Graeme Clark Collection

Permanent URI for this collection

Search Results

Now showing 1 - 9 of 9
  • Item
    Thumbnail Image
    The role of radiographic phase-contrast imaging in the development of intracochlear electrode arrays
    XU, JIN ; Stevenson, Andrew W. ; Gao, Dachao ; TYKOCINSKI, MICHAEL ; LAWRENCE, DAVID ; Wilkins, Stephen W. ; Clark, Graeme M. ; Saunders, Elaine ; Cowan, Robert S. ( 2001)
    Objective: This study describes the application of a new radiographic imaging modality, phase-contrast radiography, to in vitro human temporal bone imaging and investigates it use in the development of new electrode arrays for cochlear implants. Background: The development of perimodiolar electrode arrays for cochlear implants requires detailed information from postoperative radiologic assessment on the position of the array in relation to the cochlear structures. Current standard radiographic techniques provide only limited details. Materials and Methods: Nucleus standard electrode arrays and perimodiolar Contour electrode arrays were implanted into the scala tympani of 11 human temporal bones. Both conventional and phase-contrast radiographs were taken of each temporal bone for comparative purposes. Results: Phase-contrast imaging provides better visulization of anatomic details of the inner ear and of the structure of the intracochlear electrode array, and better definition of electrode location in relation to cochlear walls. Conclusion: Phase-contrast radiography offers significant improvement over conventional radiography in images of in vitro human temporal bones. It seems to be a valuable tool in the development of intracochlear electrode arrays and cochlear implant research. However, this new radiographic technique still requires certain computational and physics challenges to be addressed before its clinical use can be established.
  • Item
    Thumbnail Image
    The Contour electrode array: Safety study and initial patient trials of a new perimodiolar design
    Tykocinski, M ; Saunders, E ; Cohen, LT ; Treaba, C ; Briggs, RJS ; Gibson, P ; Clark, GM ; Cowan, RSC (LIPPINCOTT WILLIAMS & WILKINS, 2001-01)
    OBJECTIVE: The aim of these studies was to investigate the insertion properties and safety of a new intracochlear perimodiolar electrode array design (Contour). BACKGROUND: An electrode array positioned close to the neural elements could be expected to reduce stimulation thresholds and might potentially reduce channel interaction. METHODS: Two sequential studies were conducted. In study 1, the Contour electrode array was inserted in 12 human temporal bones. After cochlear surface preparation, the position of the array was noted and the basilar membrane was examined for insertion damage. On the basis of the outcome of this temporal bone study, study 2 investigated the Contour array, mounted on a Nucleus CI-24 M device and implanted in three adult patients. RESULTS: Study I showed that in 10 temporal bones, the Contour array was positioned close to the modiolus, and the basilar membrane was intact. In the two remaining bones, the arrays had pierced the basilar membrane and were positioned in the scala vestibuli apical to the penetration. Statistical analysis showed an equivalent probability of insertion-induced damage of the two array designs. In study 2, image analysis indicated that the Contour electrodes were positioned closer to the modiolus than the standard Nucleus straight array. Lower T and C levels, but higher impedance values, were recorded from electrodes close to the modiolus. Initial speech perception data showed that all patients gained useful open-set speech perception, two patients achieving scores of 100% on sentence material 3 months postoperatively. CONCLUSIONS: The temporal bone studies showed the Contour electrode array to be generally positioned closer to the modiolus than the standard Nucleus straight array, and to have an equivalent probability of causing insertion-induced damage.
