A Technique for Implantation of a 3-Dimensional Penetrating Electrode Array in the Modiolar Nerve of Cats and Humans
Abstract
BACKGROUND: We believe that direct intraneural stimulation of the modiolar nerve using an array of electrodes will have lower thresholds, offer greater frequency selectivity and more stimulation sites, and have a greater frequency representation than conventional cochlear implants. OBJECTIVES: To describe a potential auditory prosthesis based on electrical stimulation of the modiolar cochlear nerve and to report the development of a surgical approach in human and animal models. DESIGN: Cadaveric human and animal studies conducted in temporal bones indicated that an array of penetrating microelectrodes could be implanted in the modiolar nerve. Cat studies using anesthesia were performed to develop the surgical procedure in an animal model. Nerve viability was assessed by measurement of electrically evoked auditory brainstem responses at different stages of the surgery. SUBJECTS: Two fresh cadaveric human temporal bones, 3 cat cadavers, 1 pig cadaver, and 6 anesthetized cats were used in the experiments. RESULTS: We were able to implant arrays containing 20 microelectrodes in the human modiolar nerve after exposure by a modified extended facial recess approach. In animals, the modiolar nerve was accessed by the transbulla and the middle fossa approach. The cat was chosen as the appropriate animal model, and the transbulla approach was selected. The round window was exposed by ventral access to the bulla and after cochleostomy; drilling the modiolar bone exposed the modiolar nerve. The mean +/- SD diameter of the exposed nerve in cats was 1.64 +/- 0.07 mm (n = 9), and the mean +/- SD exposed length was 2.50 +/- 0.11 mm (n = 9); this is adequate to accommodate 20 microelectrodes. The electrically evoked auditory brainstem responses indicated nerve survival during and after the surgery. CONCLUSIONS: The surgical technique allows implantation of up to 20 microelectrodes in the cat and human modiolar nerve. The nerve survives the surgical procedure. This work enables studies in the electrophysiological properties and consequences of long-term implantation.
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The authors developed a novel, high electrode-density (25 electrodes/mm2), high electrode-count (48-96 electrodes) penetrating neural interface designed for stimulation and recording in sub-millimeter neuroanatomical structures, such as small diameter nerves (<2 mm).
“We have developed a novel, high electrode-density (25 electrodes/mm 2 ), high electrode-count (48-96 electrodes) penetrating neural interface, designed for use in stimulation and recording in sub-millimeter neuroanatomical structures, such as small diameter nerves (<2 mm) like the rat sciatic [37], feline pudendal [38], or feline/human cochlear nerves [46].”
From A new high-density (25 electrodes/mm<sup>2</sup>) penetrating microelectrode array for recording and stimulating sub-millimeter neuroanatomical structures (2013) · cites this paper as [46]
Cites
Statistical pattern recognition: a review
Jain, A. K., Duin, P., & Mao, J. (2000) · IEEE Transactions on Pattern Analysis and Machine Intelligence · doi:10.1109/34.824819 · Cited by 6,795 · see citing works
A review of methods for spike sorting: the detection and classification of neural action potentials
Lewicki, M. S. (1998) · Network Computation in Neural Systems · doi:10.1088/0954-898x_9_4_001 · Cited by 1,372 · see citing works
Campbell, P. K., Jones, K. E., Huber, R. J., Horch, K. W., & Normann, R. A. (1991) · IEEE Transactions on Biomedical Engineering · doi:10.1109/10.83588 · Cited by 881 · see citing works
