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king um which for twenty years fives five yes together
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to keep it well ah out of you
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and the last six years uh i have been working at the university teeny key in unique
00:00:15
and they i take a out of cochlear implantation
00:00:18
in the adults uh first i have um
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a film for you uh there's a read from my last talk the
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nominee hearing the x. and hope it works might lead you
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user constantly active people corruption which unchanged among the information
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you to bring gonna drool part so just
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music or speech change a partial where we can buy bring you to quickly or slowly
00:00:51
slow vibrations produced to show which will could whether she should produce high pitch show
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shouldn't interest to your interest to work through your communal word first we change to your drum
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as to your drum begins to bribery your church because she could she even wash
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because she could she could should be able to handle a i'm sure
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chandler aberration each mobile will be or should be which a union into your your
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within the interviewer to cope with your points we should cool
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use your due to mechanical energy you've shown huge converted into complex
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electrical should which which are then passed on to bring
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you should put quarter inch to cope with your user score when she trim filled with fluid
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she actually shows also called here shovels windy intermingling people quickly
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be sure should also be willing to agree should should should to prefer to do to actually
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a different tone shuffling church do solos to your to push the the entire spectrum also
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to change from mechanical boy bridgette workable polish is a complex
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process resulting from movement of her rituals indigo blue
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along the entire length of the cochlear herschel sure range what to use of a piano
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or show smoking to public school region of the coke you are responsible to one
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frequency water should also be a products are responsible for the low frequency which
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absolutely within the coconut shouldn't bush it causes a corresponding movement before instructions
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on what should be should be rituals to take it works
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these movements calls turn should approach which which produce a look we can
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should rules that are passed to more maturing nerve to the brain
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the older to record to actually bring him to produce
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information mention on for example whose music or speech
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the entire chain of approach including a very short term berkshire
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memories from your mormon into information to bring to interpret
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have them show first big individuals can hear snowball continue which will yeah interesting dream usually
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within this complex tree rubber which i remember factors
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which can consummate individual to experience your rewards
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or was appearing humour interim on moral to moderate hearing different should you would totally remorse
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in general there are three main types of hearing on switch to perform one remember
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number part of your daughter's obstructed beauty over middle work interviewer
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okay this is the repeat and and now we come to the uh
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to a w. h. o. criteria um and use fee um
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i hope ah about which we are both a if the
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average daily all the trash it may is calculated
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in fact take the frequency five hundred uh um have
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one here i have two and four okay yeah
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and only the low value is used as average value in here you can
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really uh the average and hearing off and we have a ever right
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twenty five to be we have a normal hearing um if any average between