  • Item
    Thumbnail Image
    Comparison of electrode position in the human cochlea using various perimodiolar electrode arrays
    TYKOCINSKI, MICHAEL ; Cohen, Lawrence T. ; Pyman, Brian C. ; Roland (Jr), Thomas ; Treaba, Claudiu ; PALAMARA, JOSEPH ; Dahm, Markus C. ; Shepherd, Robert K. ; XU, JIN ; Cowan, Robert S. ; Cohen, Noel L. ; Clark, Graeme M. ( 2000)
    Objective: This study was conducted to evaluate the insertion properties and intracochlear trajectories of three perimodiolar electrode array designs and to compare these designs with the standard Cochlear /Melbourne array. Background: Advantages to be expected of a perimodiolar electrode array include both a reduction in stimulus thresholds and an increase in dynamic range, resulting in a more localized stimulation pattern of the spiral ganglion cells, reduced power consumption, and, therefore, longer speech processor battery life. Methods: The test arrays were implanted into human temporal bones. Image analysis was performed on a radiograph taken after the insertion. The cochleas were then histologically processed with the electrode array in situ, and the resulting sections were subsequently assessed for position of the electrode array as well as insertion-related intracochlear damage. Results: All perimodiolar electrode arrays were inserted deeper and showed trajectories that were generally closer to the modiolus compared with the standard electrode array. However, although the precurved array designs did not show significant insertion trauma, the method of insertion needed improvement. After insertion of the straight electrode array with positioner, signs of severe insertion trauma in the majority o fimplanted cochleas were found. Conclusions: Although it was possible to position the electrode arrays close to the modiolus, none of the three perimodiolar designs investigated fulfilled satisfactorily all three criteria of being easy, safe, and a traumatic to implant.
  • Item
    Thumbnail Image
    A comparative study of phase-contrast and conventional x-ray imaging in human temporal bone samples
    XU, JIN ; TYKOCINSKI, MICHAEL ; Saunders, E. ; Clark, Graeme M. ; Cowan, R. ( 2001)
    This study compared a new x-ray modality, phase-contrast radiography, with conventional radiography for imaging in human temporal bones and also investigated its potential application in the development of electrode arrays for advanced cochlear implants. Nucleus standard electrode arrays and peri-modiolar Contourn.4 electrode arrays were implanted into the cochleae of 10 human temporal bones. Both conventional and phase-contrast radiographs were taken of ~ach temporal bon~. The phase-contrast radiographs showed significant improvements over conventional radiographs in the detail of temporal bone images. These improvements included enhanced contrast at the edge of canal type features, inherent image magnification, higher spatial resolution, and ability to use detectors such as Imaging Plates. The results demonstrate that phase-contrast imaging can have important advantages in visualisation of anatomical details of both the inner ear structures and the microelectrode. It can provide a clearer definition of electrode location in relation to cochlear walls. This study demonstrates the feasibility of applying phase-contrast radiography to studies of the human temporal bone. However, its usefulness in the imaging of larger objects or perhaps even with patients in a clinical setting will require further investigation.
  • Item
    Thumbnail Image
    Application of advanced radiographic technology in cochlear implant research
    XU, JIN ; TYKOCINSKI, MICHAEL ; Saunders, E. ; Clark, Graeme M. ; Cowan, R. ( 2001)
    The effective development of peri-modiolar or other advanced electrode arrays for cochlear implants requires detailed analysis of the insertion procedure and electrode positioning in the cochlea. Routine x-ray techniques cannot provide sufficient detail to meet this need. A new micro-focus x-ray imaging system has been built for our research. The system consists of a x-ray tube with a sub 10-micron focal spot mounted below an adjustable work surface and an image intensifier placed approximately 100 cm above the x-ray aperture. A variety of intracochlear electrode arrays and human temporal bones were studied using this system. The micro-focus x-ray imaging system allows for micro-fluoroscopy to visualise the real time implantation procedure. It also enables capturing of images onto reusable phosphor imaging plates or films for subsequent viewing or analysis. Images are produced at up to 95 times magnification with superior resolution and enhanced contrast. This new radiographic technology plays an important role in development of safe and effective advanced intracochlear electrode arrays.
  • Item
    Thumbnail Image
    Potential applications of a small and high surface area platinum electrode as an implanted impedance bio-sensor or recording electrode.
