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PubMed1999

Fos-like immunoreactivity in the auditory brainstem evoked by bipolar intracochlear electrical stimulation: effects of current level and pulse duration.

Fos-like immunoreactivity was used to compare the auditory brain stem excitation elicited by bipolar electrical stimulation of the cochlea at various current levels relative to the electrically evoked auditory brain stem response threshold for a 50-micros/phase monophasic pulse. Fos-like immunoreactive cells were labeled in primary auditory brain stem regions. The distribution of labeled cells was restricted to regions known to be cochleotopically related to the stimulated region of the scala tympani. Some labeled cells were observed at 2x electrically evoked auditory brain stem response threshold. The number, density and spatial distribution of labeled cells were quantified in the dorsal cochlear nucleus and inferior colliculus, and found to increase with increasing level of stimulation. For 50-micros pulses, the location of labeled neurons remained reasonably restricted to narrow bands within each region until the 1Ox level of stimulation (20 dB above electrically evoked auditory brain stem response threshold) was reached. While a monotonic increase in Fos-like immunoreactivity with increasing stimulus level was observed in most nuclei, for cells of the superficial layer of the dorsal cochlear nucleus, a non-monotonic change with increasing stimulus level was seen. This dorsal cochlear nucleus non-monotonicity may indicate that, at higher levels of stimulation, a secondary indirect inhibitory input, probably associated with activation of deep layer dorsal cochlear nucleus cells, reduces excitatory responses at the superficial layer of the dorsal cochlear nucleus. Electrically evoked auditory brain stem response and Fos expression showed parallel changes as a function of stimulus level and pulse duration. The data indicate that discrete activation of cell populations within the central auditory pathways can occur with bipolar electrical stimulation to the highest levels of stimulation typically useful in humans. The data also indicate a close, but not identical, quantitative relationship between Fos-like immunoreactivity and electrophysiological response amplitude. These findings support the view that a study of Fos-like immunoreactivity can provide a powerful and quantitative tool for study of the dynamic response characteristics of cells of the central auditory system to electrical stimulation at suprathreshold levels. The data suggest that there is a monotonic increase in the number of neurons responsive to intracochlear electrical stimulation as a function of stimulus level, at least through the upper half of the dynamic range, but that this increase does not result in a complete loss of spatial selectivity. Coupled with previous psychophysical studies, these results suggest that the increase in the number of activated neurons is functionally beneficial, resulting in improved discrimination of changes in the electrical signals.

Animals↗
PubMed2002

Comparison of speech perception benefits with SPEAK and ACE coding strategies in pediatric Nucleus CI24M cochlear implant recipients.

Nine congenitally deaf children who received a Nucleus CI24M cochlear implant and who were fitted with the SPrint speech processor participated in this study. All subjects were initially programmed with the SPEAK coding strategy and then converted to the ACE strategy. Speech perception was evaluated before and after conversion to the new coding strategy using word and Common Phrase speech recognition tests in both the presence and absence of noise. In quiet conditions, the mean percent correct scores for words were 68.8% with SPEAK and 91% with ACE; for phrases the percentage was 66.6% with SPEAK and 85.5% with ACE. In the presence of noise (at +10 dB signal-to-noise ratio), the mean percent correct scores for words were 43.3% with SPEAK compared to 84.4% with ACE; for phrases the percentage was 41.1% with SPEAK and 82.2% with ACE. Statistical analysis revealed significant improvement in open-set speech recognition with ACE compared to SPEAK. Preliminary data suggest that converting children from SPEAK to the ACE strategy improves their performance. Subjects showed significant improvements for open-set word and sentence recognition in quiet as well as in noise when ACE was used in comparison with SPEAK. The greatest improvements were obtained when tests were presented in the presence of noise.

Acoustic Stimulation↗
PubMed2002

[Electrically evoked auditory nerve compound action potentials in Nucleus CI24M cochlear implant users].

OBJECTIVE: To study the feasibility and clinical applicability of electrically evoked auditory nerve compound action potentials (ECAP) in young patients with Nucleus CI24M cochlear implants. METHOD: ECAPs have been recorded from 37 Nucleus CI24M cochlear implant users in response to monopolar electrical stimulation of the cochlea by using the neural response telemetry(NRT) software and the hardware. Behavioral thresholds and maximum comfortable levels were measured in 12 of those patients. RESULT: ECAPs could be recorded in 87.6% of all patients. Good relations were observed between ECAP threshold and behavioral threshold, but poor relations between ECAP threshold and the impedance of different electrodes. We also observed growth functions and threshold variations of ECAP across subjects for a given place as well as across electrodes within a subject. These findings might be that these particular physiological measures are related to the number of living neural fibers and the excitability of the auditory nerve to electrical stimulation. CONCLUSION: ECAPs were proved to be useful in adjusting the stimulation parameters of the cochlear implant speech processor in order to maximize an individual's performance with the device, especially in young children.

