The Impact of the Cochlear Implant on Society

Cochlear implant impact on children

How Adam Kissiah Changed the World

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.

The paper covers the discovery of the first accurate and patentable (US PATENT 4,063,048, December 13, 1977) description of the cochlear implant. NASA employee Adam Kissiah, Jr. initially designed the device at the John F. Kennedy Space Center.

The National Institute of Health’s Role in Cochlear Ear Implant Development

The paper briefly analyzes the Cochlear Implant, its work, and its commercial growth and utilization path. Kissiah had a personal hearing problem resulting 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, and personal research enabled Kissiah to recognize in the early 1970s that prior electronic designs of the cochlear implant were unproductive, except for the medical aspects of the design. As a result, Kissiah applied his extensive engineering knowledge and experience 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 have become a worldwide multi-billion-dollar industry. This enables millions of 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. There was a widespread effort by many highly qualified individuals and many universities, government, and private technological organizations that were deeply involved in Cochlear Implant research during the 1960s, ’70s, and ’80s.

Who Invented the Cochlear Implant?

Adam Kissiah can be considered the designer and inventor of the Cochlear Implant. However, many individuals and significant medical research organizations were involved in developing and marketing a functional cochlear implant. Examples include the National Institutes of Health, the European community, and the Australian Government..

In the late seventies and early eighties, 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 the university, private and other research centers. The NIH provided funding and guidance under Dr. F. Terry Hambrecht, director (and successors) of the National Institutes for Neurological Diseases and Stroke (NINDS). In addition, they provided a central focal point for the development and production process of the cochlear implant.

Contributions by private investors and donors added significant funds. The funds helped promote a high level of research in all sectors of society in developing cochlear implants.

In 1984, the Food and Drug Administration (FDA) approved the first cochlear implant for adults ages 18 and older. Five years later, the FDA approved the first cochlear implant for two-year-old children. Also, 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 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 standard 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. Enhancements include physical designs and performance characteristics, such as FM system compatibility, the 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 – (10) (From company published literature) The leader in the total number of Cochlear Implants made worldwide is the Australian Cochlear Americas, Ltd. They are headquartered in Sydney, Australia, and make the Nucleus Freedom implant. They have over 100,000 persons implanted.
  • Cochlear Limited is an Australia-based company that operates in the implantable hearing device industry. It is a public company established in 1981, with Headquarters in Sydney, Australia. In 2011, the company employed approximately 2,500 and had an income of 809.6 million.  The company operates in three geographic segments: the Americas, Europe, and the Asia Pacific. Cochlear has established unique purpose entities (SPEs) for trading and investment purposes. The company’s Cochlear Nucleus 5 system includes a cochlear implant, a sound processor, and 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), designs, manufactures, and sells the Nucleus Cochlear implant and 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 are shown) Advanced Bionics (AB) Inc. is a subsidiary of Sonova, Inc. Advanced Bionics is an outgrowth of Dr. William F. House’s 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.” AB is a company that is also a significant 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 globally, 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. 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, including their latest and most improved Med-El technology. MED-EL corporation in the USA is a medical devices company developing and manufacturing 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.
  • Other manufacturers include MXM Laboratories – Digisonic, Inc.; AllHear, Inc., Aurora, Oregon; and Allhear.

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.  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 that includes thousands of persons in the medical profession, specialized medical research and surgical institutions, and research projects in hundreds of colleges and universities worldwide.

The advantages of attaining or regaining the sense of hearing are profound.  The Cochlear implant has enabled thousands of persons to gain highly beneficial employment that was previously impossible to 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.

Closing Comments

The evolution of the cochlear implant has rendered deafness a matter of choice to human beings and not a life sentence of silence to persons who have lived half a normal life and suffered a very painful, sudden, or gradual, severe hearing loss. Rush Limbaugh is an example of a professional who suffered an excruciating severe hearing loss in mid-career and was restored to total 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. Most members of the hearing society DO understand and sympathize with the deaf community and their cultural pride. At the same time, 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 concerning each individual’s unique situation.

From the time we are born and each day of our lives, we acquire new knowledge and capabilities. From kindergarten to high school graduation to a college degree, to Ph.D., MD, or whatever we choose, we gain higher levels of achievement at each step. A Deaf person with a cochlear implant, in reality, is considered to have a capability that, in addition to his or her sign language capability, 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 their parents’ language (and culture) 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 communicative interaction with more significant numbers of the human population.

Indications are that, likely, significantly increasing numbers of the Deaf population will eventually choose, whether 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 their children.

