Review of current status of cochlear prostheses

Strategies to improve electrode positioning and safety in cochlear implants

An injection-molded internal supporting rib has been produced to control the flexibility of silicone rubber encapsulated electrodes designed to electrically stimulate the auditory nerve in human subjects with severe to profound hearing loss. The rib molding dies, and molds for silicone rubber encapsulation of the electrode, were designed and machined using AutoCad and MasterCam software packages in a PC environment. After molding, the prototype plastic ribs were iteratively modified based on observations of the performance of the rib/silicone composite insert in a clear plastic model of the human scala tympani cavity. The rib-based electrodes were reliably inserted farther into these models, required less insertion force and were positioned closer to the target auditory neural elements than currently available cochlear implant electrodes. With further design improvements the injection-molded rib may also function to accurately support metal stimulating contacts and wire leads during assembly to significantly increase the manufacturing efficiency of these devices. This method to reliably control the mechanical properties of miniature implantable devices with multiple electrical leads may be valuable in other areas of biomedical device design.

Discrimination of synthetic vowels by using tactile vocoder and a comparison to that of an eight-channel cochlear implant

A vowel discrimination test using a tactual vocoder was administered and the results were compared to that of an eight-channel cochlear implant. Both the tactile vocoder and the cochlear implant divided the speech signals into 16 frequency components using band-pass filters and lateral inhibition circuits. In the tactile vocoder, these 16 components were converted into a vibration with 200 Hz frequency and applied to a 3 x 16 element vibrator array using bimorph piezoelectric elements. The vibratory patterns were sensed on the fingertip. In the cochlear implant, the 16 components were reduced to eight current stimulation signals, consisting of biphasic pulses with 200 Hz frequency, which were applied to an eight-channel electrode array implanted in the scala tympani. The electrode array passed through the round window into the scala tympani to a depth of 23 mm. These psychophysical experiments investigate the ability of human subjects to discriminate synthetic vowels as a function of the number of channels employed. The results suggested that an eight-channel and a 16-channel tactile vocoder provided essentially the same discrimination scores. However, the ability to discriminate synthetic vowels decreased rapidly when less than eight channels were employed. The ability of an eight-channel tactile vocoder is expected to be better than that of the eight-channel cochlear implant because it is supposed that vowel discrimination is degraded by a phenomenon known as "current spreading" in the case of cochlear stimulation. However, the comparison between the two devices was not done on the cochlear implant subject.