Graeme Clark Collection

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    Cochlear pathology following chronic electrical stimulation of the auditory nerve: II Deafened kittens
    Shepherd, R. K. ; Matsushima, J. ; Martin, R. L. ; Clark, Graeme M. ( 1994)
    The present study examines the effects of long-term electrical stimulation of the auditory nerve on cochlear histopathology and spiral ganglion cell survival in young sensorineural deafened cats. Eight kittens were deafened using kanamycin and ethacrynic acid, and implanted with bipolar or monopolar scala tympani electrodes. Following recovery from surgery the animals were unilaterally stimulated using charge balanced biphasic current pulses for 450-1730 hours over implant periods of up to four months. Charge densities varied from 0.6-0.9 µC.cm ^-2 geom. per phase for monopolar electrodes to 12-26 µC.cm ^-2 geom. per phase for the bipolar electrodes. Electrically-evoked auditory brainstem responses (EABRs) were periodically monitored during stimulation to confirm that the stimulus levels were above threshold, and to monitor any change in the response of the auditory nerve. Following completion of the stimulation program cochleae were prepared for histological examination. EABRs exhibited relatively stable thresholds for both stimulated and implanted, unstimulated control cochleae for the stimulus duration. While the growth in response amplitude as a function of stimulus current remained stable for the bipolar control and monopolar stimulated cochleae, the five cochleae chronically stimulated using bipolar electrodes exhibited a moderate to large increase in response amplitude. These increases were associated with a more widespread fibrous tissue response which may have altered the current distribution within these cochleae. Implanted control cochleae exhibited significantly less tissue response within the scala tympani. Importantly, we observed no statistically significant difference in the spiral ganglion cell density associated with chronic electrical stimulation when compared with unstimulated control cochleae. While the present study supports the safe application of cochlear implants in young profoundly deafened children, it does not corroborate previous studies that have reported electrical stimulation providing a trophic effect on degenerating auditory nerve fibres.
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    Partial hearing loss in the macaque following the co-administration of kanamycin and ethacrynic acid
    Shepherd, R. K. ; Xu, S. A. ; Clark, Graeme M. ( 1994)
    Co-administration of kanamycin (KA) with the loop diuretic ethacrynic acid (EA) rapidly produces a profound hearing loss in the cat while maintaining normal renal function [Xu et al., Hear. Res. 70, 205-215 (1993)]. In the present paper we have applied this deafening procedure to the old world monkey Macaca fascicularis (macaque). Following the co-administration of KA and EA, the hearing loss in the macaque developed far slower than we observed in the cat. Moreover, unlike the cat, there was evidence of a partial recovery in the animal’s hearing, resulting in a bilaterally symmetrical high frequency hearing loss. The extent of this hearing loss was dependent on the dose of the EA administered. Finally, the most unexpected result of the present study was the degree of acute nephrotoxicity experienced by these animals following the drug administration. The sensitivity of this species to renal failure restricted the dose of EA that could be safely administered. In conclusion, the co-administration of KA and EA cannot reliably produce a profound hearing loss in the macaque. While it can produce a dose dependent high frequency hearing loss the animal will also experience acute renal failure that requires careful management.
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    Evaluation of leadwire fixation for paediatric cochlear implants [Abstract]
    Xu, S. A. ; Shepherd, R. K. ; Clark, Graeme M. ( 1994)
    A paediatric cochlear implant should include a leadwire system that can readily expand in the presence of tissue adhesions and can be effectively fixed at a site close to the cochlea to ensure that the electrode array is not displaced during skull growth. In this study, leadwires were implanted in six young animals for a period of five months. During explantation, the mean force � standard deviation required to expand individual leadwire was found to be 12.5 � 5.0g. In order to evaluate the efficacy of leadwire fixation techniques, four fixation procedures were initially developed in human temporal bones and subsequently used to fix leadwires implanted in the temporal bones of eight animals for a period of four months. Leadwires were fixed by platinum wires at the fossa incudis or by platinum wires with a titanium barbed nail at the mastoid. The biomechanical evaluation revealed that the forces required to displace the leadwire from fixation points were 70.6 � 33.5g. Significantly, the forces required to withdraw a chronically implanted electrode array from an animal cochlea were 1.5 � 0.4g. The present results highlight the importance of an effective leadwire fixation technique for paediatric cochlear implants, particularly in preventing the displacement of an electrode array from the cochlea during skull growth.