Graeme Clark Collection
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ItemHigh rate electrical stimulation of the auditory nerve: physiological and pathological results [Abstract]( 1995)Previous experimental studies have 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) do not adversely affect the adjacent spiral ganglion population. More recently, a number of clinical trials have indicated that speech processing strategies based on high pulse rates (1000 pps and more), can further improve speech perception. In this paper we summarize our results following acute and chronic electrical stimulation of the auditory nerve using high pulse rates.
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ItemPhysiological and histopathological response of the cochlea to chronic electrical stimulation of the auditory nerve at high stimulus rates [Abstract]( 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.
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ItemInvestigation of curved intracochlear electrode arrays [Abstract]( 1992)It has been demonstrated that the Melbourne/Cochlear multi-channel cochlear implant is safe and effective for use in profoundly-totally deaf patients. Recent studies have highlighted the importance of deaf insertion and placing the electrodes closer to the spiral ganglion neurons. In order to improve the electrode insertion depth and proximity to the modiolus, we have investigated curved electrode arrays. Prototypes of such arrays and their accessory inserter have been made. Trial insertions were performed on skeletonized cochleae of human temporal bones. The preliminary results showed that, when compared with conventional straight electrode arrays, the curved arrays could be inserted deeper and located closer to the modiolus. These findings indicate that the curved --.~ electrodes currently under investigation should result in a reduction in stimulus threshold and improve pitch perception and may also result in the use of more channels of stimulation.
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ItemElectrical stimulation of the auditory nerve: comparison of half-band with full-band scala tympani bipolar electrodes( 1993)The Melbourne/Cochlear auditory prosthesis uses an intracochlear electrode array containing 22 circumferential full-band electrodes mounted on a Silastic carrier. It could be hypothesized that half-band electrodes, oriented towards the modiolus, would produce lower stimulus thresholds than conventional full-band electrodes. This hypothesis is based on the assumption that, compared with full-band electrodes, half-band electrodes would produce an electrical field in which a greater proportion of the current would excite a defined group of neurons. In order to verify this hypothesis we recorded electrically evoked auditory brainstem responses (EABRs) for both full- and half-band electrodes inserted in the scala tympani of deafened cats. EABR thresholds for half-band electrodes oriented towards the modiolus were not significantly different from thresholds evoked using full-band electrodes (p>0.05, paired t-test), whereas thresholds evoked using half-band electrodes oriented towards the outer scala wall were significantly higher (p<0.01) than either the modiolar half-band or the full-band electrodes. These physiological results suggest that the electrical field generated within the auditory nerve by modiolar oriented half-band electrodes does not differ significantly from that produced by full-band electrodes. On the basis of these results, together with the fact that half-band electrodes would have higher current densities and electrode impedances, and would require careful orientation during implantation, we consider that there is no benefit in incorporating half-band electrodes in the design of scala tympani electrode arrays.