Development of safe and effective electrodes: a risk management approach [Abstract]

Abstract

Results from studies on experimental animals, computer modelling and preliminary psychophysical studies with three patients, have confirmed the potential for subjective improvement with electrode arrays which lie closer to the modiolus than does the Nucleus straight array. Results of psychophysical studies with three cochlear implant patients, using developmental pre-curved arrays, confirm the feasibility of improving patients' performance through improvements in electrode design. In particular, it was found in psychophysical tests, with patients using a developmental pre-curved electrode array, that both maximum comfortable level and threshold reduced with decreasing distance of a stimulated electrode from the modiolus, and that the dynamic range increased. More intense neural excitation patterns were obtained with the closer electrodes. From this it is inferred that the development of more sophisticated electrode arrays, positioned closer to the modiolus than is currently the case with the Nucleus standard array, will enable the development of improved speech processing strategies. There are technical constraints in the design of a peri-modiolar array, and currently a number of approaches to this problem have been investigated. Whilst the goal of the design is that it be effective for sophisticated and variable manners of stimulus delivery, a primary constraint is safety.