Research advances for cochlear implants

CCi-MOBILE: A Portable Real Time Speech Processing Platform for Cochlear Implant and Hearing Research

Experimental hardware-research interfaces form a crucial role during developmental stages of any medical, signal-monitoring system as it allows researchers to test and optimize output results before perfecting the design for the actual FDA approved medical device and large-scale production. These testing platforms, intake raw signals through which performance of novel algorithms can be analyzed and modified to generate the desired data points for an optimized output, allowing the advancement of the medical device. With cochlear implants (CIs) and hearing aids (HAs) becoming a more common solution for varying degrees of hearing impairment, having modern signal processing strategies tested for such speech sensitive systems is a necessity. But the rigid design requirements of commercial CI and HA processors make it difficult to explore novel algorithms for research investigations and conducting longitudinal studies. This study presents the design, development, clinical evaluation, and applications of CCi-MOBILE, a computationally powerful signal processing testing platform built for researchers in the hearing-impaired field. The custom-made, portable research platform allows researchers to design and perform complex speech processing algorithm assessment offline and in real-time. It can be operated through user-friendly, open-source software and is compatible with implants manufactured by Cochlear Corporation. The FPGA design and hardware processing pipeline for CI stimulation is discussed followed by results from an acute study with implant users' speech intelligibility in quiet and noisy conditions. The results show a consistent level of performance compared with CI users' clinical processor, thus confirming the viability of the platform in chronic CI based studies.

Biomedical studies on temporal bones of the first multi-channel cochlear implant patient at the University of Melbourne

OBJECTIVE

To analyse the temporal bones and implant of the first University of Melbourne's (UOM) patient (MC-1) to receive the multi-channel cochlear prosthesis.

METHODS

The left cochlea was implanted with the prototype multi-channel cochlear prosthesis on 1 August 1978, and the Cochlear versions CI-22 and CI-24 on 22 June 1983 and 10 November 1998, respectively. MC-1 died in 2007.

RESULTS

Plain X-rays of the temporal bones showed that after the CI-22 had been explanted seven electrode bands remained in situ. Micro-CT scans also revealed a partially united fracture transecting the left implanted and right control cochleae. Histology indicated a total loss of the organ of Corti on both sides, and a tear of the left basilar membrane. In addition, there was a dense fibrous capsule with heterotopic bone surrounding one proximal band of the CI-22 array that restricted its removal. This pathology was associated with dark particulate material within macrophages, probably due to the release of platinum from the electrode bands. Scanning electron microscopy (SEM) showed possible corrosion of platinum and surface roughening. Three-dimensional reconstruction of the cochlear histology demonstrated the position of the electrode tracts (C1-22 and CI-24) in relation to the spiral ganglion, which showed 85-90% loss of ganglion cells.

DISCUSSION AND CONCLUSIONS

This study confirms our first histopathological findings that our first free-fitting banded electrode array produced moderate trauma to the cochlea when inserted around the scala tympani of the basal turn. The difficulty in extraction was most likely due to one band being surrounded by an unusually large amount of fibrous tissue and bone, with an electrode band caught due to surface irregularities. Some surface corrosion and a small degree of platinum deposition in the tissue may also help explain the outcome for this long-term cochlear implantation.

Enhancement of neural stochastic firing in cochlear implant stimulation by the addition of noise: a computational study of the influence of stimulation settings and spontaneous activity

It is known that, in cochlear implants (CIs), the addition of noise to CI stimuli may enhance the stochastic firing in the auditory nerve (AN). The aim of this study was to investigate, by using a model of a fiber of the AN the influence of CI stimulation settings (i.e., stimulation rate and stimulus magnitude) and fiber spontaneous activity on the enhancement of stochastic firing when CI stimuli are combined with noise. Results showed that the stimulation rate had an effect on the enhancement of stochastic firing in the AN, whereas the stimulus magnitude and the spontaneous firing rate had no influence.

Physiologically inspired signal preprocessing for auditory prostheses: Insights from the electro-motility of the OHC

We designed a non-linear functional model of the outer hair cell (OHC) functioning in the filtering system of the cochlea and then isolated from it two second-order structures, one employing the mechanism of the somatic motility and the other the hair bundle motion of the OHC. The investigation of these circuits showed that the main mechanism increasing the sensitivity and frequency selectivity of the filtering system is the somatic motility. The mechanism of the active hair bundle motion appeared less suitable for realization of the band-pass filtering structures due to the dependence of the sensitivity, natural frequency and selectivity on the signal intensity. We combined three second-order filtering structures employing the mechanism of the somatic motility and the lateral inhibition to form a parallel-type filtering channel of the sixth order with the frequency characteristics of the Butterworth-type and Gaussian-type. The investigation of these channels showed that the Gaussian-type channel has the advantage over the Butterworth-type channel. It is more suitable for realization of a filter bank with common lateral circuits and has less distorted frequency characteristic in the nonlinear mode.

