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we address a list of topics that
more like
they also involve the general population
I’m sure that between the themes
scientists neuroscience would occupy
one of the first positions and is that the
brain exerts a fascination
similar to dinosaurs or
egypt of pharaohs or galaxies
distant
every year there are advances
neuroscientists so spectacular that
are fueling the belief that
everything is possible
today more than ever it seems that it is
fulfilling the biblical prophecy that
announced that the blind see the lame
the lepers walk , the
deaf today the dead are resurrected because
doctors and scientists today
we are witnesses of a series of advances
that we could well qualify as
miracle your among the numerous examples
that I could have selected for this
chat
I’m going to stay with those related
with the restoration of hearing
lost because they are the ones that are
closer to my scientific heart
and that is that I have dedicated the most
of my career at the University of
Salamanca and in other centers
investigate the productive regions of the
0
those that work 2
it is usual to start talking about the
hearing
referring to the middle external ears
reiterated
when a person today a sound that does not
it is but a mechanical stimulus a wave
of pressure that spreads through the air
the acoustic energy so the
tympanic membrane pib
this vibration is amplified by the
middle ear ossicles chain
that transmits it to the ear wall
inter whose auditory portion
that coiled structure to which all
we call the auditory snail or in the
snail cells are found
sensory hearing are a
sympathetic cells endowed with a
Syrian tuft so we call it
filial cells and arranged in four
rows throughout the field with
each vibration caused by the sound
the cilia is bent and with it the
Hair cells are activated when activated
they release a neurotransmitter that acts
on the first neurons of the pathway
auditory
the reason for these neurons forms the
popular nerve the role of cells
hair is essential because in
definitive transform a stimulus
mechanical but a biological signal in
impulses electrical impulses
violent generated in the copla travel
to the brain through the nerve
pop lear and the brain structure that
receive nuclear energy are the
cochlear nuclei located in the trunk
of ceases and popular numbers the
auditory information is processed and
subsequently travels through
different routes to other nuclei
auditory brain that are not seen in the
image that continue processing the
sounds until finally the
information reaches the cerebral cortex
where sounds acquire all their
meaning
so it’s not really it’s not the
ear is the brain when it occurs
an alteration in any of the
components of the auditory system can
to become a single
If the fault affects the outer ear at
middle ear
then we talk about hearing loss
driving and driving deafness
calls like that because the sound energy
does not arrive properly has heard internal
this is what happens for example when
a third plug posture the conduit
external auditory situation
Solve by removing plug
in other cases the bad driving is
it owes to a rupture of the membrane
tympanic or increased rigidity
of the ossicular chain of the ear
medium and many of these patients
improve with hearing aids or with
large surgical interventions
precision they return to the middle ear
the ability to transmit
vibrations
when the problem lies in the snail
or in the cochlear nerve or in any
of the nuclei of the brain
we talk about sensorineural hearing loss is
in mild cases or deafness
sensorineural diseases are the most serious
I’m not going to devote the rest of a chat to
comment how science faces the
most serious auditory problem of the
sensorineural deafness I will focus
in cases that have their origin in the
purchase or the cochlear nerve
I’m afraid that for the injuries of
auditory nuclei of the brain still
we do not have dealing with most of the
sensorineural deafness occur
for the loss of hair cells of the
inner ear
this image shows the snails to the
left a pretty face with its four
rows of hair cells the snail
on the right has lost enough of
your hair cells and many of the
that are left are altered
There are many reasons why
some hair cells may be lost
they have to do with our style of
modern life
for example exposure to such sounds
intense that come to cause a trauma
acoustic
look at these two cells and the arts
the one above is intact the one below
belongs to an experimental vaccine
stimulated with an intense sound during
a few minutes and his vices do not seem
precisely happy and sure that
neither will many of you be achieved
when I tell them that the intensity that
used in this experiment was
significantly lower than the one they emit
the speakers of any concert of
modern music or those of many bars and
nightclubs
you can also lose cells
ciliated with certain infections or
river treatments with certain
antibiotics anticancer agents
necessary to save the life of the
patient but that may result
toxic to the ears to the right
we have the copla of three animals
experimental in the first case with a
small dose some were lost
ciliated cells the central image
shows that increasing the dose
many more disappeared and in the
third example with a dose still
higher
the loss was total since the degree of
deafness is proportional to the loss of
ciliated cells the absence of these
cells implies a complete deafness and
permanent and irreversible because
misfortune when in the snail of a
mammal dies a splintered cell already
you will never be general you will miss steps that
we can do in these cases where
a person has a deafness
deep sensorial because they have
dead all or almost all of your cells
glial
luckily, it is common that when
the hair cells disappear on
Cochlear nerve is preserved with good
state
we can therefore think about stimulating
artificially the cochlear nerve to
thus supplying the function of the cells
ciliated and this is the idea that gave
origin to the popular implants a
Cochlear implant is a prosthesis in
real time capture the sounds the
process and transform them into a stimulus
electric that is applied directly to
the couplet to try to stimulate
nerve fibers under normal conditions
are activated by hair cells
the infant consists of a series of
external components the internal and
external capture the sounds process them
they convert them into digital signals that
they are sent to a receiver and stimulator
located under the skin of this
simulator starts a cable that ends in
a fine and flexible and regretted that it
inserted throughout the whole couplet
stretch possesses a series of
electrodes that are the ones that apply
electrical stimulation so that
each electro batua only on one
small portion of the cake
the most modern implants have little
more than 20
bush below let’s see the
moment when it is activated for the first time
time the cochlear implant of a very young girl
little
this is going to be born with a deafness
deep sensorineural and when I had
seven months they placed two implants
one in each ear in the department of
otorhinolaryngology clinic
University of Navarre
a few weeks later the
first implant although if they will not
I had never heard and can not
identify sounds turns the head
when noticing the sensation unchained by
human voices already communicates with their