Action Potentials↗
PubMed2001

Relationship between NRT measurements and behavioral levels in children with the Nucleus 24 cochlear implant may change over time: preliminary report.

OBJECTIVE: Response from spiral ganglion cells to electrical stimulation via the Nucleus 24 cochlear implant can be measured using the neural response telemetry system. The purpose of this study was to assess, in children, the correlation between the neural response threshold and the behavioral levels used for cochlear implant programming process. METHODS: The neural response telemetry test was administered to 23 children (mean age at implantation: 4 years) with the Nucleus 24 cochlear implant. Four intra-cochlear electrodes (electrodes 5, 10, 15 and 20) were tested. The neural response threshold at 3, 6, 9 and 12 months post-implantation was compared with the behavioral threshold and the maximum comfort level estimated during the same periods: a Pearson's correlation test was performed for each tested electrode. RESULTS: On apical electrodes, the correlation with the behavioral threshold remained significant from 3 to 12 months post-implantation (r ranging from 0.696 to 0.909, P<0.05), and the correlation with the maximum comfort level was also significant throughout the study period, except on electrode 15 at 9 months (tendency to significance). On basal and intermediate electrodes, statistical correlations were found only at some points of time; nonetheless, at 12 months post-implantation, a significant correlation with behavioral levels could be clearly demonstrated both on electrode 15 (r=0.914--0.778, P<0.05) and on electrode 10 (r=0.845--0.720, P<0.05). CONCLUSIONS: This preliminary study suggests that the correlation between the neural response threshold and behavioral levels may improve from the base towards the apex of the cochlea. However, a significant correlation can be demonstrated for all tested electrodes at 12 months post-implantation. During the first months post-implantation care must be exercised when interpreting neural response telemetry measurements: a positive test does not necessarily mean that the stimulus delivered to the acoustic nerve will be centrally processed with the result of an auditory perception.

Action Potentials↗
PubMed1983

Cytology of periolivary cells and the organization of their projections in the cat.

Projections of cells located near principal nuclei of the superior olive, periolivary cells, were studied by injecting horseradish peroxidase or fluorescent tracers into the cochlea, cochlear nucleus, and inferior colliculus. At least two distinct cytological classes of periolivary cells were found to project to each of these structures. "Large" and "small" olivocochlear cells were labelled. Their cytology and locations were found to be as had been previously described. Some olivocochlear cells also project to the cochlear nucleus. Other major periolivary cell classes that project to the cochlear nucleus include a lateral group of multipolar cells whose members are located around the ipsilateral lateral superior olive and have coarse, darkly staining Nissl substance. The other major periolivary cell class that projects to the cochlear nucleus is the small cell of the ventral nucleus of the trapezoid body. This cell is characterized by its size and by only one or two intensely staining clumps of Nissl substance. Projections of these cells to the cochlear nucleus is from both sides. Periolivary cells that project to the inferior colliculus include medial and lateral groups. Cells of the lateral group project from both sides. These cells are multipolar in shape and contain lightly staining, flocculent Nissl substance. They are predominantly located immediately ventral to the lateral superior olive. Projections from the medial group are predominantly ipsilateral and arise from the region medial to the medial superior olive. The cells are multipolar and contain clumped Nissl substance. They often lie near "large" olivocochlear cells, which they resemble in Nissl material, but are distinguished from the latter in Protargol material by having ring-type axosomatic endings. The appearance and locations of these six classes of periolivary cells make it possible to recognize them in nonexperimental material and to infer with confidence what their projections are. These results show considerable organization of these previously little understood structures.

Animals↗
PubMed1999

Transient CD15 expression reflects stages of differentiation and maturation in the human subcortical central auditory pathway.