To see the true impact of the technology, watch these videos:

Adam M. Kissiah, Jr.June 22, 2012

Bibliography

  1. Wikipedia – Cochlear Implant – History.
  2. The Cochlear Implant NIH Publication number 11-4798 (2011-03-01). “Cochlear Implants” National Institute on Deafness and Other Communication Disorders.
  3. U.S.Department of Health & Human Services – National Institutes of Health – Research Portfolio Online Reporting Tools (RePORT – Reports, Data analyses of NIH Research Activities.
  4. W.F. House (May-June 1976). “Cochlear Implants.”  Annals of Otology, Rhinology, and Laryngology 85 (suppl 27) (3pt2): 1-93.PMID779582.
  5. F. Blair Simmons (July 1966). “Electrical Stimulation of the Auditory Nerve in Man.”
  6. Archives of Otolaryngology84 (1) 2-54.PMID5936537.
  7. Burian K. Hochmair, Hochmair-Desoyer IJ. Lesser MR (1979).
  8. Bionic ear prototype,NationalMuseumofAustralia. http://www.nidcd.nih.gov/health/hearing/coch.html#c.
  9. Amy E. Nevala (2000-09-28). “Not everyone is sold on the cochlear implant.”SeattlePost-Intelligencer. http://www. Seattlepi.com/lifestyle/cont28.shtml.Retrieved 2009-11-04.
  10. Delost, Shelli; Sarah Lashley (2000-03). “The Cochlear Implant Controversy.” Drury Interdisciplinary Research Conference.
  11. Adam Kissiah, Jr. Cochlear Implant Technology by Adam Kissiah, Jr.
  12. Adam Kissiah, Jr.- www.hearagain.org.
  13. Adam Kissiah, Jr. www.NASA.gov-NASA Spinoff-Hearing is Believing.
  14. NASA-Cochlear Implant Inventor Recognized 25 years Later, http://www.nasa.gov/centers/kennedy/news/releases/2002/release-20020913.html.
  15. Adam Kissiah, Jr. NASA’s Office of the Chief Technologist NASA’s Office of the Chief Technologist recognizes technology developed by NASA that benefits the entire nation. In the article “Hearing is Believing”. http://www.sti.nasa.gov/tto/spinoff2003/hm_3.html.
  16. The social-emotional impact of cochlear implants on children – Janna R Stein, PaceUniversityJanuary 2007.
  17. Gallaudet university– Cochlear Implants in Children – John B. Christiansen, and Irene Leigh, January 2002.
  18. Journal of the American Medical Association, Medical News (JAMA) in May 2012 issue of the archives of Otolaryngology-Head and Neck Surgery.
  19.  Innovation and Industry Development: The Case of Cochlear Implants by Andrew H. Van de Ven and Raghu Garud 31 Ashley Nicole Norkus, History of the cochlear implant-BloomsburgUniversity, June 2007.
  20.  NASA, Spinoff Article on engineer Adam Kissiah’s contribution to cochlear implants beginning in the 1970s.
  21.  Cochlear Implants, Information from the National Institutes of Health. “Defense Research and Development Organisation” develops affordable cochlear implant.” Retrieved 20 May 2012.
  22. Bae Ji-sook (2010-02-28). “Procedure Gives Hearing to Auditory Disabled.” TheKoreaTimes. Retrieved 2010-03-05.
  23. “The Cochlear Implant Controversy, Issues, and Debates.” NEWYORK: CBS News.September 4, 2001. Retrieved 2008-11-09.
  24. NAD Cochlear Implant Committee. “Cochlear Implants.” Archived from the original on 2007-02-20. Solomon, Andrew (1994-08-28). “Defiantly deaf.” The New York Times.
  25. U.S.Patent 4,063,048, December 13, 1977, Adam M. Kissiah, Jr., Reissue 31031, Sept 1982.
  26. The Social-emotional impact of cochlear implants on children – Janna R. Stein, PaceUniversity, 2007.
  27. Gallaudet university-Cochlear Implants in Children: John B. Christiansen, Irene Leigh Jan 2002.
  28. Cochlear Corporation, Ltd. and Cochlear Americas, Ltd. Annual Report 2011 Consolidated results – 2011 809,646.
  29. Med-El, Ltd.
  30. Advanced Bionics is an outgrowth of Dr. William F. House’s Hearing Research Center and later the House Ear Institute (HEI).
  31. 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.
  32. Gallaudet university- Cochlear Implants in Children – Ethics and Choices -John B Christiansen and Irene W. Leigh
  33. The American Speech-Language-Hearing Association is a 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 internationally.
  34. See the design of Dr. Phillip C. Loizou, Professor in the Engineering Department of The University of Texas at Dallas.

One thought on “The Impact of the Cochlear Implant on Society

  1. Just read Second Stage. . . Reminded me of the day I got my hearing aids. Near the end of teaopphintment I asked Susan to write out the check (her handwriting isso much better than mine) and I turned to talk with the doctor.Suddenly I heard this loud ripping noise that made me actually jump.Scared the bejesus out of me. I looked to see the source and saw thatit was the check being ripped out of the check book. That’s all, justthe check being removed from the checkbook but, thanks to the hearingaids, way way louder than I have ever heard it before. Caught me wayoff guard.Later when we went to check out and schedule the next appointment withthe receptionist in the waiting room, I was stunned at the loudness ofthe conversations in the room. Distracting and annoying.Mostly, now, those sorts of surprises and confusions are over.Sometimes in an unusually noisy restaurant or reception I have troublewith background noises, but that’s about it.It has been an adventure but, nothing compared to yours. Hope allcontinues to go well for you.

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