A wide-field retinal prosthesis was stable and well tolerated during long-term suprachoroidal implantation in a cat model. The surgical approach was reproducible and overall safe.
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 CochlearlMelbourne array. Background: Advantages to be expected of a perimodiolar electrode array inclu<;le 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. Intracochlear multichannel cochlear implants have successfully provided auditory information for profoundly deaf patients by electrically stimulating discrete populations of auditory nerve fibers via a scala tympani electrode array. The straight, yet flexible, tapered Melbourne/Cochlear electrode array can be safely implanted into the human cochlea. However, histologic and radiologic examination of implanted temporal bones showed that the electrode array is usually positioned along the outer wall of the scala tympani (1-5). The array is, therefore, some distance from the spiral ganglion cells in the Rosenthal canal and their peripheral processes. However,
Discharge patterns of single auditory nerve fibers were recorded from normal-hearing cats implanted with a 12-band intracochlear electrode array. Stimuli were biphasic current pulses of specifiable width, amplitude, and rate. Acoustic tuning curves were obtained to determine the cochlear positions of the fibers. Response latencies to electrical stimuli formed two groups. Short latency (0.3 to 0.7 ms) responses were attributed to direct activation of spiral ganglion neurons. At high stimulus intensities, these often exhibited abrupt shifts toward even shorter latencies. Long latency (> 1.5 ms) responses were probably caused by electrophonic activation of functional hair cells. Response thresholds to electrical stimuli depended on a fiber's proximity to the stimulating electrodes, and they did not depend on a fiber's acoustic response threshold or spontaneous discharge rate. High intensity (> 1.5 mA) stimuli could excite fibers over a wide range of characteristic frequencies, even for the narrowest (0.45 mm) electrode separations. Response threshold was an exponentially decreasing function of pulse width for widths up to 300 μs/phase. Fiber discharges were highly phase-locked at all suprathreshold intensities, and saturation discharge rates usually equaled stimulus pulse rates for rates up to at least 800 pulses/s. Dynamic ranges were small (1 to 6 dB), increased with pulse rate, and were uncorrelated with electrical response threshold. Within the dynamic range, shapes of poststimulus time and interspike interval histograms resembled those obtained in response to acoustic stimuli. Depolarization block caused fiber activity to cease in 2 to 5 seconds for sustained stimuli presented at high (> 600 pulses/s) pulse rates and intensities.
A banded free-fit scala tympani array was inserted into the basal turn of nine human cochleas to evaluate the trauma produced by the procedure. These nine cochleas, together with five nonimplanted controls, were serially sectioned and examined microscopically for damage to the membranous labyrinth, in particular the spiral ligament, the basilar and Reissner's membranes, the stria vascularis, and the osseous spiral lamina. The severity and location of any trauma along the cochlear spiral were recorded. The results indicate that the insertion of the banded scala tympani array resulted in minimal mechanical damage, occurring primarily to a localized region of the spiral ligament. This would not result in significant neural degeneration, and therefore would not compromise the efficacy of the multichannel cochlear prosthesis.
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