The expression of the terminal saccharide determinant CD15 (3[a1-3]-fucosyl-N-acetyl-lactosamine) was evaluated in the central auditory system of the human developing brain by using monoclonal antibodies against this epitope. CD15 immunoreactivity was first observed in the ventral cochlear nucleus at 10 weeks of gestation, whereas the dorsal cochlear nucleus became positive from 13 weeks of gestation. In both nuclei, the intensity of immunoreactivity increased until 16 weeks of gestation and lasted until 25 weeks of gestation. In the inferior colliculi, CD15 was poorly expressed in the central nucleus from 13 to 23 weeks of gestation and later with moderate levels until birth. Within the medial geniculate nucleus, a biphasic pattern of expression was observed with peaks around 14-17 and 21-24 weeks of gestation. Heterogeneous expression in the medial geniculate nucleus, which was associated either with neurons or the neuropil, allowed distinction of subnuclei. In many of the auditory pathway structures (e.g., ventral cochlear nucleus and central nucleus of the inferior colliculus), a heterogeneous pattern of CD15 expression in the form of repeating parallel bands, possibly related to tonotopic organization, became transiently apparent around 23 weeks of gestation, whereas in the magnocellular part of the medial geniculate nucleus, a striking modular or compartmental arrangement of immunoreactive structures (which could also be associated with tonotopic organization) was also noted at about 23 weeks of gestation. We propose that the initiation of CD15 expression in each nucleus heralds the appearance of functional contacts and that high levels of neuropil labeling are related to the formation of nonstabilized synaptic contacts. Thus, transient CD15 expression in the central auditory system is possibly correlated with phases of functional plasticity in this pathway.

Aging↗
PubMed1999

Spatial organization of the reciprocal connections between the cat dorsal and anteroventral cochlear nuclei.

We are studying the interconnections between the anteroventral cochlear nucleus (AVCN) and the dorsal cochlear nucleus (DCN). Biotinylated dextran was injected into the DCN, where the best frequency of responses was also recorded. Ventrotubercular neurons in AVCN were labeled, along with cochlear nerve fibers and the axons of cells in DCN. In AVCN, a central band of labeled cochlear nerve axons and large endbulbs was labeled. Bordering this band was a 'fringe' of smaller tuberculoventral axonal endings forming pericellular nests. Most AVCN neurons projecting to DCN were stellate, elongate, or giant cells, located in the posterior division of AVCN, regardless of the DCN injection site. About 75% of the labeled AVCN cells lay within the bands of labeled cochlear nerve fibers. Another 15% were in the outer fringes on either side of these bands, while 10% were outside the bands and the fringes. These findings suggest that most AVCN neurons projecting to the DCN conform to the tonotopic map. A significant portion of the ventrotubercular neurons occupy side-bands in AVCN. Reciprocally, the tuberculoventral tract forms a robust fringe of axonal endings flanking the central bands. The neuronal and axonal bands and side-bands may underlie excitatory and inhibitory signal transformations.

Animals↗
PubMed1983

On the origin of the compound action potentials (N1, N2) of the cochlea of the rat.

The origin of N2 component of the compound action potential was studied by comparing the potential recorded at the round window with the response recorded from the cochlear nucleus, by comparing the potential recorded at the round window before and after the cochlear nucleus was removed by suction, and by comparing latencies of unit responses from auditory nerve fibers and cochlear nucleus units with the responses from the round window. The results indicated that the N2 potential, as well as the positive potential between the N1 and N2, was generated by secondary auditory neurons situated in the cochlear nucleus. The results were based on the response to click sounds and cross correlograms of the response to continuous sounds that were amplitude-modulated with pseudorandom noise.

Acoustic Stimulation↗
PubMed1987

Maturation of synapses and electrical properties of cells in the cochlear nuclei.

Auditory nerve fibers carry impulses from the cochlea to the cochlear nuclei. There the temporal firing patterns of auditory nerve fibers are preserved by some cells and altered by others. The two factors which govern how firing patterns are shaped are (1) the intrinsic electrical properties of cells that determine the size and time course of voltage changes caused by synaptic currents and (2) the synaptic circuitry between cells. The electrical properties of cells were measured by recording the responses to current injected intracellularly into brain slice preparations. The synaptic responses to electrical shocks of the auditory nerve were used to determine the functional properties of synaptic connections. The three distinct types of electrical properties of cells that can be distinguished electrophysiologically in similar preparations of mature tissue, bushy and stellate cells in the ventral cochlear nucleus [(1984) J. Neurosci. 4, 1577-1588] and cells in the dorsal cochlear nucleus [Hirsch and Oertel (1987) (submitted); Oertel et al. (1987) In: Functions of the Auditory System, Editor: S. Hassler. J. Wiley and Sons (in press)] can be differentiated at least as early as 7 days after birth. Young cells, however, have higher input resistances and lower input capacitances than mature cells, and they cannot sustain high firing rates. Bushy and stellate cells in the ventral cochlear nucleus respond to electrical stimulation of the auditory nerve with both excitatory and inhibitory postsynaptic potentials as early as 4 days after birth. The synaptic potentials occur with longer and more variable latencies than in mature cells and synapses fatigue more easily, however. Cells of the dorsal cochlear nucleus also receive both excitatory and inhibitory synaptic inputs 4 days after birth, upon stimulation of the auditory nerve. No systematic changes were detected in these synaptic responses as a function of age but this may have been because the variability in the shape and timing of synaptic responses was large even in mature tissue.