Self-citationMaynard, E. M., Nordhausen, C. T., & Normann, R. A. (1997) · Electroencephalography and Clinical Neurophysiology · doi:10.1016/s0013-4694(96)95176-0 · Cited by 640 · see citing works
Self-citationA neural interface for a cortical vision prosthesis
Normann, R. A., Maynard, E. M., Rousche, P. J., & Warren, D. J. (1999) · Vision Research · doi:10.1016/s0042-6989(99)00040-1 · Cited by 411 · see citing works
Self-citationAuditory‐Nerve Activity in Cats with Normal and Abnormal Cochleas
Kiang, N. Y. S., Moxon, E. C., & Levine, R. A. (1970) · Novartis Foundation symposium · doi:10.1002/9780470719756.ch15 · Cited by 386 · see citing works
Selective Stimulation of Cat Sciatic Nerve Using an Array of Varying-Length Microelectrodes
Branner, A., Stein, R. B., & Normann, R. A. (2001) · Journal of Neurophysiology · doi:10.1152/jn.2001.85.4.1585 · Cited by 358 · cited 3× · see citing works
“A significant feature of intraneural stimulation with an array of penetrating electrodes is that the active tips of the electrodes are directly apposed to the fibers of the nerve.(4) This apposition, and the small diameters of the tips of the penetrating electrodes, result in highly selective stimulation of nerve fibe…”
BackgroundMethodInfluentialSelf-citationA method for pneumatically inserting an array of penetrating electrodes into cortical tissue
Rousche, P. J., & Normann, R. A. (1992) · Annals of Biomedical Engineering · doi:10.1007/bf02368133 · Cited by 305 · see citing works
Self-citationAuditory brain stem responses in the cat. I. Intracranial and extracranial recordings
Achor, L. J., & Starr, A. (1980) · Electroencephalography and Clinical Neurophysiology · doi:10.1016/0013-4694(80)90301-6 · Cited by 268 · see citing works
Auditory brain stem responses in the cat. II. Effects of lesions
Achor, L. J., & Starr, A. (1980) · Electroencephalography and Clinical Neurophysiology · doi:10.1016/0013-4694(80)90302-8 · Cited by 222 · see citing works
Cochlear Implants in Adults and Children
Gates, G. A. (1995) · JAMA · doi:10.1001/jama.1995.03530240065043 · Cited by 212 · see citing works
Rousche, P. J., & Normann, R. A. (1999) · IEEE Transactions on Rehabilitation Engineering · doi:10.1109/86.750552 · Cited by 187 · see citing works
Self-citationThe Contour Electrode Array: Safety Study and Initial Patient Trials of a New Perimodiolar Design
Tykocinski, M., Saunders, E., Cohen, L. T., Treaba, C. G., Briggs, R., Gibson, P., Clark, G. M., & Cowan, R. (2001) · Otology & Neurotology · doi:10.1097/00129492-200101000-00007 · Cited by 114 · see citing works
Shapes of Tuning Curves for Single Auditory-Nerve Fibers
Kiang, N. Y. S., Sachs, M. B., & Peake, W. T. (1967) · The Journal of the Acoustical Society of America · doi:10.1121/1.1910723 · Cited by 89 · see citing works
Perimodiolar Electrodes in Cochlear Implant Surgery
Gstoettner, O. A. W. K. (2001) · Acta Oto-Laryngologica · doi:10.1080/000164801300043569 · Cited by 85 · see citing works
CURRENT DISTRIBUTIONS IN COCHLEAR STIMULATIONa
Black, R. C., Clark, G. M., Tong, Y. C., & Patrick, J. F. (1983) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1983.tb31626.x · Cited by 49 · see citing works
On the Separation of Signals from Neighboring Cells in Tetrode Recordings
Sahani, M., Pezaris, J. S., & Andersen, R. A. (1997) · CaltechAUTHORS (California Institute of Technology) · Cited by 44 · see citing works
Cat anatomy;: An atlas, text, and dissection guide
McClure, R. C., Dallman, M. J., & Garrett, P. D. (1973) · Medical Entomology and Zoology · Cited by 37 · see citing works
Electrically Induced Auditory Brainstem Response as a Clinical Tool in Estimating Nerve Survival
Simmons, F. B., Meyers, T., Lusted, H. S., & Shelton, C. (1984) · Annals of Otology Rhinology & Laryngology · doi:10.1177/00034894840930s417 · Cited by 34 · see citing works