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twenty think of what to keep me we have of my hearing loss
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yeah right i'm forty one between portable and and think it could be we have a motivated viewing
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and it the average i'm sixty one eighty d. b. s. c. via hearing loss we have and
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uh it's a eighteen wanted me we have a profound me a
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nameless that we have with no funny um it area
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yeah thigh in with a union you do when
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i'm with here we have a wide cool
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and they are like a vacation in indication from cochlear implant um
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yes now we have uh the indication flowing age for
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and um if it's surgical improvement if possible
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or not fact fifth for me
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and you a hearing aid at the end up how make um
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prequel preconditions of wearing hearing a i've given
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if they hear enough of a better here from thirty p. p. high in whatever
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the needs of the frequency from five hundred cats before he would have
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and if a lot of discrimination with each or ingram with with twenty percent
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at each pay 'em off sixty five to me it's okay and uh
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if the uh have a here nothing union data or whatever to
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now we have um the audio graham uh and uh we can and
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actually you the indication for hearing aid he and or right um
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button and um of the people have a um a in the
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higher frequency anything else we can use that i'm hearing a
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with um the for the higher frequency and um you must fey
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they all the indication can overlap with a indication of
00:06:44
a copy and then oh overlap um to the implant midway
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yeah implant um i i want to show you this
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hearing aid concerts often microphone and amplify and the receiver
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might to motivate here in los can mostly be covered by conventional hearing
00:07:06
aids you find a right behind here and india hearing aids
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and for special cases for example does plus the out the
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oracle uh or chronic what we ought to just media
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um we have um active media implants that i'm here
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i have the a vibrant phone which for example
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how are hearing it works the sound which comes from the microphone would be
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empty fired and transformed into an electric signal by the a. d. converter
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and then the next step the electrical signals
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transform backwards into the analogue acoustic signals
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da converter by the loudspeaker is amplified acoustic signal and pick your drum
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the amplification depends on frequency space specific level increasing
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which is adapted to the specific hearing loss
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and hearing aids i divide it into an aloe you
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get tired programmed and fully to get talent devices
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yes the success of speech understanding with hearing aids depend on
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the leather and type of that you in notes
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um for example the contract of hearing loss could be covered by new within hearing any
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and um if we have a sense or another during
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those depends on the t. three of hearing loss
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and we have limits of hearing a it's it's the hearing loss and
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the main speech every are five hundred hertz to for hillary hats
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it's both then uh seventy five to be high and
00:08:57
amplification of hearing aids is sometimes not efficient
00:09:01
dynamic range is limited and the hearing it works at the power i'll put the minutes
00:09:08
and speech sounds distorted hold the signal can't be fully we presented
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and the patient must concentrate on concentration for example in the society
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um conclusion is is important for a better speech
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understanding is so if it's sufficient amplification
