Cochlear Pathology: Hazards of Long-term Implants

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Abstract
• There is increasingly diverse evidence that multichannel intrascalar or modiolar implants can cause long-term changes in cochlear structure. Experimental studies show that nerve-cell loss and osteogenesis are related to electrical stimulation. Low charge densities may limit such intracochlear changes. Middle-ear stimulation presents an alternative to the intracochlear implant, although its degree of effectiveness is not well characterized. Monitoring electrically produced auditory brain-stem responses may help detect progressive pathologic changes occurring in the implanted cochlea. (Arch Otolaryngol 1984;110:164-166)