had learnt spoken language normally during
childhood (Hochmair et al, 2014). More so, present-day cochlear implants exhibit outstanding
speech understanding performance despite that the non-optimized coding strategies that concern
the spread of tonal information. This is because most of the systems depend on place pitch
information despite the large deviations that are derived from correct tonotopic placement of vast
stimulation sites. In addition, low frequency information is limited because of the constant pulse
rate stimulation of the limited insertion depth of the electrodes. This grants a compromised
perception of both music and tonal languages (Laback, Egger & Majdak, 2014). In addition,
cochlear implants through the deep insertion electrodes have greatly improved the speech
understanding and sound quality to its users especially when they are exposed in noisy areas.
More so, cochlear implants depicted a great achievement in aiding voice and emotion recognition
in children especially when their hearing aid is not disrupted by various factors that include sine
wave speech noise vocoding, reverberation as well as background noise.
Chao, W., Lee, L., Liu, T., Tsou Y, Chan K, & Wu, C. (2014). Behavior Problems in Children
With Cochlear Implants. International Journal of Pediatric Otorhinolaryngology 7, 648
Chatterjee, M., Zion, D., Deroche, M., Burianek, B., Limb, C., Goren, A., Kulkarni, A,. &
Christensen, J. (2014).Voice Emotion Recognition By Cochlear-Implanted Children and
Their Normally- Hearing Peers. Hearing Research 322 (15)1e162.
Hochmair, I., Hochmair, E., Nopp, P., Waller, M, & Jolly, C. (2014). Deep Electrode Insertion
And Sound Coding In Cochlear Implants. Institute for Ion Physics and Applied Physics,
University of Innsbruck, Technikerstrasse 25, A-6020 Innsbruck, Austria
Laback, B., Egger, K, & Majdak, P. (2014). Perception and Coding of Interaural Time
Differences with Bilateral Cochlear Implants. Acoustics Research Institute, Austrian
Academy of Sciences, Wohllebengasse 12-14, A-1040 Vienna, Austria
Zhou, N., Pfingst, B., Colesa, D., Watts, M., Strahl, S, Garadat, S., Schvartz-Leyzac, K., Budenz,
C., Raphael Y, & Zwolan, T. (2014). Importance of Cochlear Health For Implant
Function. Hearing Researc,h 322 (77) e88.

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