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not close at the power limit of the hearing aid and the call
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your result it into a hundred fifty hats and four q. yes
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and the amplification of the best evaded the hearing aid is not efficient
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and successfully now than a cochlear implant it's the next best choice for the patient
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yeah hefty indication flow cochlea implant um
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this is um in germany and the the indication for cochlear implant
00:10:01
the compiler it's in the i. n. t. society or the white book now and are as follows
00:10:08
uh no surface yeah interested in hearing here we have a german standard test hypo
00:10:14
components so that those under thirty percent
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and the house and sentences comprehension
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sentences tests uh and uh fifty percent and we
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need a function of the you know
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posting wait deaf and visited yelling children teenagers and adults
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i'm a cute death haitian as well as patients social program d. and deafness
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it's deafness is more than ten years ago we need a special
00:10:48
demands in the rehabilitation that is very difficult and individually
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patient with president hearing are included to speech
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company haitians not um stuff that sufficient
00:11:02
for printing way to have adults the coffee and and that is an individual decision
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and then um we have children that one before it doing
00:11:13
learning the speech comprehension and that's really the earring
00:11:17
and um you can um say want only implantation
00:11:22
with the c. i. s. come recommended
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and we have a lot of children in the first six months
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of within the first yeah after the indication of deafness
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and knew this is one more patient we have with the single site deafness that means that uh the
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other yeah it is a normal hearing enough the other side um we have the cochlea implant
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now in here um the next slide uh shows the only um
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of the area of the indication of the continent implantation
00:12:00
and using the lasts a few yet the fee age of indication has been increase
00:12:05
and that means is that big challenges for the tempest as well and that uh
00:12:12
one and you show you on the next slide um
00:12:17
here are the surprise when he didn't actually make um have
00:12:22
everyday life we have the singers type deafness that mean
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based um i won a cochlear implant of the one side and the normal hearing
00:12:33
on the other side and we have uh the pilot to the supply
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a somewhat hannah sequence yearly uh also to cochlea implants and then the
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most people and they have a this have the time to supply
00:12:50
uh they have the cochlea implant of the one site and they he made of the other side
00:12:55
and then um we have a special okay in space that get in
00:13:00
special case electric acoustic stimulation um we have the hearts of um
00:13:07
a cochlear implant in the short frequency uh and the high frequency the shot electrode
00:13:14
and uh the acoustic stimulation is uh from the hearing aid
00:13:19
um and if it's if it's a hearing loss on the old side we practised the hearing
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training only with the cochlea implant the controller to the a side has to be closed
00:13:33
and bit by model supplied patient hearing aid
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is often speech often recognise kept
00:13:39
uh in the here uh but the but is the result and hearing
00:13:44
very good or can the patients normally hearing on this site
00:13:50
uh we need uh oh you cobble or indeed keith who
00:13:55
uh because when we um close our um yes
00:13:59
but the hand uh we can understand
00:14:03
oh can further understand this is not good because we might most we make a singer
00:14:11
um yeah so training with the cochlea implant and then we have um struck
00:14:17
a successful um speech understanding with the cochlea implant for the patient
00:14:24
and yes there are the trainings option um and we must look
00:14:30
to the rest of the viewing of the other side
00:14:32
um we need the audio copy order or inducted flew
00:14:37
when uh um the patient had a normal hearing of the one side
00:14:42
um if we have the pilots for a supply
00:14:48
we um should make it training with the cochlea implants the
00:14:52
first call graham and willow and then goes together
00:14:57
and um if you have a cochlear implant
00:15:03
and it's a a hearing h. and we make the training
00:15:07
without being an eight only the cochlea implant in
00:15:11
case of use of the residue hearing with or without the only okay but i don t. through
00:15:19
and then we have the electric acoustic stimulation on one side and
00:15:23
and we can uh training with and without acoustic you wouldn't
00:15:31