    Duan, Yvonne Y. ; Millard, Rodney E. ; Tykocinski, Michael. ; Lui, Xugang ; Clark, Graeme M. ; COWAN, ROBERT ( 2001)
    A small Platinum (Pt) electrode (geometric area: -0.43 mm2) was treated in an electrochemical etching process, to produce a highly porous columnar thin layer (-600 nm) on the surface of the electrode. The modified Pt electrode (Pt-p) showed similar electrical properties to a platinum-black electrode but with high mechanical integrity. Previous studies of chronic stimulation had also shown good biocompatibility and surface stability over several months implantation. This paper discusses the potential applications of the modified electrode as an implanted bio-sensor: (1) as a recording electrode compared to an untreated Pt electrode. (2) as a probe in detecting electrical characteristics of living biological material adjacent to the electrode in vivo, which may correlate to inflammation or trauma repair. Results of electrochemical impedance spectroscopy (BIS) revealed much lower electrode interface polarisation impedance, reduced overall electrode impedance, and a largely constant impedance above 100 Hz for the Pt-p electrode compared with untreated Pt electrodes. This provides a platform for recording biological events with low noise interference. Results of A.C. impedance spectroscopy of the high surface area electrode only reflect changes in the surrounding biological environment in the frequency range (1 kHz to 100kHz), interference from electrode polarisation impedance can be neglected. The results imply that the surface-modified electrode is a good candidate for application to implantable biosensors for detecting bio-electric events. The modification procedure and its high surface area concept could have application to a smart MEMS device or microelectrode.
  • Item
    Thumbnail Image
    The role phase-contrast imagining in intra-cochlear electrode development
    Wilkins, S. ; Saudners, E. ; Clark, Graeme M. ; Cowan, R. ; XU, JIN ; Stevenson, A. W. ; Gao, D. ; Tykocinski, M. ; Cohen, L. ; Dahm, Markus ( 2000)
    In order to improve the design of intracochlear multichannel electrode arrays, it is fundamental that we have knowledge of the exact anatomical , position of the electrode within the scala of the cochlea. Currently, conventional skull radiography is still the mainstay of post-operative radiological assessment of electrode positioning. The present work investigates the use of phase-contrast radiography, a new x-ray modality, to provide improved imaging of the inner ear and the intracochlear electrode array in the human temporal bone (TB).
  • Item
    Thumbnail Image
    Safety studies and preliminary patient trails with a new perimodiolar electrode array
    Clark, Graeme M. ; COWAN, ROBERT ; Saunders, Elaine ; TYKOCINSKI, MICHAEL ; COHEN, LAWRENCE ; Treaba, Claudiu ; BRIGGS, ROBERT ; Dahm, Markus ( 2000)
    A new perimodiolar electrode array, the curly-with stylet (CwS), has been developed and undergone safety trials in human cadaver temporal bones. The array was developed as a result of animal and modelling studies which indicated that there are potential advantages in situating the electrode array in closer proximity to the neural elements. Preliminary studies with four patients in Melbourne implanted with a developmental pre-curved array had supported the predictions of lower current requirements and possibly more focussed spread of excitation.
  • Item
    Thumbnail Image
    Where to now? - Impact of New Technologies on use of cochlear implants
    Van Hoesel, R. ; Zhang, A. ; Tykocinski, M. ; Dham, M. ; Patrick, J. ; Parker, J. ; Clark, Graeme M. ; Cowan, R. S. C. ; Saunders, E. ; Vandali, A. E. ; Dowell, R. C. ; Treaba, C. ; Harrison, J. M. ( 2000)
    The history of cochlear implant use by adults and children with profound hearing loss although relatively short (20 some years), has been characterised by continual technological innovations which have enhanced the performance, packaging, and clinical use of these devices. In particular, the development of the Nucleus multiple channel cochlear implant has included a series of speech processing hardware and speech processing strategy, implemented by Cochlear Limited, and based on research findings that have resulted in an increase in mean speech perception benefits for adults and children.