韩国产人工耳蜗将在2年内低价问世!!

蓝天.白云.风

此技术由韩国汉城国立大学研发, 2001年其技术被Nurobiosys Corp公司购买, 将之商业化, 转化为现在的Nurobiosys Cochlear Implant system. 估计2年内可以进入到中国市场, 从他们的网站上看, 他们的目标是低价, 估计价格在5-7万左右. 大家有兴趣可以去看一下, 网站是英文和韩文的.
http://helios.snu.ac.kr/sub_02_02-eng.html

Cochlear Implant
1. Introduction
Cochlear implant device is a kind of neural prosthetic devices and it can restore the lost hearing sensation for the sever hearing disabled and profound deaf. Figure 1 shows the structure of the auditory system (left side). The visible portion of the ear consists primarily of cartilage covered by skin, forming a sort of funnel called the pinna (Latin for “wing”), which helps collect sounds from a wide area. The entrance to the internal ear is called the auditory canal, and it extends about 2.5 cm inside the skull before it ends at the tympanic membrane, also known as the eardrum. Connected to the medial surface of the tympanic membrane is a series of bones called ossicles (from the Latin for “little bones”; the ossicles are indeed the smallest bones in the body). Located in a small air-filled chamber, the ossicles transfer movements of the tympanic membrane into movements of a second membrane covering a hole in the bone of the skull called the oval window. Behind the oval window is the fluid-filled cochlea, which contains the apparatus (especially organ of Corti) for transforming the physical motion of the oval window membrane into a neuronal response.

In organ of Corti, there are transducers called hair cells that convert the mechanical signal into the electrical signal. That is, the cochlea is the frequency and amplitude analyzer of sound. If the hair cells in the cochlea are damaged, sound sensation is completely impossible. Then, Cochlear Implant can helping to restore the original neural function of auditory system. Auditory system can respond to pressure waves over the remarkable range of 20~20,000 Hz.



Figure 1. The ear and cochlear canal

2. The configuration of Cochlear Implant device and its function  
Several cochlear implant devices have been developed over the 20 years. All the implant devices have the following features in common: a microphone that picks up the sound, a speech processor that converts the sound into electrical signals, a transmission system that transmits the electrical signals to the implanted electrodes with transcutaneous RF link, and an intra-cochlear electrode array (consisting of multiple electrodes) that is inserted into the cochlea by a surgeon (Figure 2).


Fig. 2. Cochlear Implant System

In multi-channel cochlear implants, an electrode array is inserted in the cochlea so that different auditory nerve fibers can be stimulated at different places in the cochlea, thereby exploiting the place mechanism (Figure 3) for coding frequencies. Different electrodes are stimulated depending on the frequency of the signal. Electrodes near the base of the cochlea are stimulated with high frequency signals, while electrodes near the apex are stimulated with low frequency signals. Figure 3 is the X-ray image of cochlea that contains the intra-cochlear electrode array.

3. In vivo Neural Recording

Fig. 3. Place mechanism

The signal processor is responsible for breaking the input signal into different frequency bands or channels and delivering the filtered signals to the appropriate electrodes. The main function of the signal processor is to decompose the input signal into its frequency components, much like a healthy cochlea analyzes the input signal into its frequency components. The designers of cochlear prosthesis are faced with the challenge of developing signal processing techniques that mimic the function of a healthy cochlea.

The cochlear implant is based on the idea that there are enough auditory nerve fibers left for stimulation in the vicinity of the electrodes. Once the nerve fibers are stimulated, they fire and propagate neural impulses to the brain through the auditory nerves. The brain interprets them as sounds. The perceived loudness of the sound may depend on the number of nerve fibers activated and their rates of firing. If a large number of nerve fibers is activated, then the sound is perceived as loud. Likewise, if a small number of nerve fibers is activated, then the sound is perceived as soft.

The number of fibers activated is a function of the amplitude of the stimulus current. The loudness of the sound can therefore be controlled by varying the amplitude of the stimulus current. The pitch on the other hand is related to the place in the cochlea that is being stimulated. Low pitch sensations are elicited when electrodes near the apex are stimulated, while high pitch sensations are elicited when electrodes near the base are stimulated. In summary, the implant can effectively transmit information to the brain about the loudness of the sound, which is a function of the amplitude of the stimulus current, and the pitch, which is a function of the place in the cochlea being stimulated.