yes what's is the c. i. system and the c. i. system
00:15:36
consists of two hearts um i on the external ha
00:15:43
this is the only processor with a quite quiet you on this one
00:15:48
um or we have a single unit process are here
00:15:53
from the company make uh the rounded to
00:15:57
um and those uh on our controlled with the fine tune now
00:16:03
uh this is x. m. n. x. m. o. we
00:16:05
have um three other arm cochlea implants uh companies
00:16:12
uh for example a costly are uh i'm from us last time in on this um
00:16:20
advanced ion ex um america or and what you can't
00:16:25
now we have you guys seen yeah then made a
00:16:29
um cochlear implant system then we have internal hearts
00:16:35
this is the implant but the electro out here from the
00:16:39
company made a we have a veg electro contact um
00:16:47
and it's concerts off the electric and um
00:16:51
he in i yeah an actual support and the electrode support this place it into the cochlea
00:16:57
the single electrode context i each relevant for a certain sound serious
00:17:03
as it said in the normal hearing and we have a large hopeful you off
00:17:09
a electrodes uh um and the lengths are
00:17:13
very from short to long electrode
00:17:19
now we have a fit in to a hearing with the cochlea implant
00:17:26
uh_huh
00:17:29
mushroom cochlear implant system was to go look for individuals
00:17:33
with should be report won't change your your remote
00:17:36
the most crucial your system can shove 'em home you process a small device
00:17:41
we won't be home you are you wanna which usually blinks obviously
00:17:47
cool which is connected to the border postage due to
00:17:50
exactly over big employed this complex point magnetic attraction
00:17:55
circles are shown from the point of processor to your blood bugle corps
00:18:01
during the operation you shoot shoot shoot some special come for to look really
00:18:07
good coat we're in order to stimulate the maximum number of move forward
00:18:13
i'm shooting when we're probably going to go to the entire frequency range of the cochlea can be stimulated
00:18:20
the mom function in puerto rico q. because point curves
00:18:24
into some should movies directly passport he rimmer
00:18:28
the microphone movie or washington picks up to change which
00:18:33
your processor usually shown into especially current colour credentials
00:18:40
the school should also should record or convert rooms will resume to review board
00:18:46
the employer what people choose from recorded should watch baseball teams are related to the corresponding
00:18:53
workgroup contracts come on your program depending upon the frequency you should we should
00:19:00
do you remember received usable changed intrudes prison deported to
00:19:04
record direction to bring were bureaucracy you do shown
00:19:11
the armour processor can be employed work looking extremely fast miniature computer
00:19:16
you're constantly processing uh mention member comes to read
00:19:20
allowing shall be pushy naturally would contain realtor
00:19:25
in this work and for the first time it is
00:19:27
possible to usually become published to replace human shaped
00:19:36
the most brutal rambling choose to come shoes should actually be proven components
00:19:41
actual components including bush to come before him to remote controller
00:19:47
internal components include some up to your one hundred ten people so she one hundred
00:19:54
your doctor will help you choose the right proper comedy should fit your individual needs and preferences
00:20:02
you should actually holding flexible approach would approach to should be
00:20:06
point for each remote construction going to go to
00:20:11
longer or shorter work roads will complete your coverage maximise the entire potential cochlear
00:20:17
altering users prefer stronger actions to perform details of show
00:20:24
the ones to procure your one choose to takes advantage of family which the government important i'm sure we're
00:20:30
talking about you and is designed to be easy to use for both children and a dog
00:20:38
before into remote control you'd our shoes used to make sure the more volume
00:20:43
changes usually conquered without the need to remove the processor from here
00:20:49
with the remote noisy restaurant or require for mushrooms sure
00:20:54
management technology adapts to change relationships work change
00:20:58
more optimal viewing experience to air pollution in parliament polymer clay
00:21:07
so we have also thirty thousand it's yeah sarah and now
00:21:13
we have a implanted with twelve uh electron contact
00:21:18
and this is a difficult for some patient to understand the speech
00:21:23
um yes we have success an immense awful cochlear implant
00:21:28
and he uh that's accept success of hearing depends on time of the hearing notes before
00:21:35
and after language because it's 'cause that she lengths of hearing loss motivational location
00:21:42
ability of the lip reading support of the family and friends experience
00:21:48
with giving it before call the implantation then we have limits
00:21:54
hearing sensation is not as before it's not acoustic ewing
00:21:59
um the limits by music in diamonds different could understand the
00:22:04
noise environment and this is very important before the implantation
00:22:11
um and this is my work uh to clarify it expectation but
00:22:17
this is indeed we do it lee and and the patients
00:22:23
um the c. i. a. is very successful but there are limits and
00:22:27
these limits have to drive a lot in d. b. two and
00:22:32
um
00:22:34
yeah there's a check a precedent joe uh of a coffee i'm count um
00:22:40
the um to ration out the search search we as one and two hours
00:22:47
who performs as a should we as a c. i. and she spits yeah dust
00:22:53
the the wouldn't hiding for says as a car uh four to six weeks and the
00:22:59
first use of coffee i'm under the first fitting is a four weeks after surgery
