Cochlear Implant Research and Development in the Twenty-first Century: A Critical Update

Cochlear implants (CIs) are the world’s most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day...

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Published inJournal of the Association for Research in Otolaryngology Vol. 22; no. 5; pp. 481 - 508
Main Authors Carlyon, Robert P., Goehring, Tobias
Format Journal Article
LanguageEnglish
Published New York Springer US 01.10.2021
Springer Nature B.V
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Abstract Cochlear implants (CIs) are the world’s most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The review focuses on the processing, stimulation, and audiological methods that have been used to try to improve speech perception by human CI listeners, and on fundamental new insights in the response of the auditory system to electrical stimulation. The introduction of directional microphones and of new noise reduction and pre-processing algorithms has produced robust and sometimes substantial improvements. Novel speech-processing algorithms, the use of current-focusing methods, and individualised (patient-by-patient) deactivation of subsets of electrodes have produced more modest improvements. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of promising technologies that are currently being developed in animal models, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.
AbstractList Cochlear implants (CIs) are the world’s most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The review focuses on the processing, stimulation, and audiological methods that have been used to try to improve speech perception by human CI listeners, and on fundamental new insights in the response of the auditory system to electrical stimulation. The introduction of directional microphones and of new noise reduction and pre-processing algorithms has produced robust and sometimes substantial improvements. Novel speech-processing algorithms, the use of current-focusing methods, and individualised (patient-by-patient) deactivation of subsets of electrodes have produced more modest improvements. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of promising technologies that are currently being developed in animal models, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.
Cochlear implants (CIs) are the world's most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The review focuses on the processing, stimulation, and audiological methods that have been used to try to improve speech perception by human CI listeners, and on fundamental new insights in the response of the auditory system to electrical stimulation. The introduction of directional microphones and of new noise reduction and pre-processing algorithms has produced robust and sometimes substantial improvements. Novel speech-processing algorithms, the use of current-focusing methods, and individualised (patient-by-patient) deactivation of subsets of electrodes have produced more modest improvements. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of promising technologies that are currently being developed in animal models, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.Cochlear implants (CIs) are the world's most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The review focuses on the processing, stimulation, and audiological methods that have been used to try to improve speech perception by human CI listeners, and on fundamental new insights in the response of the auditory system to electrical stimulation. The introduction of directional microphones and of new noise reduction and pre-processing algorithms has produced robust and sometimes substantial improvements. Novel speech-processing algorithms, the use of current-focusing methods, and individualised (patient-by-patient) deactivation of subsets of electrodes have produced more modest improvements. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of promising technologies that are currently being developed in animal models, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.
Author Carlyon, Robert P.
Goehring, Tobias
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  organization: Cambridge Hearing Group, MRC Cognition & Brain Sciences Unit, University of Cambridge
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  givenname: Tobias
  surname: Goehring
  fullname: Goehring, Tobias
  organization: Cambridge Hearing Group, MRC Cognition & Brain Sciences Unit, University of Cambridge
BackLink https://www.ncbi.nlm.nih.gov/pubmed/34432222$$D View this record in MEDLINE/PubMed
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IngestDate Thu Aug 21 17:49:48 EDT 2025
Mon Jul 21 10:25:02 EDT 2025
Sat Aug 16 17:12:43 EDT 2025
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Thu Apr 24 23:03:19 EDT 2025
Tue Jul 01 00:35:29 EDT 2025
Fri Feb 21 02:48:32 EST 2025
IsDoiOpenAccess true
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Issue 5
Keywords Pitch
Cochlear implants
Hearing
Plasticity
Language English
License 2021. The Author(s).
Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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PublicationSubtitle JARO
PublicationTitle Journal of the Association for Research in Otolaryngology
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  doi: 10.1121/1.410475
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Snippet Cochlear implants (CIs) are the world’s most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We...
Cochlear implants (CIs) are the world's most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We...
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SubjectTerms Acoustic Stimulation
Algorithms
Animal models
Auditory system
Clinical outcomes
Cochlea
Cochlear Implantation
Cochlear Implants - history
Cochlear Implants - trends
Deactivation
Electrical stimuli
History, 20th Century
History, 21st Century
Humans
Medicine
Medicine & Public Health
Neurobiology
Neurosciences
Noise
Noise reduction
Otorhinolaryngology
R&D
Research & development
Review
Speech Perception
Transplants & implants
Title Cochlear Implant Research and Development in the Twenty-first Century: A Critical Update
URI https://link.springer.com/article/10.1007/s10162-021-00811-5
https://www.ncbi.nlm.nih.gov/pubmed/34432222
https://www.proquest.com/docview/2576936583
https://www.proquest.com/docview/2564489336
https://pubmed.ncbi.nlm.nih.gov/PMC8476711
Volume 22
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