Graeme Clark Collection

Permanent URI for this collection

Search Results

Now showing 1 - 4 of 4
  • Item
    Thumbnail Image
    Chronic electrical stimulation of the auditory nerve at high stimulus rates: preliminary results
    Shepherd, R. K. ; Xu, J. ; Millard, R. E. ; Clark, Graeme M. ( 1994)
    The present preliminary report describes the electrophysiological response of the cochlea during long-term stimulation. The data indicate that electrical stimulation at a rate of 1000 pulses per second does not appear to adversely affect the implanted cochlea.
  • Item
    Thumbnail Image
    Cochlear implantation in young children: histological studies on head growth, leadwire design, and electrode fixation in the monkey model
    Burton, M. J. ; Shepherd, R. K. ; Xu, S. A. ; Xu, J. ; Franz, B. K-H. G. ; Clark, Graeme M. ( 1994)
    For safe cochlear implantation in children under 2 years of age, the implant assembly must not adversely affect adjacent tissues or compromise head growth. Furthermore, growth changes and tissue responses should not impair the function of the device. Dummy receiver-stimulators, interconnect plugs, and leadwire-lengthening systems were implanted for periods of 36 months in the young monkey to effectively model the implantation of the young child. The results show that implanting a receiver-stimulator package has no adverse effects on skull growth or the underlying central nervous system. The system for fixing the electrode at the fossa incudis proved effective. There was marked osteoneogenesis in the mastoid cavity, resulting in the fixation of the leadwire outside the cochlea. This study provides evidence for the safety of cochlear implantation in young subjects.
  • Item
    Thumbnail Image
    "Cochlear View" and its application in cochlear implant patients [Abstract]
    Xu, J. ; Xu, S. A. ; Clark, Graeme M. ; Marsh, M. A. ( 1994)
    Recent advances in multichannel intracochlear implantation have generated interests in correlating individual stimulating electrodes to pitch perception. An appropriate radiographic technique is required to precisely document the location of the implanted intracochlear electrode array. Anatomical studies, including the measurements of the temporal bone using high-resolution CT films and 3D reconstruction from the petrous bone sections, were conducted to define the spatial position of cochlea in the skull. Thus, a "Cochlear View" was designed and introduced for postoperative radiological evaluation of multichannel intracochlear implantation. In this paper, a detailed radiographic method and radiological interpretation of the "Cochlear View" are described. A plain radiograph of the "Cochlear View" was taken of 120 patients who had received the Nucleus multichannel implant. Studies have shown that a plain radiograph of the "Cochlear View" provides sufficient information to correctly evaluate the results of implantation, including the insertion depth and position of individual electrodes. It plays an important role in guiding the management of frequency mapping and acts as a useful reference for further research purposes.
  • Item
    Thumbnail Image
    Physiological and histopathological response of the cochlea to chronic electrical stimulation of the auditory nerve at high stimulus rates [Abstract]
    Shepherd, R. K. ; Xu, J. ; Clark, Graeme M. ( 1994)
    Previous research has shown that chronic electrical stimulation of the auditory nerve using charge balanced biphasic current pulses at rates of up to 500 pulses per second (pps) does not adversely affect the adjacent spiral ganglion population. More recently, a number of clinical trials have suggested that speech processing strategies based on high pulse rates (e.g. 1000 pps), can further improve speech perception. In the present study we evaluated the physiological and histopathological response of the cochlea following long-term stimulation using rates of 1000 pps. Thirteen normal hearing cats were bilaterally implanted with scala tympani electrodes and unilaterally stimulated using 25-50 �s per phase charge balanced biphasic current pulses presented at 1000 pps. Additional charge balance was achieved by shorting the electrodes between current pulses. Each animal was stimulated for periods ranging from 700 - 2100 hours at current levels within its dynamic range. Auditory brainstem responses to both acoustic (ABR) and electrical (EABR) stimuli were periodically recorded throughout the chronic stimulation program. At completion of the program the cochleas were prepared for histological examination. While all animals exhibited an increase in acoustic thresholds following surgery, click evoked ABR's returned to near normal levels in half the animals. Frequency specific stimuli indicated that the most extensive hearing loss occurred adjacent to the array (>12 kHz) while lower frequency thresholds appeared at or near normal Our EABR data showed that the majority of animals exhibited slight increases in threshold, although response amplitudes remained very stable for the duration of the stimulus program. The physiological data reported here will be correlated with cochlear histopathology. These initial findings suggest that chronic intracochlear electrical stimulation at high pulse rates, using a carefully designed charge balanced stimulator, does not appear to adversely affect the implanted cochlea.