00:23:06
and total costs cochlea implant the l. p. and
00:23:09
the rehabilitation um cause forty thousand you
00:23:16
the cochlear implantation at the i. n. t. search to you with the lowest complication right
00:23:24
ah they o. p. operation we have the first fifteen
00:23:29
and the first rehabilitation says session after the temptation
00:23:34
and so we tore from the sea by attack here
00:23:40
this c. i. after cast starts about four to six weeks post surgery
00:23:44
and we starting with the first fitting all the audio cassettes so
00:23:49
and it's um first the patients by the engine yeah and the audio processor was fitting
00:23:56
then uh the patient come to me on my clinics and we make the first hearing and speech training
00:24:04
then we have standards hearing tests and medical after okay yeah
00:24:09
the regular after k. r. takes place during the whole lifetime anise individually and
00:24:16
so we uh see complication complication could do
00:24:20
we recognise and removed and we have
00:24:23
a quality else's c. i. system and so we have stopped mice supply
00:24:30
here are a shot that time process uh of our clinic
00:24:35
uh we have the first fitting for up to six be a two weeks pointless set surgery
00:24:41
and then we have the my one man's appointment then three months after the
00:24:47
fitting six months after the first fitting and then we have the one yep mind meant
00:24:54
um and then once a yep point and and if it's necessary that um we
00:24:59
have problems or a question of the patient can come um every day and
00:25:08
now the content of the c. i. after k. r.
00:25:12
um the first fitting on optimisation else's c. i. process or
00:25:17
and william how make it technical or check out of the c. i. system
00:25:22
and we have a we give the patient information of technically news up great
00:25:27
uh from for a new audio processor for example
00:25:32
check out of the reach hearing you have the the ambulance hearing training advice
00:25:38
of training mature and should press it free description of additional trainings for
00:25:45
example rehabilitation for three or four weeks
00:25:49
advice of patient and family members
00:25:53
support and social medical questions so viruses satisfaction
00:25:58
with the cochlea implant where income for
00:26:01
um need the patient record um for the we're in and for the we're
00:26:07
in the cochlea implant and we look to the controller letter the side
00:26:14
interdisciplinary cooperation there's medical doctor speech terrorists close to home
00:26:19
town hearing eight acoustic than us safe had groups
00:26:26
then every common to one heart all sissy i object yeah hearing
00:26:30
training and and it's up to the c. i. supply
00:26:34
um this is very important but most keep the said
00:26:40
um they can here but not understand um
00:26:47
and of the first fifteen he's able to here and uh
00:26:50
not understand and the brain must learn to transform
00:26:55
then you are hearing impressions but just the receive by a
00:26:58
coffee and a liar cochlea implant into the speech
00:27:03
and this is very um difficult for the patient
00:27:07
texas start x. um acceptance is not uh
00:27:12
good on the first uh the first hour but then we um make
00:27:17
viewing training and that is um that of of the patient
00:27:24
after first activation of the hourly process so um i said electric sounds no
00:27:29
acoustic union anymore and i'm from a hearing sensation quite often understanding
00:27:36
and the hearing acting easy station and an input says start
00:27:40
and can be supported by hearing and speech therapy
00:27:43
this defines trainings keychain can learn the new sounds hostile with this yeah right
00:27:50
and they hearing competence could be extended faster and more refined define it
00:27:58
we have a lot of stacks of hearing yeah on a um
00:28:03
here are of us putting the patient and uh okay and i sounds
00:28:10
identification but the understanding here on both of them as
00:28:15
a way uh and it's very difficult um
00:28:21
yes the the most patient say that everything they hear sounds like a mickey
00:28:27
mouse voice or like a radio channel that is not just probably
00:28:33
and they don't have an acoustic hearing but an electrical hearing one
00:28:39
and this is unfamiliar hearing of not understand in the beginning
00:28:46
now i have um accent who fought discrimination what counts um
00:28:53
the patient him um they come to me um
00:28:59
this patient is um the prevailing what are the um
00:29:04
okay she and she had the segments cochlea
00:29:08
implants and um i have um
00:29:13
uh training um for you um they the machine she masks
00:29:20
um the vocals art need you'd board which different
00:29:25
and depending of the degree out of difficulty the words have to presented with or
00:29:30
without reading that waiting for the patient huge but has to repeat it
00:29:36
and this is my work with no um
00:29:41
after the first uh fitting um
00:29:50
they worked yeah yeah yeah i they
00:29:57
will just a oops i
00:30:04
oh oh i see ye ah e.
00:30:14
e. e. i. e. e. e. e. l. e. i. e.
00:30:23
i. e. i. mm ooh ah ah ah ah
00:30:35
ah
00:30:39
i e. e. okay now if um for example you can
00:30:46
uh you can know what could discrimination and well it's
00:30:51
and i have a list of words and i say one word and
00:30:56
just uh she amassed so the here which but i set
00:31:03
what ah e. r. ah i. e. ah okay uh_huh
00:31:12
mm ah e. e. ah ah ah ah ah ah
00:31:23
will say oh oh oh
00:31:30
will you should ah e. shah
00:31:40
oh yes that's um if you and um this is very difficult
00:31:47
for the patient and the first time but the brain
00:31:51
um can learn that and uh if we have to six months appointment we have
00:31:57
um uh the most patient heart can good here with the cochlea implant
00:32:04
now we have a um to condition
00:32:07
