This paper, written by Adam Kissiah, discusses the impact of the cochlear implant on society. It covers the technology transfer of the discovery, growth and expansion of the subject of the Cochlear Implant and its impact on the deaf community. This technology transfer was brought to the public light through the provisions of NASA’s Technology Utilization / Commercialization program. This Paper covers the discovery of the first accurate and patentable (US PATENT 4,063,048,December 13, 1977) description of the cochlear implant, which was designed by NASA employee Adam Kissiah, Jr. at the John F. Kennedy Space Center.
The National Institute of Health’s Role in Cochlear Ear Implant Development
A brief history of the Cochlear Implant, how it works, and its commercial growth and utilization path are discussed. Kissiah had a personal hearing problem from NAVAL gunfire concussion. His discovery was aided by personal research and experience gained through prior U.S. NAVY electronics training, a Bachelor of Science Degree in Physics from the University of North Carolina, the technical environment of his employment, and participation in NASA’s activities in aerospace launch instrumentation.
This knowledge, experience, personal research enabled Kissiah to recognize in the early 1970s that prior electronic designs of the cochlear implant were heretofore unproductive except for the MEDICAL aspects of the design. Kissiah’s engineering knowledge and experience was therefore applied to the discovery of an electronic substitute for the non-functioning neurological auditory sensory network within the human Cochlea.
The development and production of the Cochlear Implant has become a world-wide multi-billion dollar industry that has enabled previously hopelessly deaf people to hear sounds and the human voice. It thus provided the electronic capability for deaf people to exchange intelligence by voice. It is understood and emphasized that there was widespread effort by many highly qualified individuals, and many university, government, and private technological organizations that were deeply involved in Cochlear Implant research during the 1960’s, 70’s and 80’s.
Even though Adam Kissiah can be considered the designer and inventor of the cochlear Implant, it must be stressed that many individuals and major medical research organizations, including the National Institutes of Health, the European community, and the Australian Government, were also involved in the development and marketing of a functional Cochlear Implant.
In the late nineteen seventies and early eighties and beyond, as a result of research by the leaders above, and technology breakthroughs (Patent 4063048 ), the National Institutes of Health (NIH) (1, 2) significantly increased its output of research money to university, private and other research centers. The NIH provided funding and guidance under the direction of Dr. F. Terry Hambrecht, director (and successors) of the National Institutes for Neurological Diseases and Stroke (NINDS), and they also provided a central focal point for the development and production process of the cochlear implant.
Contributions by private investors and donors added significant funds in promoting a high level of research in all sectors of society in development of the cochlear implant.
In 1984, the Food and Drug Administration (FDA) approved the first cochlear implant for use in adults ages 18 and older. Five years later, the FDA approved the first cochlear implant for use in children ages 2 years and older. And in 2000, the FDA approved the implantation of children as young as 12 months of age for one type of cochlear implant. The above shows clearly that the National Institutes of Health and many persons and institutions were vital in bringing the cochlear implant into the public domain.
Commercial Development of the Cochlear Implant
As stated above, because all implants share a common basic design, there is no clear-cut consensus that any one of the implants is superior to the others. Users of all devices display a wide range of enhancements, physical designs and performance characteristics, such as FM system compatibility, usability of external components, cosmetic factors, battery life, reliability of the internal and external components,MRI compatibility, mapping strategies, customer service from the manufacturer, and the familiarity of the user’s surgeon and audiologist with the particular device.
Following is a list of some significant commercial implant providers:
- Cochlear Americas, Ltd – (10) From Company published literature) The leader in the total number of Cochlear Implants made world-wide is the Australian Cochlear Americas, Ltd., headquartered in Sydney, Australia and maker of the Nucleus Freedom implant, with over 80,000 persons implanted. Their web-site is www.cochlearamericas.com. Cochlear Limited (Cochlear) is an Australia-based company, website: www.cochlear.com which operates in the implantable hearing device industry. It is a public Company that was established in 1981, with Headquarters in Sydney,Australia.The Company employed approximately 2,500 (2011) and income of 809.6 million in 2011. The Company operates in three geographic segments:Americas,Europe and Asia Pacific. Cochlear has established special purpose entities (SPEs) for trading and investment purposes. The Company’s Cochlear Nucleus 5 system includes a cochlear implant, a sound processor, including an automatic phone detection feature. The Company’s controlled entities include Cochlear AG, Cochlear Americas, Cochlear Benelux NV, Cochlear Canada Inc, Cochlear Deutschland GmbH & Co KG, Cochlear Finance Pty Limited, Cochlear Holdings NV, Cochlear Italia SRL, Cochlear Investments Pty Ltd and Cochlear Medical Device (Beijing) Co., Ltd.
