Supplementary Material for: Clinical Evaluation of an Image-Guided Cochlear Implant Programming Strategy

<p>The cochlear implant (CI) has been labeled the most successful neural prosthesis. Despite this success, a significant number of CI recipients experience poor speech understanding, and, even among the best performers, restoration to normal auditory fidelity is rare. While significant research efforts have been devoted to improving stimulation strategies, few developments have led to significant hearing improvement over the past two decades. We have recently introduced image processing techniques that open a new direction for advancement in this field by making it possible, for the first time, to determine the position of implanted CI electrodes relative to the nerves they stimulate using computed tomography images. In this article, we present results of an image-guided, patient-customized approach to stimulation that utilizes the electrode position information our image processing techniques provide. This approach allows us to identify electrodes that cause overlapping stimulation patterns and to deactivate them from a patient's map. This individualized mapping strategy yields significant improvement in speech understanding in both quiet and noise as well as improved spectral resolution in the 68 adult CI recipients studied to date. Our results indicate that image guidance can improve hearing outcomes for many existing CI recipients without requiring additional surgery or the use of ‘experimental' stimulation strategies, hardware or software.</p

The use of models and methods for strategic planning: towards an holistic view of strategy

Formulating manufacturing business strategy is often fragmented in as much as current tools address upstream and downstream vertical integration with product integration, or more recently, product and infrastructure integration. Rarely do tools address all of these dimensions in an holistic manner. The research described in this paper is that undertaken in the MAPSTRAT project: a scoping study with industrial partners, aiming to satisfy this business need. A comprehensive literature study is described which is contextualized using six case studies. The paper stresses the importance of ‘joined-up thinking’ and outlines plans for an appropriate tool that is under development