um with acoustic and electric hearing
00:32:12
first he um and the audio graham testing its
00:32:16
height deafness um you're the normal hearing
00:32:21
and the indication installing um and then of the other five o'clock am that
00:32:27
yeah they we need and the the training um they all you have
00:32:31
it all of it in the teeth group and um via
00:32:36
i'm a hearing act and think case we
00:32:40
can train the acclaim and uh no
00:32:44
um and then we have the primers supply and the indication of your from
00:32:52
the hearing aid and then a year from the coffee and then
00:32:56
um you mean is much uh of the hearing aid and we
00:33:01
make a training with the cochlea implant only and um
00:33:07
this is the acoustic um most acoustic um
00:33:12
a patient groups they would find in the clinic um
00:33:17
yeah they he with a hearing aid and the cochlea implants
00:33:20
and within the framework of my dissertation i cared about
00:33:25
hearing test of this we different hearing constellation
00:33:30
i'm here do you think uh i only the coffee and then only and then hear
00:33:35
the bimonthly that i think the diagram and uh we have a test area um
00:33:42
uh uh uh one yeah after office fifty then we uh make the test a
00:33:49
three month after the first meeting six and one yeah ah of that okay
00:33:54
and uh now we have the resides muscle both
00:33:59
you know that right to be made by by model and
00:34:03
we see it um if the patient eight it
00:34:07
is a hearing aid to the cochlea implant a you
00:34:11
have a better understanding and then one syllable
00:34:15
and he is he is he didn't we think of the copy and
00:34:19
then um in the first yeah and we have a significant um
00:34:26
uh and the friend um at the three month appointment from by
00:34:32
multiple hearing aid and him after one yeah we have oh
00:34:38
a significant different um from copy and and hearing to
00:34:43
the ewing hate hearing a hearing with constant
00:34:48
um interesting is is in the uh other resides in the lights
00:34:54
we have a house and sets type test um and
00:35:01
he is he um that the by marine supply is better then uni lateral supply
00:35:07
only with healing at only with the copy and then and the um
00:35:14
the most people say that says um yeah um they have um
00:35:21
oh hello uh hearing of fought excess of for him
00:35:28
then and the primer groups this is
00:35:32
oh speaking at them
00:35:37
mute moans nothing
00:35:42
and i am
00:35:47
sorry
00:35:52
mm
00:36:06
uh_huh
00:36:09
uh_huh
00:36:12
uh_huh
00:36:22
but yeah
00:36:25
try to can
00:36:48
uh_huh
00:36:51
it's not something ah uh_huh uh_huh
00:36:56
thank you
00:37:02
the next slide i what like to show you
00:37:06
the localisation test with the prime rules apply
00:37:11
and um we see them that um
00:37:18
yes the mistakes of localisation of the time it's supply and um
00:37:26
yeah hearing aids copy and kenneth i'm month supply
00:37:31
and the made mistakes uh i'm getting ah i it's a
00:37:36
two by a um you know that the um supply
00:37:42
and we can we have the conclusion by the by middle supply
00:37:47
and this is the supply uh we need every day
00:37:53
a better speech understanding quiets compares to the human
00:37:57
letter it's a cochlear implant well unilateral supply
00:38:01
significant avid th and no lights and the localisation
00:38:07
uh it's better by a binaural um supply and every day
00:38:12
there's and and satisfaction much more easier to here
00:38:17
uh and this is you usually the result that he and the binders supply
00:38:21
can be for the options before bilateral c. c. i. s. line
00:38:27
so i'm the and thanks for your attention and um
00:38:32
yes enjoy your lunch i'm in time and yeah
00:38:43
i should
00:38:47
uh_huh
00:38:50
yeah
00:38:57
hi manhattan and and this in my mind is not very good uh sorry
00:39:12
uh_huh
00:39:24
hi
00:39:31
uh_huh uh
00:39:37
e. feeling yeah
00:39:42
to yeah
00:39:46
um i don't know i wanted to be a individually yes yeah
00:39:56
e. s. p. two p. a.
00:40:03
wow
00:40:07
yes i i
00:40:20
like yes i see now
00:40:24
mm kay
00:40:29
uh_huh
00:40:32
yes but it
00:40:39
that that is the individual for to a patient to patient
00:40:44
uh_huh
00:40:45
uh_huh uh yes i i i i
00:41:02
uh_huh
00:41:07
in the fitting our
00:41:15
but the child is learn very uh of costs of the hearing
00:41:20
with e.
00:41:26
no it's the same in that yeah yeah it's it's it's m. now that that this is
00:41:31
the um implant is for a child and for um at or it's not
00:41:42
no them up
00:41:45
uh_huh
00:41:49
the fallen off the um cup um
00:41:53
great racing but um the electrode can you
00:41:57
um and there's um um um um
00:42:07
the electronic commanders who even doesn't it takes to meet him from one is um s. and contact
00:42:13
that life look was yeah that's that's back in and then outlined exactly by oxnard that's yeah
00:42:19
i am a yes or a yes
00:42:29
the cop copy yes um one at least i'm of oxnard depend
00:42:33
can show uh that that what i think was um
00:42:39
no canonical yeah sixty now uh_huh
00:42:47
okay
00:42:49
yes thank you
00:42:54
huh
00:42:59
uh_huh yeah

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Conference program

Introduction to Phonetics and Speech
Rob van Son, Amsterdam
24 Sept. 2018 · 9:02 a.m.
Dysarthria
Marc de Bodt, Antwerp
24 Sept. 2018 · 9:45 a.m.
Hearing Aids and Cochlear Implants
Stephanie Rühl, München
24 Sept. 2018 · 11:45 a.m.
Children’s speech: development, pathologies and processing
Alberto Abad, Lisbon
24 Sept. 2018 · 2 p.m.
Speech after Treatment for Head and Neck Cancers
Michiel van den Brekel, Amsterdam
24 Sept. 2018 · 2:45 p.m.
Speech therapy
Marc de Bodt, Antwerp
25 Sept. 2018 · 11 a.m.
eTherapy
Elmar Nöth, Erlangen-Nürnberg
25 Sept. 2018 · 11:45 a.m.
Assessment in speech disorders
Virginie Woisard, Toulouse
25 Sept. 2018 · 2:45 p.m.

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