Graeme Clark Collection
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ItemIntracellular responses of anteroventral cochlear nucleus neurones to intracochlear electrical stimulation in the rat [Abstract]( 1996)The anterior division of the ventral cochlear nucleus (AVCN) is the first relay station of the auditory pathway. Currently little is known about the intracellular physiological responses of neurones in the AVCN to electrical stimulation of the cochlea. We investigated the effect of cochlear electrical stimulation in the rat AVCN using in vivo intracellular recordings. Male rats were anaesthetised with urethane (1.3g/kg i.p), placed in a stereotaxic frame, the crania and dura removed and the cochlear nucleus exposed.
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ItemElectrophonically driven single unit responses of the anteroventral cochlear nucleus in cat [Abstract]( 1996)Electrical stimulation of the cochlea results in both direct and electrophonic excitation of auditory nerve fibres. It has been proposed that electrophonic stimulation results from the creation of a mechanical disturbance on the basilar membrane which has properties similar those resulting from acoustic stimuli. Auditory nerve compound action potential (CAP) forward masking studies1 show the level of frequency specific electrophonic stimulation is highly correlated with the spectral energy of the electrical stimulus waveform. The level of spectral energy in pulsatile biphasic electrical stimuli decreases toward low frequencies suggesting the level of electrophonic stimulation will be diminished in the low frequency region of the cochlea.
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ItemReduction in excitability of the auditory nerve in guinea pigs following acute high rate electrical stimulation [Abstract]( 1996)Electrical stimulation of neural tissue involves the transfer of charge to tissue via electrodes. Safe charge transfer can be achieved using biphasic current pulses designed to reduce the generation of direct current (DC) or the production of electrochemical products. However, neural stimulators must also use capacitors in series with electrodes, or electrode shorting between current pulses, to further minimize DC due to electrode polarization.
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ItemThe histological and physiological effects of the auditory brainstem prosthesis of the auditory pathway [Abstract]( 1997)The cochlear implant can successfully rehabilitate the majority of profoundly deaf patients. However, some of them cannot benefit from the cochlear implant due to bilateral interruption of the auditory nerve, particularly from neurofibromatosis II. These patients can be stimulated directly with an auditory brainstem prosthesis on the cochlear nucleus. To examine the safety and the efficacy of this prosthesis, the cochlear nuclei of guinea pigs were implanted unilaterally with bipolar surface electrodes, and stimulated acutely using charge-balanced, biphasic current pulses at rates of 250, SOO or 1000 Hz and charge intensities of 1.8, 2.8, 3.5 or 7.1?C/phase/cm2.
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ItemEffects of chronic electrical stimulation on cochlear nuclear neuron size in deaf kittens [Abstract]( 1996)It is now well recognized that normal afferent innervation is necessary for the development. This study investigated the effect of chronic electrical stimulation of the auditory nerve on the maturation of cochlear nucleus soma area of the neonatally deafened kittens. Eight kittens were deafened using kanamycin and ethacrynic acid, received a stimulated intracochlear implant in the left side and a dummy implant in right side, and classified two groups - the stimulated and the control group.
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ItemExpandable leadwires for a paediatric cochlear implant [Abstract]( 1993)Anatomic studies of skull growth have shown an increase (about 20 mm) in the distance between the round window and the asterion where the receiver-stimulator is usually located. In order to accommodate the skull growth of young patients, an expandable leadwire connecting the receiver-stimulator and the electrode array is necessary. Several expandable leadwires were evaluated in experimental animals, including helical leadwires protected by Silastic tubes and leadwires, with "V" or "W"-shaped levels in a single phase, and protected by thin Silastic or Teflon bags. The leadwires together with their controls were implanted on young animal's scapulae, temporal and parietal bones and in subcutaneous tissue. The in vivo expansion of the leadwire was monitored by periodic x-ray examination and the force to expand the leadwire was measured at the completion of implantation. The results showed that helical leadwires weresurrounded by fibrous tissue and a large force was required to expand them. The V or W-shaped leadwires were able to expand up to 20 mm in vivo and only a moderate force was required to expand them. For most of the cases, there was none or little fibrous tissue in Silastic or Teflon bags. The results indicated that for a paediatric cochlear implant, leadwires with V or W-shaped levels could, expand and biocompatible envelopes could effectively protect the leadwires from being bound by fibrous tissue.