Action Potentials↗
PubMed1981

HRP study of the organization of auditory afferents ascending to central nucleus of inferior colliculus in cat.

The ascending auditory projections to central nucleus of inferior colliculus and its ventrolateral and dorsomedial subdivisions (ICVL and ICDM) have been studied in cat using both pressure and electrophoretic injections of horseradish peroxidase (HRP). The results indicate that the predominant ascending projections to inferior colliculus originate in (1) contralateral cochlear nucleus, (2) contralateral and ipsilateral lateral superior olive, (3) ipsilateral medial superior olive, (4) ipsilateral ventral nucleus of the lateral lemniscus, (5) ipsilateral and contralateral dorsal nucleus of the lateral lemniscus, and (6) contralateral inferior colliculus. In addition, ipsilateral cochlear nucleus, ipsilateral and contralateral intermediate nucleus of the lateral lemniscus, ipsilateral, and to a lesser extent contralateral, periolivary nuclei project to inferior colliculus. Of these nuclei, the lateral superior olive projects exclusively to ICVL and ipsilateral cochlear nucleus and contralateral inferior colliculus project mostly, if not exclusively, to ICDM. Many of these projections demonstrate a cochleotopic organization and frequency a nucleotopic organization as well. A cochleotopic organization of the projections is apparent for cochlear nucleus and superior olivary complex. A nucleotopic organization suggests that the heaviest terminations of contralateral inferior colliculus are medial and dorsal in inferior colliculus, of medial superior olive are dorsal and lateral, of superior olivary complex are rostral, of cochlear nucleus are caudal, and of ventral nucleus of the lateral lemniscus are caudal.

Animals↗
PubMed1999

Cochlear and trigeminal systems contributing to the startle reflex in rats.

The startle reflex is evoked by strong acoustic or tactile stimuli, or by electrical stimulation of acoustic or tactile pathways. To dissociate the contributions of acoustic and tactile pathways, stimulating electrodes were placed in adjacent cochlear and trigeminal nuclei. The currents needed to evoke startle-like responses were an order of magnitude lower in ventral trigeminal sites (12-80 microA for a 0.1-ms pulse) than in cochlear nucleus sites (150-800 microA). At low threshold sites in both areas, brief acoustic stimuli were followed 0-4 ms later by a single electrical pulse and the current required to evoke startle was measured at several interstimulus intervals. Summation between the acoustic and electrical stimuli for startle was strong in both cochlear and trigeminal sites. Collision effects were found in the anteroventral cochlear nucleus when the electrical stimulus followed the ipsilateral acoustic stimulus by 2.0 ms, suggesting that acoustic startle is mediated by axons in the anteroventral cochlear nucleus. Collision effects were found at 4.0 ms if the electrical stimulus was presented in the contralateral pontine reticular formation, suggesting that acoustic signals mediating startle mainly cross to the pontine reticular formation. Collision effects were not found in medial or posterior sites in the cochlear nucleus, or trigeminal sites, suggesting that the neurons that mediate startle in these sites do not mediate acoustic startle. Therefore, acoustic startle is mediated through high threshold cochlear nucleus sites, while low threshold sites are non-acoustic, probably as a result of trigeminal or vestibular stimulation.

Acoustic Stimulation↗
PubMed2005

Electrical stimulation of the cochlear nerve in rats: analysis of c-Fos expression in auditory brainstem nuclei.

