Niparko JK, Pfingst BE, Johansson C, Kileny PR, Kemink JL, Tjellström A. Cochlear wall titanium implants for auditory nerve stimulation.
Ann Otol Rhinol Laryngol 1993;
102:447-54. [PMID:
8512272 DOI:
10.1177/000348949310200608]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Genetically deaf dalmatian dogs and ototoxically deafened macaque monkeys were implanted with electrodes housed in cochlear wall titanium implants to assess long-term stability, tolerance, and performance. Short-term human implantation, followed by trials of stimulation, was performed in 4 unilaterally deaf patients. In the dog experiments, cochlear wall electrode stimulation produced consistent electrophysiologic thresholds that were higher, by approximately 6 dB, than those obtained with bipolar scala tympani stimulation. Clinical testing revealed electrically evoked middle latency response, auditory brain stem response, and/or behavioral detection responses in 3 of 4 patients, at levels below those for facial nerve activation and pain sensation. Electrode place discrimination studies, with controls for loudness cues, revealed near-perfect discrimination in a monkey subject. Eleven of the 12 animal implants were found to be rigidly fixed in the cochlear bone, with direct contract between bone and implant over 8% to 23% of the implant surface for the 6 implants examined in detail. These results suggest that long-term fixation of titanium cochlear wall implants occurs by virtue of intimate implant-bone contact in restricted areas. This approach to prosthetic stimulation demonstrates encouraging performance characteristics in achieving auditory activation.
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