Algorithmic representation of common ground programming in children with the Nucleus device.
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Biomedical subjects
Publications and source records attributed to T Lenarz.
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The prospective, matched-pair study comparing users of the Clarion system and the Nucleus system seems to indicate that the patients using the Clarion system are obtaining open-set speech understanding at a faster rate than Nucleus patients. The sample size in this study is very small at present, but with increasing numbers of Clarion patients, we will carry on with this study. Further, it remains to be seen whether or not the observed advantage will continue for the Clarion users in the longer term.
Our experience with deaf adults and children who have received the Clarion multistrategy implant are very encouraging. Because of certain programming characteristics of the current device, access to the compressed analog coding strategy has been limited. We expect to see this change in the near future. The CIS strategy, however, appears to provide patients with important, full-spectrum speech information so that they accommodate to the auditory sensations rapidly and begin to interpret sound into meaningful speech within a short time.
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At present thrombosis of the internal jugular vein is an uncommon event that is now more frequently associated with diagnostic or therapeutic catheterization. If an apparent spontaneous thrombosis occurs, malignancy should be considered in the differential diagnosis. Two cases of clinically asymptomatic thrombosis of the internal jugular vein are presented. A 69-year-old female patient with metastasizing renal cell carcinoma had bilateral thrombosis and a 73-year-old male with a small laryngeal carcinoma had a unilateral thrombosis. Increased blood coagulability as part of a paraneoplastic syndrome was considered to be the possible etiology. The role of sonography in the diagnosis is emphasized.
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The probability of system failures increases as the number of cochlear implants increases throughout the world. Whether a malfunction is a technical or physiological problem remains to be defined, particularly in very young children, while a psychogenic hearing disorder after implantation must not be excluded in adults. The battery of objective measurements used clinically at the Medizinische Hochschule, Hannover has provided useful diagnostic information for distinguishing possible causes of failure. In a normally functioning device, an electrical signal equivalent to the biphasic rectangular stimulation pulse can be recorded by measuring skin potentials from surface electrodes placed on the mastoid of the implant side and the forehead. The signal from the stimulated implanted electrodes is derived by applying a constant pulse rate. Signal averaging is not necessary. If no signals are observed, a non-functioning device should be suspected. If the device works normally, function of the auditory pathways can be examined by recording the electrically elicited stapedius reflex or electrically evoked brain-stem responses. In our experience with more than 450 cochlear implant patients, eight internal device failures occurred, while an additional three patients had either reduced or no hearing sensations due to a disorder of the auditory pathways.