We investigated functional activation of central auditory brainstem nuclei in response to direct electrical stimulation of the cochlear nerve using c-Fos immunoreactivity as a marker for functional mapping. The cochlear nerve was stimulated in the cerebellopontine angle of Lewis rats applying biphasic electrical pulses (120-250 muA, 5 Hz) for 30 min. In a control group, bilateral cochlectomy was performed in order to assess the basal expression of c-Fos in the auditory brainstem nuclei. The completeness of cochlear ablations and the response of auditory brainstem nuclei to electrical stimulation were electrophysiologically verified. C-Fos immunohistochemistry was performed using the free floating method. In anaesthetized animals with unilateral electrical stimulation of the cochlear nerve, increased expression of c-Fos was detected in the ipsilateral ventral cochlear nucleus (VCN), in the dorsal cochlear nucleus bilaterally (DCN), in the ipsilateral lateral superior olive (LSO) and in the contralateral inferior colliculus (IC). A bilateral slight increase of c-Fos expression in all subdivisions of the lateral lemniscus (LL) did not reach statistical significance. Contralateral inhibition of the nuclei of the trapezoid body (TB) was observed. Our data show that unilateral electrical stimulation of the cochlear nerve leads to increased expression of c-Fos in most auditory brainstem nuclei, similar to monaural auditory stimulation. They also confirm previous studies suggesting inhibitory connections between the cochlear nuclei. C-Fos immunoreactivity mapping is an efficient tool to detect functional changes following direct electrical stimulation of the cochlear nerve on the cellular level. This could be particularly helpful in studies of differential activation of the central auditory system by experimental cochlear and brainstem implants.

Animals↗
PubMed1997

Localization of Fos-like immunoreactivity induced by the NK3 tachykinin receptor agonist, senktide, in the guinea-pig brain.

1. The effects of intracerebroventricular (i.c.v.) administration of the NK3 tachykinin receptor agonist, senktide (10 nmol each side), in guinea-pigs pretreated with the selective NK3 tachykinin receptor antagonist, SR142801 (3 mg kg(-1) subcutaneous, s.c., 30 min before senktide), or its less active enantiomer, SR142806 (3 mg kg(-1) s.c. 30 min before senktide), on behaviour and on the distribution of Fos-like immunoreactivity (Fos-LI) in central neurones were investigated. Guinea-pigs were chosen for the study since they possess NK3 tachykinin receptors with pharmacological characteristics similar to those in man. 2. Wet-dog shakes, but not locomotor activity, elicited by senktide i.c.v. were significantly reduced by SR142801 but not by SR142806, confirming the involvement of NK3 tachykinin receptors in wet-dog shake behaviour. 3. Senktide induced increased numbers of Fos-LI neurones in the following brain areas: frontal, parietal and piriform cortex, the lateral septum, the CA1, CA2, subiculum and dentate gyrus of the hippocampus, most areas in the amygdala, thalamus and hypothalamus, medial geniculate nucleus and the ventral cochlear nucleus. Pretreatment with SR142801, but not with SR142806, before administration of senktide inhibited Fos-LI expression in the cingulate cortex, dentate gyrus of the hippocampus, some regions of the thalamus, hypothalamus and amygdala and the ventral cochlear nucleus. 4. The present results are the first demonstration that senktide induces Fos-LI in widespread areas of the guinea-pig brain. It is proposed that NK3 tachykinin receptors may play a more extensive role in the control of diverse brain functions, including cortical processing, learning and memory, neuroendocrine and behavioural regulation, than is currently recognized.

Animals↗
PubMed1994

Distribution of Fos-like immunoreactivity in the auditory pathway of the Sprague-Dawley rat elicited by cochlear electrical stimulation.

Fos-like immunoreactivity (FLI) was mapped in the auditory pathway of Sprague-Dawley rats in response to unilateral electrical stimulation of the cochlea implanted with two stimulating electrodes. Densely packed FLI neurons were widely distributed in the dorsal cochlear nucleus (more ipsilaterally than contralaterally), while FLI neurons were rare in the posteroventral cochlear nucleus and virtually absent in the anteroventral cochlear nucleus. Sparse FLI was detected in the superior olivary complex, the pontine nuclei and the ipsilateral dorsal nucleus of the lateral lemniscus, whereas the contralateral dorsal nucleus of the lateral lemniscus was moderately labeled. In the inferior colliculus, the pattern of FLI was similar on both sides, restricted mainly to its dorsal and external cortices. At the thalamic level, FLI neurons were seen in the dorsal and medial divisions of the medial geniculate body as well as in the peripeduncular nucleus. A significant increase of FLI was observed in the temporal cortex. This study demonstrates the presence of selective functional changes along the auditory pathway elicited by electrical stimulation of the cochlea, as revealed by FLI.

Acoustic Stimulation↗
PubMed2005

External inferior colliculus integrates trigeminal and acoustic information: unit responses to trigeminal nucleus and acoustic stimulation in the guinea pig.