Self-citationComparison of electrode sites in electrical stimulation of the cochlea
Lusted, H. S., Shelton, C., & Simmons, F. B. (1984) · The Laryngoscope · doi:10.1288/00005537-198407000-00003 · Cited by 28 · see citing works
Self-citationWalker, W. F. (1993) · Cited by 6 · see citing works
Atlas of the human and cat temporal bone
Silverstein, H. (1972) · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Radman, T., Ramos, R. L., Brumberg, J. C., & Bikson, M. (2009) · Brain stimulation · doi:10.1016/j.brs.2009.03.007 · Cited by 704 · see citing works
Safety of long-term electrical peripheral nerve stimulation: review of the state of the art
Günter, C., Delbeke, J., & Ortiz-Catalan, M. (2019) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/s12984-018-0474-8 · Cited by 198 · see citing works
Wark, H. A. C., Sharma, R., Mathews, K. S., Fernandez, E., Yoo, J., Christensen, B., Tresco, P., Rieth, L., Solzbacher, F., Normann, R. A., et al. (2013) · Journal of Neural Engineering · doi:10.1088/1741-2560/10/4/045003 · Cited by 148 · see citing works
Self-citationRoche, J. P., & Hansen, M. R. (2015) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2015.07.009 · Cited by 149 · see citing works
Intraneural stimulation for auditory prosthesis: Modiolar trunk and intracranial stimulation sites
Middlebrooks, J. C., & Snyder, R. L. (2008) · Hearing Research · doi:10.1016/j.heares.2008.04.001 · Cited by 55 · see citing works
Cartee, L. A., Miller, C. A., & van den Honert, C. (2006) · Hearing Research · doi:10.1016/j.heares.2006.02.012 · Cited by 41 · see citing works
Development of a Novel Eighth‐Nerve Intraneural Auditory Neuroprosthesis
Badi, A. N., Kertesz, T. R., Gurgel, R. K., Shelton, C., & Normann, R. A. (2003) · The Laryngoscope · doi:10.1097/00005537-200305000-00012 · Cited by 38 · see citing works
Self-citationForward-masking patterns produced by symmetric and asymmetric pulse shapes in electric hearing
Macherey, O., Wieringen, A. V., Carlyon, R. P., Dhooge, I. J. M., & Wouters, J. M. (2010) · The Journal of the Acoustical Society of America · doi:10.1121/1.3257231 · Cited by 33 · see citing works
Prosthetic Stimulation of the Auditory System with Intraneural Electrodes
Arts, H. A., Jones, D. A., & Anderson, D. J. (2003) · Annals of Otology, Rhinology & Laryngology · doi:10.1177/00034894031120s905 · Cited by 22 · see citing works
Biomedical Manufacturing: A Review of the Emerging Research and Applications
Chen, R. K., Chang, R. C., Tai, B. L., Huang, Y. H., Özdoğanlar, O. B., Li, W., & Shih, A. J. (2020) · Journal of Manufacturing Science and Engineering · doi:10.1115/1.4048043 · Cited by 20 · see citing works
Augmented Reality Based Transmodiolar Cochlear Implantation
Guigou, C., Hussain, R., Lalande, A., & Grayeli, A. B. (2021) · Otology & Neurotology · doi:10.1097/mao.0000000000003437 · Cited by 13 · see citing works
Afifi, W. F. S., Guigou, C., Mazalaigue, S., Camuset, J.-P., Ricolfi, F., & Grayeli, A. B. (2015) · Audiology and Neurotology · doi:10.1159/000366513 · Cited by 11 · see citing works
Development of an electrode for the artificial cochlear sensory epithelium
Tona, Y., Inaoka, T., Ito, J., Kawano, S., & Nakagawa, T. (2015) · Hearing Research · doi:10.1016/j.heares.2015.08.007 · Cited by 10 · see citing works
Kim, S., Badi, A. N., & Normann, R. A. (2007) · The Laryngoscope · doi:10.1097/mlg.0b013e31804714a7 · Cited by 10 · see citing works
Self-citationTranscanal approach for implantation of a cochlear nerve electrode array
Kiumehr, S., Mahboubi, H., Middlebrooks, J. C., & Djalilian, H. R. (2013) · The Laryngoscope · doi:10.1002/lary.23833 · Cited by 8 · see citing works
Modifying Cochlear Implant Design: Advantages of Placing a Return Electrode in the Modiolus
