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JOURNAL CLUB Cochlear Implantation: Asia–Pacific Symposium Is an Emerging Force By Fan-Gang Zeng, PhD; Shi-Ming Yang, MD, PhD; & Zhiqiang Gao, MD T he 10th Asia–Pacific Symposium on Cochlear Implants and Related Sciences (APSCI 2015) drew about 2,000 professionals to dis- cuss the latest research in Beijing from April 30 to May 3. The number of attendees was unprecedented, the weather cooperative, and the venue splendid, but the science was even better. One hot topic that consistently came up at the conference was how to narrow the re- maining gaps between prosthetic and normal hearing. Bruce J. Gantz, MD, of the University of Iowa designed special electrodes Blake S. Wilson, DSc, DEng, of Duke to produce a hybrid cochlear implant that preserves low-­frequency University reviewed the progress of co- acoustic hearing. chlear implant performance from essentially and 1,000 Hz needs to be preserved, preferably using the chance-level success with single-channel short (10-mm) electrodes while saving the long (16- or 20- devices in the 1980s to today’s multichannel devices that mm) electrodes for people who are older than 70 and have even allow most users to carry on cell phone conversations. more than 30 years of profound loss at high frequencies. He also noted a lack of improvement in unilateral cochlear Most surgeons also favored atraumatic insertion and struc- implant performance in the last two decades and suggested tural preservation in cochlear implantation, which are critical that improving unilateral performance serves as a “bedrock” to both short-term protection and long-term maintenance of critical to narrowing the gap between prosthetic and normal residual acoustic hearing. hearing. Using a biological approach in an animal model, Shi-Ming As a means to improve unilateral performance, Ingeborg Yang, MD, PhD, of Chinese People’s Liberation Army Gen- Hochmair, PhD, of MED-EL advocated the use of deep elec- eral Hospital in Beijing demonstrated that stem cells promote trodes to access low-frequency neurons while matching them auditory nerve growth toward the intra-cochlear electrodes, with appropriate temporal fine structure (Hear Res 2015; reducing power consumption while increasing spatial selec- tivity. For people with residual low-frequency acoustic hearing, This technique, similar to a gene-therapy approach (Sci Bruce J. Gantz, MD, of the University of Iowa designed spe- Transl Med 2014;6[233]:233ra54), may still be years away cial electrodes to produce a hybrid cochlear implant that pre- from human application, but it represents a promising future serves low-frequency acoustic hearing, augmenting and direction for enhancing the nerve–electrode interface and ul- enhancing the implant performance. timately the bionic ear performance. To achieve a hybrid hearing advantage, acoustic hearing better than 85 dB pure-tone average (PTA) between 125 Hz Dr. Zeng is chairman of The Hearing Journal Editorial Advisory Board, as well as director of the Center for Hearing Research and professor of anatomy and neurobiology, biomedical engineering, cognitive sciences, and otolaryngology at the University of Cali- fornia, Irvine. Dr. Yang is chairman of the Department of Otolaryngology–Head and Neck Surgery at the Chinese People’s Liberation Army Gen- eral Hospital in Beijing and copresident of the APSCI 2015 Scien- tific Committee. Dr. Gao is chairman of the Department of Otorhinolaryngology at Peking Union Medical College Hospital and the Chinese Acad- emy of Medical Sciences in Beijing, and copresident of the APSCI 2015 Scientific Committee. The Hearing Journal BINAURAL HEARING: SENSITIVE PERIOD Another major area covered at the conference was under- standing and utilizing brain plasticity in cochlear implanta- tion. Robert Briggs, MBBS, of the University of Melbourne re- viewed lessons learned from cochlear implant outcomes in children over the past 30 years, such as the younger the im- plant age, the better the outcome, particularly for children im- planted before their first birthday. Other significant factors are the child’s cognitive status and communication mode, with superior outcomes related to an oral versus a signing environment. A somewhat surprising finding was that children with bilateral implants have better July 2015

USING SOUND TO CURE TINNITUS Sound therapy, via either acoustic or electric stimulation, uses external sounds to provide short- and longterm relief from tinnitus. The interactions between external sounds and tinnitus are well established, as the external sounds can not only induce tinnitus, but can alter its perception as well. Excessive exposure to loud sounds is the single greatest risk associated with tinnitus onset, and for those with tinnitus, sound overexposure may exacerbate it. However, sounds used at safe levels can be highly beneficial to an individual with tinnitus. Sounds can not only distract a person’s attention away from tinnitus, but also affect the overall quality of the tinnitus. In some cases, people report noticeable changes in tinnitus pitch or quality following exposure to certain external sound sources. For example, a variety of sounds, ranging from constant, low-level background sounds mimicking running water to intermittent sounds mimicking fire crackling have been used to mask the overall perception of tin