The development of the Nucleus Freedom Cochlear implant system

Cochlear Limited (Cochlear) released the fourth-generation cochlear implant system, Nucleus Freedom, in 2005. Freedom is based on 25 years of experience in cochlear implant research and development and incorporates advances in medicine, implantable materials, electronic technology, and sound coding. This article presents the development of Cochlear's implant systems, with an overview of the first 3 generations, and details of the Freedom system: the CI24RE receiver-stimulator, the Contour Advance electrode, the modular Freedom processor, the available speech coding strategies, the input processing options of Smart Sound to improve the signal before coding as electrical signals, and the programming software. Preliminary results from multicenter studies with the Freedom system are reported, demonstrating better levels of performance compared with the previous systems. The final section presents the most recent implant reliability data, with the early findings at 18 months showing improved reliability of the Freedom implant compared with the earlier Nucleus 3 System. Also reported are some of the findings of Cochlear's collaborative research programs to improve recipient outcomes. Included are studies showing the benefits from bilateral implants, electroacoustic stimulation using an ipsilateral and/or contralateral hearing aid, advanced speech coding, and streamlined speech processor programming.

Neural prosthesis in the wake of nanotechnology: controlled growth of neurons using surface nanostructures

Neural prosthesis has been successfully applied to patients with motional or sensory disabilities for clinical purpose. To enhance the performance of the neural prosthetic device, the electrodes for the biosignal recording or electrical stimulation should be located in closer proximity to target neurons than they are now. Instead of revising the prior implanting surgery to improve the electrical contact of neurons, we propose a technique that can bring the neurons closer to the electrode sites. A new method is investigated that can control the direction of neural cell growth using surface nanostructures. We successfully guide the neurons to the position of the microelectrodes by providing a surface topographical cue presented by the surface nanostructure on a photoresponsive polymer material. Because the surface structure formed by laser holography is reversible and repeatable, the geometrical positioning of the neurons to microelectrodes can be adjusted by applying laser treatment during the surgery for the purpose of improving the performance of neural prosthetic device.

Plasma-enhanced chemical vapor deposited silicon carbide as an implantable dielectric coating

Amorphous silicon carbide (a-SiC) films, deposited by plasma-enhanced chemical vapor deposition (PECVD), have been evaluated as insulating coatings for implantable microelectrodes. The a-SiC was deposited on platinum or iridium wire for measurement of electrical leakage through the coating in phosphate-buffered saline (PBS, pH 7.4). Low leakage currents of <10(-11) A were observed over a +/-5-V bias. The electronic resistivity of a-SiC was 3 x 10(13) Omega-cm. Dissolution rates of a-SiC in PBS at 37 and 90 degrees C were determined from changes in infrared absorption band intensities and compared with those of silicon nitride formed by low-pressure chemical vapor deposition (LPCVD). Dissolution rates of LPCVD silicon nitride were 2 nm/h and 0.4 nm/day at 90 and 37 degrees C, respectively, while a-SiC had a dissolution rate of 0.1 nm/h at 90 degrees C and no measurable dissolution at 37 degrees C. Biocompatibility was assessed by implanting a-SiC-coated quartz discs in the subcutaneous space of the New Zealand White rabbit. Histological evaluation showed no chronic inflammatory response and capsule thickness was comparable to silicone or uncoated quartz controls. Amorphous SiC-coated microelectrodes were implanted in the parietal cortex for periods up to 150 days and the cortical response evaluated by histological evaluation of neuronal viability at the implant site. The a-SiC was more stable in physiological saline than LPCVD Si(3)N(4) and well tolerated in the cortex.

Electrodeposited iridium oxide for neural stimulation and recording electrodes

Iridium oxide films formed by electrodeposition onto noniridium metal substrates are compared with activated iridium oxide films (AIROFs) as a low impedance, high charge capacity coating for neural stimulation and recording electrodes. The electrodeposited iridium oxide films (EIROFs) were deposited on Au, Pt, PtIr, and 316 LVM stainless steel substrates from a solution of IrCl4, oxalic acid, and K2CO3. A deposition protocol involving 50 potential sweeps at 50 mV/s between limits of 0.0 V and 0.55 V (versus Ag AgCl) followed by potential pulsing between the same limits produced adherent films with a charge storage capacity of >25 mC/cm2. Characterization by cyclic voltammetry and impedance spectroscopy revealed no differences in the electrochemical behavior of EIROF on non-Ir substrates and AIROF. The mechanical stability of the oxides was evaluated by ultrasonication in distilled water followed by dehydration and rehydration. Stability under charge injection was evaluated using 200 micros, 5.9 A/cm2 (1.2 mC/cm2) cathodal pulses. Loss of iridium oxide charge capacity was comparable for AIROFs and the EIROFs, ranging from 1% to 8% of the capacity immediately after activation or deposition. The EIROFs were deposited and evaluated on silicon microprobe electrodes and on metallized polyimide electrodes being developed for neural recording and stimulation applications.

Cochlear implants and electrical brainstem stimulation in sensorineural hearing loss

Cochlear implants and multichannel auditory brainstem implants enable patients with bilateral total or profound hearing loss to receive at least acoustic information. Both types of prosthesis are based on electrical stimulation of the auditory pathway. Different speech coding strategies and the number of electrodes used may influence the postoperative results. The preoperative evaluation of patients is of utmost importance. The cochlear implant is suitable for patients with hearing loss due to inner ear disorders, but who have functioning hearing nerve. Patients with a defect of the hearing nerve can be provided with an auditory brainstem implant.