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Surgery for an improved multiple-channel cochlear implant.

G M Clark·B C Pyman·R L Webb·Q E Bailey·R K Shepherd
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Abstract

An improved multiple-channel cochlear implant has been developed. The titanium container with enclosed electronics, the receiver coil, and the connector are embedded in medical-grade Silastic. The upper half of the implant has a diameter of 35 mm and a height of 4.5 mm, and the lower half a diameter of 23 mm and a height of 5 mm. The electrode array has also been designed to reduce the possibility of breakage due to repeated movements over many years. The surgery involves drilling a bed in the mastoid bone for the receiver-stimulator, and fixing the proximal electrode under the mastoid cortex. Gentle insertion of the electrode array through the round window and along the scala tympani is achieved with a specially designed microclaw .

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Cochlear ImplantsDeafnessElectrodes, ImplantedEquipment DesignEquipment FailureHumansMethodsOtolaryngologyPostoperative PeriodSurgical InstrumentsJournal ArticleResearch Support, Non-U.S. Gov't

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G M Clark, B C Pyman, R L Webb, Q E Bailey, R K Shepherd. Surgery for an improved multiple-channel cochlear implant.. https://doi.org/10.1177/000348948409300302

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The multiple-channel cochlear implant is the first sensori-neural prosthesis to effectively and safely bring electronic technology into a direct physiological relation with the central nervous system and human consciousness, and to give speech perception to severely-profoundly deaf people and spoken language to children. Research showed that the place and temporal coding of sound frequencies could be partly replicated by multiple-channel stimulation of the auditory nerve. This required safety studies on how to prevent the effects to the cochlea of trauma, electrical stimuli, biomaterials and middle ear infection. The mechanical properties of an array and mode of stimulation for the place coding of speech frequencies were determined. A fully implantable receiver-stimulator was developed, as well as the procedures for the clinical assessment of deaf people, and the surgical placement of the device. The perception of electrically coded sounds was determined, and a speech processing strategy discovered that enabled late-deafened adults to comprehend running speech. The brain processing systems for patterns of electrical stimuli reproducing speech were elucidated. The research was developed industrially, and improvements in speech processing made through presenting additional speech frequencies by place coding. Finally, the importance of the multiple-channel cochlear implant for early deafened children was established.

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