Figure 4 shows, as an example, the operation of a four-channel implant. Sound is picked up by a microphone and sent to a speech processor box worn by the patient. The sound is then processed through a set of four bandpass filters which divide the acoustic waveform into four channels. Current pulses are generated with amplitudes proportional to the energy of each channel, and transmitted to the four electrodes through a radio-frequency link. The relative amplitudes of the current pulses delivered to the electrodes reflect the spectral content of the input signal (Figure 4). For instance, if the speech signal contains mostly high frequency information (e.g., /s/), then the pulse amplitude of the fourth channel will be large relative to the pulse amplitudes of channels 1-3. Similarly, if the speech signal contains mostly low frequency information (e.g., vowel /a/) then the pulse amplitude of the first and second channels will be large relative to the amplitudes of channels 3 and 4 (Figure 4). The electrodes are therefore stimulated according to the energy level of each frequency channel.


Figure 4. Example of the 4 channel Cochlear Implant system

3. Commerical Support
We’ve been developing the system since 2001 under the Nurobiosys Corp. It is shown in Figure 5. The main different point from the commercially available systems is that low cost but effective system to support many people including the poverty-stricken. This system will show up at the commercial field in two years.



Figure 5. Nurobiosys Cochlear Implant system

苏文

不知道和国产的相比，哪个更好一点？

比国产的贵是肯定的。

蒙蒙

不错,这就是我所能承受的价格,不过我需要的还是质量!!!!
或许再等几年,装上耳蜗的梦将会成为现实.

心月

5_7万元是人民币吗?

老k

读了一遍，怎么感觉说的在2年内才能在韩国商用？
不清楚这篇东西的日期。
不懂韩语，麻烦……
它的BBS也没什么相关信息。

林照跃

确实是好消息,就是希望这个行业来点竞争,否则只有一两家公司垄断价格是不会降下来的

苏文

引用第5楼林照跃于2006-04-11 17:38发表的“”:
确实是好消息,就是希望这个行业来点竞争,否则只有一两家公司垄断价格是不会降下来的

是啊！最好竞争能够激烈到手机的程度！呵呵

李子园

这个价位的耳蜗，不是我打消大家的期待，在中国没有市场的！

这个属于三类医疗器械，只有有资格的医院才能做这样的手术，如果没有利润，医院是不会做的。
就这一点，中国没有低价耳蜗人市场，因为中国没有民主，在这个既当裁判又汉运动员的的国家，他们不准许你生存。

苏文

楼上说的有道理！

不过我想将来医院引进韩国产人工耳蜗后，会加价的，在韩国5_7万元，国内可能会卖个10万，比国产的贵，比别国（如澳大利亚）产的便宜。

在线听力专家

引用第7楼李子园于2006-04-12 15:39发表的“”: 这个价位的耳蜗，不是我打消大家的期待，在中国没有市场的！ 这个属于三类医疗器械，只有有资格的医院才能做这样的手术，如果没有利润，医院是不会做的。就这一点，中国没有低价耳蜗人市场，因为中国没有民主，在这个既当裁判又汉运动员的的国家，他们不准许你生存。

我个人认为人工耳蜗如果价格在5-7万的话,应该有很多人都可以接受了,那么不仅仅是孩子,很多经济不是十分宽裕的语后聋的成年病人都有可能通过手术重返有声世界了,做人工耳蜗手术的人会大大增加,是件大好事情.

至于李子圆的但心我想是没有必要的,本身耳蜗手术的植入手术费用是没有变化的,对于医院来说并不受到多大的影响,

我们可以这样来分析,由于台湾商人捐赠的人工耳蜗数量已经大大超过了过去十年中国植入数量的总和,也就是在未来的六年内,大部分耳蜗的(暂定3岁以下,以后还会放开范围)儿童使用者都将是免费获得耳蜗的,耳蜗手术也必须是在指定的定点医院完成,手术的费用是由病患自行解决的. 耳蜗本身的价格不会对做手术的医院造成影响,对于成人市场说,目前市场上已经销售的耳蜗,绝大多数是病患直接在耳蜗公司购买的,而医院仅仅是负责完成手术植入的过程.耳蜗的价格也不对医院造成影响.

反过来说.如果说真的有因为耳蜗价格便宜,从中无利可图而不愿意做耳蜗手术这样的医院存在的话,对于这么狭隘的医院或管理者,我想他也必将被社会所淘汰,回被老百姓所淘汰!!!

相信有正义感的人毕竟是占绝大多数的!!!!!1