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ItemPaediatric cochlear implant surgery [Abstract]( 1992)The operation in children is similar to that in adults, but special care needs to be taken with the skin flap, the anchoring of the electrode array and the sealing of .the cochleostomy. Research into the effects of head growth and otitis media in an implanted ear indicates that these should not be a problem. Surgical complications are also similar to those in adults, with the most common being related to the skin flap. The major complication rate at 4 % is slightly less than that in adults and most of these get effective implant function.
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ItemPaediatric cochlear implantation: radiological and histopathological studies of skull growth in the monkey( 1993)The human skull undergoes significant growth within the first two years of life (Dahm et aI, 1992). Therefore, before children under two can be considered candidates for cochlear implantation, the effects of the surgical procedure on subsequent skull growth must be well understood. To evaluate the effects of implantation on skull growth four macaque monkeys were implanted with dummy cochlear implants at six months of age. To model the procedure in the very young child, the bed for the receiver-stimulator was drilled across a calvarial suture down to the underlying dura and an electrode array inserted into the scala tympani via a mastoidectomy and posterior,tympanotomy. Plain skull radiographs were perioqical1y taken to monitor skull growth for periods of up to three years following implantation. Their longitudinal measurements revealed no evidence of asymmetrical skull growth when compared with unimplanted control animals. Computer tomographic scans taken at post-mortem confirmed these findings. Finally, subsequent histopathological evaluation of the receiver-stimulator package bed indicated that it becomes obliterated by hard tissue, resulting in a localized flattening of the vault under the receiver-stimulator. However, this tissue exhibited histological evidence of sutures, indicating that the surgical procedure should not lead to premature sutural closure. In conclusion, the present experimental results suggest that long-term cochlear implantation in very young children will not lead to any significant skull deformity.
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ItemSteady state evoked potentials: an objective measure of residual hearing in young cochlear implant candidates [Abstract]( 1993)Precise determination of hearing thresholds in prospective cochlear implant candidates is essential. As the minimum age of implantation for youl1g children has been reduced, the use of objective measures of hearing has become an important part of their pre-operative evaluation. Steady-state evoked potentials are scalp potentials elicited in response to sinusoidally amplitude and/or frequency modulated tones. A system has been developed at The University of Melbourne which allows the presence: of such a response to be detected automatically thus permitting an objective. frequency specific estimate of hearing to be made in sleeping or awake subjects. This paper investigates the use of SSEPs in determining hearing thresholds in young profoundly deaf children. Responses in such patients are compared with those: obtained in neonates, and a group of sleeping adult subjects with varying degrees of sensori-neural hearing loss. Results indicate that the SSE? procedure is well suited as a measure assessing residual hearing in profoundly deaf children suitable for a cochlear implant in that it can provide an accurate estimate of auditory thresholds using frequency specific stimuli presented at high levels.
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ItemElectrical stimulation of the auditory nerve in deaf kittens: effects on the spiral ganglion [Abstract]( 1992)Cochlear pathology following the administration of ototoxic drugs results in a widespread and rapid loss of sensory hair cells followed by a gradual degeneration of auditory nerve fibres and their cell bodies, the spiral ganglion. Recently, two studies have described increased spiral ganglion cell survival in the cochleas of deafened animals following chronic electrical stimulation of the auditory nerve (Hartshorn et al., 1991; Leake et al., ]991). If electrical stimulation is shown to have a trophic effect on degenerating auditory nerve fibres, these findings will significantly influence the preoperative management of cochlear implant patients. The aim of the present study was to corroborate these earlier reports and to evaluate the general tissue response of deafened cochleae in young animals following chronic electrical stimulation.