- Cochlear Limited (ASX: COH), also designs, manufactures and sells the Nucleus Cochlear implant along with the Bone Conduction Hearing Solution Baha osseointegrated bone conduction implant, with an estimated 250 000 cochlear implant/Baha recipients receiving a Cochlear Limited product since their establishment in 1981.
- Advanced Bionics-(12) (from Wikipedia and references shown) Advanced Bionics (AB) Inc. is a subsidiary of Sonova, Inc. Websites: www.cochlearimplant.com, and www.bionicear.com. Advanced Bionics is an outgrowth of Dr. William F. House’ Hearing Research Center, and later the House Ear Institute (HEI). They were the makers of the older “Clarion” model implant, and they are also known as the maker of the “Bionic Ear” Hi-resolution (Hi-Res) system. Their latest models include the Hi-Res 90k implant and the Hi-Res “Auria”, with web sites at www.cochlearimplant.com, and www.bionicear.com. AB is a company that is also a major manufacturer of heart pacemakers.Their offices are located in Sylmar, CA and France. Advanced Bionics is a global leader in developing, manufacturing and distributing the most advanced cochlear implant systems in the world, with revenues of USD 117 million in 2008. Acquired by Sonova Holding AG and working with Phonak since 2009, AB develops cutting-edge cochlear implant technology. With operations in over 50 countries. Sonova is the leading provider of innovative hearing healthcare solutions. Present in over 90 countries, and with a workforce of over 5,300 employees, Sonova generated sales of CHF 1.249 billion in the financial year 2008/09 and a net profit of CHF 284 million. For more information please visit www.sonova.com. Sonova shares (ticker symbol: SOON) have been listed on the SIX Swiss Exchange since 1994.
- Med-El, Ltd. (11) headquarters are located in Innsbruck, Austria. Ingeborg and Irwin Hochmiar are Executive Directors. Primary U.S. Offices are in Raleigh-Durham, NC. Med-El makes the Combi 40+ implant and the New Pulsar CI-100 which includes their latest and most improved Med-El technology. Med-El’s website is www.medel.com.MED-EL CorporationUSA, is also a medical devices company that develops and manufactures hearing solutions. It offers hearing systems, middle ear implants, implantable hearing devices, and speech processors. The company was incorporated in 1994 and is based in Durham,North Carolina.MED-EL Corporation operates as a subsidiary of Med-El Elektromedizinische Geräte Gesellschaft M.B.H.MED-EL Elektromedizinische Geräte Gesellschaft M.B.H. develops hearing implant solutions for children and adults. It offers cochlear implant and middle ear implant systems. The company was founded in 1977 and is based in Innsbruck,Austria. It has additional offices in Australasia,Austria,China,France,Germany,Hong Kong,India,Indonesia,Italy,Japan,Korea,Malaysia, the Philippines,Portugal,Singapore,Spain,Thailand,Vietnam, the United Kingdom, and the United States, as well as Latin America and the Middle East.
- Others manufacturers include: MXMLaboratories – www.mxmlab.com. Digisonic, Inc.; AllHear, Inc., Aurora, Oregon; and Allhear:[email protected] [update].
In the European Union Countries (EU), an additional device manufactured by Neurelec, of France, is available. Each manufacturer has adapted some of the successful innovations of the other companies to its own devices. There have been news reports of other organizations working to develop cochlear implants, in South Korea by the Seoul National University Hospital (Wiki #53) and in India by a branch of the Defense Research and Development Organisation (Wiki India).
Effect of the Cochlear Implant on Society
The COCHLEAR IMPLANT is a multi-billion dollar industry which includes thousands of persons in the medical profession, specialized medical research and surgical institutions, and research projects in hundreds of colleges and universities around the world.
The advantages of attaining, or regaining the sense of hearing is profound. The Cochlear implant has enabled thousands of persons to gain highly beneficial employment that was previously impossible to even consider, thus increasing the enjoyment and quality of many lives. According to the U.S. Food and Drug Administration (FDA), as of December 2010, approximately 219,000 people worldwide have received implants. In the United States, roughly 42,600 adults and 28,400 children have received them.
The evolution of the cochlear implant has rendered deafness to be a matter of choice to human beings, and not a life sentence of silence to persons whom have lived half a normal life, and suffered a very painful, either sudden or gradual, severe loss of hearing. Rush Limbaugh is an example of a professional person who suffered an excruciating severe hearing loss in mid-career and was restored to full capacity by a cochlear implant.