Ed i to riA L A Long-Deserved Award for the Cochlear Implant We congratulate Graeme Clark, Inge- borg Hochmair, and Blake Wilson on receiving the 2013 Lasker~DeBakey Clinical Medical Research Award for their outstanding contributions to the development of the modern cochlear implant. While celebrating this long-deserved recognition, of which all in the hearing field should be proud, we take this oppor- tunity to reflect on the achievement of the cochlear implant and its impact. Since the U.S. Food and Drug Admin- istration approved the first commercial device in 1984, more than 300,000 people have received the cochlear implant to restore partial hearing. Of these recipients, greater than half are children, with many able to develop nearly normal language skills and seamlessly merge into mainstream schools and professions. The cochlear implant has now been used to treat a range of disorders, from par- tial hearing loss and single-sided deafness to tinnitus, and has paved the way for research and development of other neural prostheses. By any measure, the cochlear implant has “conferred the greatest benefit to mankind” (alfred Nobel’s will). We have been able to see further by standing on the shoulders of giants. William F. House was such a giant, who, despite his insistence on a single-electrode device and lack of commercial success, more than any- body deserves credit for making the cochlear implant a viable medical product and an acceptable medical prac- tice. He was among the first to realize the need for a strong comprehensive team approach to fitting and rehabilitation. F. Blair Simmons and Robert L. White of Stan- ford University developed a multi-electrode device and evaluated its perform- ance—how often do you see an article titled “Audi- tory Nerve: Electrical From left, Blake Wilson, Ingeborg Hochmair, Stimulation in Man” these and Graeme Clark were presented with the 2013 days (Science 1965; Lasker~DeBakey Clinical Medical Research Award. Robin P. Michelson and Michael M. As we celebrate the great honor received Merzenich of the University of California, by Drs. Clark, Hochmair, and Wilson, we San Francisco, not only developed one of cannot rest on our laurels. The contemporary the first multichannel cochlear implants, cochlear implant has much room to improve. but also organized the first international We also need to reduce the cost and increase conference on cochlear implants, developed access to the cochlear implant. animal models, and established the first The spotlight of the Lasker Award will comprehensive evaluation standards. help to raise public awareness. The future Donald K. Eddington of Utah and looks bright. Claude-Henri Chouard of Paris devel- Dr. Shannon is professor of otolaryngol- oped multi-electrode devices that pro- ogy–head and neck surgery, biomedical duced open-set speech recognition and engineering, and neuroscience at the University were certainly precursors to the modern of Southern California. cochlear implants. Dr. Zeng is chairman of The Hearing Jour- Thanks to these pioneers, deafness is no nal Editorial Advisory Board, as well as director longer a disability that separates people. of the Center for Hearing Research and profes- They and many other engineers, research- sor of anatomy and neurobiology, biomedical ers, and clinicians have greatly enriched and engineering, cognitive sciences, and otolaryngology at the expanded the hearing health field. University of California, Irvine. editorial advisory Board Fan-Gang Zeng, PhD, Chairman University of California Irvine, CA sales aNd advertisiNG vice President, sales Fabien Savenay sales director, lWW Journals Ray Lender editorial office Managing editor Michelle Hogan HJ@wolterskluwer.com Scott L. Austin, BC-HIS Willoughby Hearing Aid Centers, Inc. Oregon and Washington executive editor Serena Stockwell editorial assistant Paul Bufano James W. Hall III, PhD Nova Southeastern University Fort Lauderdale, FL The Hearing Journal Lippincott Williams & Wilkins 333 Seventh Avenue, 19th Floor New York, NY 10001 Nina Kraus, PhD Northwestern University Evanston, IL sales Manager Tom Pitofsky 661-296-3262 (fax) Tom.Pitofsky@wolterskluwer.com careers & events sales Taron Butler Taron.Butler@wolterskluwer.com Lippincott Williams & Wilkins 351 West Camden St. Baltimore, MD 21201 President & ceo, Medical research Cathy Wolfe vice President, Global Publishing Jayne Marks vice President, Nursing, Health & Wellness Publishing Jennifer E. Brogan www.thehearingjournal.com Deborah Price, AuD Hearing Professional Center Dallas, TX Kenneth E. Smith, PhD Hearing Center of Castro Valley Castro Valley, CA Brian Ach, Getty Images By Robert V. Shannon, PhD, & Fan-Gang Zeng, PhD custoMer service (subscriptions only) 978-671-0449; 978-671-0460 (fax) Outside U.S. and Canada: www.lww.com director, Publishing Theresa M. Steltzer desktop Manager Peter Castro Production associate Nick Strickland Manager of circulation Deborah Benward ©2013 by Lippincott Williams & Wilkins. All rights reserved. No part of this pub lication may be reproduced, stored in a retrieval system, or transmitted in any form, or by any means, without the prior written per mis sion of the Publisher. Pro- duced in the U.S.A.