Ho, S. Y., Wiet, R. J., & Richter, C. (2004) · Otology & Neurotology · doi:10.1097/00129492-200407000-00017 · Cited by 8 · see citing works
Custom Skull Cap With Precision Guides for Deep Insertion of Cellular-Scale Microwire Into Rat Brain
Chen, L., Hartner, J. P., Dyke, D. V., Dong, T., Watson, B. O., & Shih, A. J. (2019) · doi:10.1115/msec2019-2967 · Cited by 7 · see citing works
Thomas, W., Zuniga, S. A., Sondh, I., Leber, M., Solzbacher, F., Lenarz, T., Lim, H. H., Warren, D. J., Rieth, L. W., & Adams, M. E. (2024) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1308663 · Cited by 7 · see citing works
Theunisse, H. J., Gotthardt, M., & Mylanus, E. A. M. (2012) · Otology & Neurotology · doi:10.1097/mao.0b013e318259b5b3 · Cited by 5 · see citing works
Recent and future developments in cochlear implant technology: review of the literature
Forlì, F., Lazzerini, F., Bruschini, L., Danti, S., & Berrettini, S. (2021) · Otorhinolaryngology · doi:10.23736/s2724-6302.21.02379-3 · Cited by 5 · see citing works
Guigou, C., Leterme, G., Pasquis, B., Martin, L., Tourrel, G., Brétillon, L., & Grayeli, A. B. (2016) · Audiology and Neurotology · doi:10.1159/000444005 · Cited by 5 · see citing works
Miller, B. T., & Hillman, T. A. (2006) · The Laryngoscope · doi:10.1097/01.mlg.0000221966.27228.a8 · Cited by 4 · see citing works
Self-citationThe auditory nerve implant—concept and device description of a novel electrical auditory prosthesis
Lenarz, T., Solzbacher, F., Rieth, L. W., Leber, M., Adams, M. E., Salcher, R. B., Warren, D. J., Oxenham, A. J., Dyballa, K.-H., Samii, A., et al. (2025) · Bioelectronic Medicine · doi:10.1186/s42234-025-00188-3 · Cited by 4 · see citing works
Chiou, L.-K., Brown, C. J., Abbas, P. J., Hansen, M. R., Holte, L., & Oleson, J. (2016) · doi:10.17077/etd.gko4dc57 · Cited by 1 · see citing works
Cochleotopy of human cochlear nucleus
Sharma, S., Ray, B. S., Dinda, A. K., & Roy, T. S. (2015) · Journal of Anatomical Society of India · doi:10.1016/j.jasi.2015.04.001
A Penetrating Auditory Nerve Array for Auditory Prosthesis
Middlebrooks, J. C., & Snyder, R. L. (2011) · Springer handbook of auditory research · doi:10.1007/978-1-4419-9434-9_7
Edin, F. (2016) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Development of a non-human primate model for preclinical research of a novel auditory nerve implant
Sondh, I., Johnson, L. A., Ghose, G. M., Loveland, A., Larson, L., Lim, H. H., & Adams, M. E. (2025) · Frontiers in Neuroscience · doi:10.3389/fnins.2025.1669116
- Authors
- Badi, A. N., Hillman, T., Shelton, C., & Normann, R. A.
- Affiliations
- University of Utah (US)
- Corresponding author
- Normann, Richard A.
- Venue
- Archives of Otolaryngology–Head & Neck Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 2002-09-01
- Volume
- 128
- Issue
- 9
- Pages
- 1019
- ISSN
- 0886-4470 (ISSN-L)
- OpenAlex
- W1969874650
- Cited by
- 30
- References
- 22
- Citations by year
- 2025: 2 · 2024: 1 · 2021: 3 · 2020: 2 · 2019: 2 · 2016: 3 · 2015: 4 · 2013: 2 · 2012: 1
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Otolaryngology - Head and Neck Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Deafness and Other Communication Disorders (N01-DC-1-2108)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Keywords
- auditory prosthesis, cochlear implant alternative, electrically evoked auditory brainstem response, surgical implantation technique, cat model, cadaveric temporal bone
- MeSH terms
- Animals, Cats, Cochlear Nerve, Disease Models, Animal, Electric Stimulation, Electrodes, Implanted, Electrophysiology, Feasibility Studies, Hearing Disorders, Humans, Swine, Temporal Bone, Prosthesis Implantation
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