The external nucleus of the inferior colliculus (ICx) receives ascending projections from both auditory and somatosensory nuclei. In the guinea pig, both the spinal trigeminal nucleus (TN) and the cochlear nucleus converge in the ventrolateral region of ICx. We investigated the function of trigeminal-collicular pathways by electrically stimulating the TN while recording unit responses from ICx. Pairing electrical stimulation with acoustic stimuli allowed us to investigate the function of converging auditory and somatosensory inputs, i.e. multisensory integration. Unit responses were recorded from ICx using a multi channel, single shank electrode. Electrical stimulation of the TN produced small changes above or below spontaneous rate, but resulted in significant suppression or enhancement of sound-evoked responses. Multisensory integration has been demonstrated in the dorsal cochlear nucleus (DCN), superior colliculus and sensory cortices and may play a role in plasticity that occurs after sensory deprivation.

Acoustic Stimulation↗
PubMed1984

Changes in subcortical visual and auditory evoked potentials following amygdaloid kindling in cats.

In this study we dealt with the changes in visual and auditory evoked potentials following kindling, to reveal the distant effects of epileptic activity. The experiments were performed using cats. Visual and auditory evoked potentials were obtained initially. Daily stimulation of 60 Hz (rectangular wave, 1 ms in duration, 500 microA in peak current, 2-s train) was given to the right amygdala, for kindling. After the completion of kindling, evoked responses were recorded again. In the auditory system the changes of responses in the cortex, medial geniculate nucleus, and cochlear nucleus were distinguished. The changes of potentials in the subcortex were larger than those at the cortical level. For visual evoked potentials there was a discrepancy between stimulation with light and electrical stimulation of the optic chiasm. There was no significant change in amplitude of visual evoked potentials by flash. In the case of optic chiasm stimulation, an enlargement of evoked responses was obtained. These results indicate modality-specific change of the auditory system and widespread subcortical change. These results might be caused by some vulnerability of the auditory system in the case of amygdaloid kindling, as a result of the epileptogenic process.

Amygdala↗
PubMed2000

Plasticity of the auditory brainstem: cochleotomy-induced changes of calbindin-D28k expression in the rat.

Calbindin is a calcium binding protein that is characteristically expressed in several auditory brainstem nuclei during ontogeny and is thought to serve as a buffer, protecting cells against toxic levels of calcium. Upon maturation, calbindin is drastically reduced or entirely lost in many auditory nuclei. We made cochleotomies in mature rats to study effects of deafening and deafferentation on the expression of calbindin in the auditory brainstem. Following unilateral cochleotomy, we observed a substantial increase in the number of calbindin-immunoreactive fibers and boutons in the ventral subdivisions of the ipsilateral cochlear nucleus. At the same time, calbindin-positive astrocytes emerged in the dorsal and ventral cochlear nucleus. Beyond the immediately affected ipsilateral cochlear nucleus, we found calbindin-positive neurons in the lateral superior olive and in the central inferior colliculus, both contralateral to the operation. The loss of one cochlea reduces auditory input and puts the flow of neuronal activity originating in the two ears out of balance. Our findings indicate that the need for the neuronal networks in the auditory brainstem to adjust to this drastically changed pattern of sensory signals invokes the expression of calbindin in glial cells as well as in directly and indirectly affected neuronal cell populations.

Animals↗
PubMed1997

Speech perception performance of nucleus multichannel cochlear implant users with partial electrode insertions.

OBJECTIVE: The present investigation examined the speech perception performance of five children with ossified cochleas who received partial insertions of the Nucleus 22-channel cochlear implant. DESIGN: The partial-insertion subjects' preimplant and 1.5 yr postimplant performance on a battery of speech perception tests was compared to the average performance of age-matched control subjects who received full electrode insertions. All the partial-insertion subjects were fit with their Nucleus cochlear implant between the ages of 2 and 5 yr, and had used their device for at least 1.5 yr. More extended comparisons also were made for the two partial-insertion subjects who had used their cochlear implants for a longer period of time. RESULTS: The subjects with partial electrode insertions performed similarly to the control group at both the preimplant and 1.5 yr postimplant intervals. Furthermore, the partial-insertion subjects showed continued improvements in speech perception performance with increased device experience past 1.5 yr, again similar to the full-insertion control group. CONCLUSIONS: The present results suggest that partial insertion of a multichannel implant device is an appropriate and feasible approach to the surgical management and auditory rehabilitation of children with extensive or complete ossification of the cochlea.

Child, Preschool↗