mother though you should only look at it because
if the one that was born deaf
now that he hears our cameras
they record the moment in which the girl
listen for the first time in his eight
months of life or the girl as well as the
really exciting final girl a girl
deeply deaf that for the first time
the recovery of these patients does not
ends with the placement of the implant
is more after the operation has
that learning today nothing happened process and
they work for months or years
with a multidisciplinary team that
determines which electrodes are more
effective and optimize the way in which
the implant processed are doubtful
this rehabilitation is essential
because the information that it provides
the infant is not exactly the same as
which brings the normal hearing we can
check with a quick comparison
let’s hear a simple phrase
pronounced by a normal female voice
the clock in the square marked the four of
the afternoon and that’s how the scientists
believe that a person today is the same
phrase with a cochlear implant
today we are going to again the difference is
abysmal
let’s now do the test upside down
let’s open another simple sentence but
now we are going to listen to him like the
proportion to the implant to see if we can
understand what the voice has said is
plant a tree in the forest all
years
as strange as the sound is not
artificial implant
The truth is that most of these
patients achieve a level of
success in recognition and
understanding of spoken language
really satisfying
the differences between cases are very
notable the most striking results
are obtained with the babies that receive
the implants before the age at which
the language is usually acquired if it were not
because you see the implant itself
many of these children would go through
people with totally normal hearing
today there are around the world
400,000 people with one or two implants
cochlear people very solvent to the
that these prostheses have changed the
life for the better
from what we have seen so far is
clear that the success of the implants
cochlear is the integrity of the
nerve to fight but there is a series of
patients who can not benefit from
cochlear implants
for example some patients to whom
as a result of an infection
a malformation not copy them
can insert in the snail the
filament of electroshocks and a case
clearer that can be done with the
people who are born their cochlear nerves
or those patients who for a
medical reason
you have to cut nerves coplans in
the team neurofibromatosis 2 thanks
God is a very rare disease
form tumors in different media of the
body and often affect the
Popular nerve from both sides though
these tumors are benign grow in the
inside the cranial cavity where no
there is room for expansion and
grow can end
compressing brain structures
next that compromises your life for
save the lives of some of these
patients, there is no choice but
remove the tumors and in doing so the
surgeon will inevitably section his
media by blogs
the only hope that you are
people can hear now is to act
directly on your brain and that’s
what trunk implants pursue
three years an implant but when
manufactured is a prosthesis appeared in
many aspects to a cochlear implant
same as this trunk example
Brain capture and process
sounds warn digital signals that
sends to a receiver located under
Earth
the main difference is that now the
cable that comes out of the stimulator does not
they finish a strand of their doors the
copla but of a small palette
provided with a plurality of electrodes
surface and these electrodes are
carefully deposit in contact by
the popular nuclei of the trunk of
Access therefore the implant but was
emphatically electrically stimulates
popular nuclei this is a
hearing aid that draw snail
janerio clear to stimulate
directly to yield
naturally place an implant
proportion is much more committed
to put a cochlear implant because
it implies a delicate intervention
European football
let’s now see the moment in which
went through this American boy of
three years was reactivated for the first time
in the theater as it was made that
had placed a few weeks before
bessón had had very bad luck
this child was born with a rare
disease that is accompanied by
multiple congenital malformations
after a few weeks of life he underwent surgery
of a serious cardiac malformation and
a few months later it was found to be
totally it lacked only because
cochlear nerves and he was also blind
of the left eye and if all this
outside little
grayson did not have a family that
will occupy the and ended up being adopted
for incredible parents
I want you to notice the reaction of
child when his school is activated
proposal is high but that is not something
but he does not know what it is
he can not recognize the speech and a lot
to understand it because he has never
In addition, it is completely
spatially disoriented does not know of
where does the stimulus come from
he does not know the clues of people
listeners
we use to locate the sources of
his eyes looks at the child’s reaction
from the web of your fence
[Music]
so today around the world about 2,000
people with implants stumbled phallic
approximately 10 percent are children
in general the results are more
variables of the implants
cochlear which undoubtedly reflects the
enormous heterogeneity of conditions
doctors who took these patients
to need her own her also is
lower the degree of recognition and
speech understanding
however some patients with
implants brainstem sos sos tan
positive achieve levels more than
Acceptable speech recognition
which shows that it is a
very promising therapy
there is no doubt that as it increases
the number of patients operated and the
scientific community gain experience
improve the effectiveness of the treatment
this is the point where we
we find
I do not think I exaggerate in saying that
hearing implants constitute the
World ‘s most successful prosthesis as
thanks to them hundreds of thousands of
people have recovered to a large extent
the audition
also the technology of the implants
cocleares is serving as a model for
inspiration for the development of
new prostheses that address problems
no students
but as much as all this
Proud we can not give ourselves for
satisfied
it is true that these patients understand
nothing but not enough
they are still unable to appreciate the
subtleties of the world complex adjusted
how music becomes the
sense of hearing not only in a
extraordinary means to communicate
but also in an inexhaustible source
of pleasurable experiences
that’s how any of us hears
a
for that purpose by this is how this
same fragment sounds through a
control plan
[Applause]
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I would like to close your speech with
a triple appeal to our society
so that sensitivity continues to grow
that promotes the integration of
disabled to understand that
biomedical research the use
of experimental animals is a
need for these animals and today not
I could have talked about 400 thousand
miracles but only from floors and by
last so that it supports decided and
generously researches
biomedical
with that support and with the effort and
success of neuroscientists soon
will be at least 400,000 the blind cd and
so many paralytics who do
thank you very much
[Applause]
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