The vast majority of hearing persons have complete respect for persons who consider themselves to be exclusive and proud members of the Deaf community, and most members of the hearing society DO understand and sympathize with the deaf community and their cultural pride, while it is also our hope that deaf persons, especially parents, will continue to keep an open mind, as they have in recent years in increasing numbers, toward looking seriously at the pros and cons of implants with respect to each individual’s own unique situation.
From the time we are born, and each day of our lives we are acquiring new knowledge and gaining new capabilities. From kindergarten to high school graduation, to a college degree, to PhD, MD or whatever we choose, we gain higher levels of achievement each step of the way. A Deaf person with a cochlear implant in reality is considered to have a capability that is in addition to his or her sign language capability that renders them superior to the communication abilities of hearing-only persons in that they can communicate with both the worlds of the deaf and hearing. Accepting an implant does not require a person to leave the Deaf culture and be limited to the hearing only world.
Millions of immigrant children entering this country have learned the language of their new country while fully retaining the language (and culture) of their parents, and have lost nothing in the process. Likewise, cochlear implant patients are not required to reject or denounce a single prior friend, business or family member to receive the new benefit of hearing. The attainment of a cochlear implant is simply a new capability for learning and for communicative interaction with greater numbers of the human population.
Indications are that it is very likely that significantly increasing numbers of the Deaf population will eventually choose, whether it be in a decade, a generation or a lifetime, that the cochlear implant is a very positive choice as an aid for the enrichment of life for themselves and for their children.
To see the true impact of the technology, watch these videos:
Adam M. Kissiah, Jr.June 22, 2012
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- Bionic ear prototype,NationalMuseumofAustralia. http://www.nidcd.nih.gov/health/hearing/coch.html#c.
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- Adam Kissiah, Jr. NASA’s Office of the Chief Technologist NASA’s Office of the Chief Technologist recognizes technology developed by NASA that has benefits for the entire nation. In the article “Hearing is Believing”. http://www.sti.nasa.gov/tto/spinoff2003/hm_3.html.
- The social-emotional impact of cochlear implants on children – Janna R Stein,PaceUniversityJanuary, 2007.
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- Cochlear Implants, Information from the National Institutes of Health. “Defense Research and Development Organisation” develops affordable cochlea implant”. www.indiatimes.com. 2012-05-20. Also http://timesofindia.indiatimes.com/city/bangalore/Defence-Research-and-Development-Organisation-develops-affordable-cochlea-implant/articleshow/13309792.cms. Retrieved20 May 2012.
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- NAD Cochlear Implant Committee. “Cochlear Implants”. Archived from the original on 2007-02-20. http://web.archive.org/web/20070220131900/http://www.nad.org/site/pp.asp? Solomon , Andrew (1994-08-28). “Defiantly deaf”. The New York Times. http://query.nytimes.com/gst/fullpage.html?res=9A00E2D91639F93BA1575BC0A962958260&sec=health&pagewanted=10. Retrieved 2010-04-30.
- U.S.Patent 4,063,048,December 13, 1977, Adam M. Kissiah, Jr., Reissue 31031, Sept , 1982 .
- The Social-emotional impact of cochlear implants on children – Janna R. Stein,PaceUniversity, 2007.
- GallaudetUniversity-Cochlear Implants in Children: John B. Christiansen, Irene Leigh Jan, 2002 .
- Cochlear Corporation, Ltd. and Cochlear Americas, Ltd. Annual Report 2011 Consolidated results – 2011 809,646.
- Med El, Ltd. Med-El’s website is www.medel.com.
- Advanced Bionics is an outgrowth of Dr. William F. House’HearingResearchCenter, and later the House Ear Institute (HEI). Websites: www.cochlearimplant.com, and www.bionicear.com
- Annals of the New York Academy of Sciences volume 405, cochlear prostheses: An International Symposium pages 377-386, June 1983 Atlas, L.E. Herndon M.K., Simmons, F.B., Dent, L.J. and White, R.L. (1983), RESULTS OF STIMULUSANDSPEECH-CODING SCHEMES APPLIED TO MULTICHANNEL ELECTRODES.
- GallaudetUniversity- Cochlear Implants in Children – Ethics and Choices -John B Christiansen and Irene W. Leigh
- The American Speech-Language-Hearing Association is the professional, scientific, and credentialing association for more than 150,000 members and affiliates who are audiologists, speech-language pathologists, and speech, language, and hearing scientists in the United States and internationally.
- See The design of Dr Phillip C. Loizou, Professor in the Engineering Department of The University ofTexasatDallas. www.utdallas.edu/-loizou/cimplants/tutorial/loifig4.gif.