The Underlying Mechanism of Preventing Facial Nerve Stimulation by Triphasic Pulse Stimulation in Cochlear Implant Users Assessed With Objective Measure

Bahmer, Andreas; Baumann, Uwe

doi:10.1097/mao.0000000000001156

Cited by 34 publications

(40 citation statements)

References 11 publications

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“…FNS was either completely or partially eliminated during this study using various programming techniques during fitting, such as deactivating channels, changing the phase duration, changing the coding strategy, or using triphasic pulses. Previous studies have reported good results with the use of triphasic pulses instead of biphasic pulses, 2,15–17 and they proved effective in our study for reducing FNS, particularly for higher‐grade FNS. Triphasic pulses reduce the effects of FNS by distributing the charge across two negative phases of the same duration and one positive phase with a double duration time 2 .…”

Section: Discussionsupporting

confidence: 56%

“…Several methods have been applied to reduce the effects of FNS. These include changing the mapping program, turning off the electrode contacts that are causing FNS, changing the current levels, or using triphasic pulses instead of biphasic pulses 2,15–17 . However, these strategies can sometimes result in a less than ideal fitting map for the CI recipient 12 .…”

Section: Introductionmentioning

confidence: 99%

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Investigating Facial Nerve Stimulation After Cochlear Implantation in Adult and Pediatric Recipients

et al. 2020

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Objectives/Hypothesis Facial nerve stimulation (FNS) can occur after cochlear implantation for a small number of recipients. This study aimed to investigate if a correlation exists between the variables involved in FNS. Study Design Retrospective cohort review. Methods There were 32 out of 1,100 cochlear implant recipients who experienced FNS in our clinic between 2010 and 2019. The following variables were recorded from a retrospective chart review: grade of FNS, onset of FNS, the number of channels stimulating FNS, and radiological findings of abnormalities in the inner ear. Statistical analyses were performed to identify a correlation between any of the variables involved. The techniques used to reduce FNS were analyzed. Results Eleven adult ears had progressive hearing loss, three had idiopathic sudden sensorineural hearing loss (SNHL), and one congenital SNHL. All pediatric ears were diagnosed with congenital SNHL, except for one ear with idiopathic sudden SNHL. The grade of FNS ranged from mild stimulation or slight motion in the eye, mouth, nasolabial, or forehead regions (n = 8) to total severe stimulation of the facial musculature and/or severe pain (n = 3). The onset of FNS occurred immediately after activation for nine ears, and up to 16 months later for the other subjects. A significant correlation was observed between the number of channels stimulating FNS, the grade of FNS, and the radiological findings of the inner ear. FNS was completely resolved for 30 ears and partially resolved for two ears. Conclusions FNS can occur any time after cochlear implantation and can affect both adult and pediatric. However, it can be effectively resolved using specific fitting techniques. Level of Evidence 2c Laryngoscope, 131:374–379, 2021

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Investigating Facial Nerve Stimulation After Cochlear Implantation in Adult and Pediatric Recipients

et al. 2020

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“…The upper limit of electric stimulation was in most mice determined by the presence of a facial nerve response. Facial nerve stimulation is one of the most well-known and most frequent complications in the cochlear implantation procedure 24 . It is therefore of high clinical relevance to try to minimize it.…”

Section: Ramped Shapes Have Steeper Eabr Growth Function Slopes Compamentioning

confidence: 99%

Ramped pulse shapes are more efficient for cochlear implant stimulation in an animal model

Navntoft

Marozeau

Barkat

2020

Sci Rep

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In all commercial cochlear implant (CI) devices, the electric stimulation is performed with a rectangular pulse that generally has two phases of opposite polarity. To date, developing new stimulation strategies has relied on the efficacy of this shape. Here, we investigate the potential of a novel stimulation paradigm that uses biophysically-inspired electrical ramped pulses. Using electrically-evoked auditory brainstem response (eABR) recordings in mice, we found that less charge, but higher current level amplitude, is needed to evoke responses with ramped shapes that are similar in amplitude to responses obtained with rectangular shapes. The most charge-efficient pulse shape had a rising ramp over both phases, supporting findings from previous in vitro studies. This was also true for longer phase durations. Our study presents the first physiological data on CI-stimulation with ramped pulse shapes. By reducing charge consumption ramped pulses have the potential to produce more battery-efficient CIs and may open new perspectives for designing other efficient neural implants in the future.

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“…Based on the idea of targeting certain neuronal networks, strategies have been proposed in electrical stimulation of neuronal networks for cochlear implants, auditory brain stem implants, auditory mid brain implants, as well as for deep brain stimulation (Bahmer et al, 2009 ; Bahmer, 2016 , 2017 ; Bahmer and Schleich, 2016 ). These stimulation strategies and alternative pulse shapes (Bahmer et al, 2010 ; Bahmer and Baumann, 2016 ) may also be useful for the deep brain stimulation in psychiatric diseases (Buzsáki and Watson, 2012 ).…”

Section: Oscillations As a Target For Brain-computer-interfacesmentioning

confidence: 99%

Role of Oscillations in Auditory Temporal Processing: A General Model for Temporal Processing of Sensory Information in the Brain?

Bahmer

Gupta

2018

Front. Neurosci.

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We review the role of oscillations in the brain and in the auditory system showing that the ability of humans to distinguish changes in pitch can be explained as a precise analysis of temporal information in auditory signals by neural oscillations. The connections between auditory brain stem chopper neurons construct neural oscillators, which discharge spikes at various constant intervals that are integer multiples of 0.4 ms, contributing to the temporal processing of auditory cochlear output. This is subsequently spatially mapped in the inferior colliculus. Electrophysiological measurements of auditory chopper neurons in different species show oscillations with periods which are integer multiples of 0.4 ms. The constant intervals of 0.4 ms can be attributed to the smallest synaptic delay between interconnected simulated chopper neurons. We also note the patterns of similarities between microcircuits in the brain stem and other parts of the brain (e.g., the pallidum, reticular formation, locus coeruleus, oculomotor nuclei, limbic system, amygdala, hippocampus, basal ganglia and substantia nigra), dedicated to the processing of temporal information. Similarities in microcircuits across the brain reflect the importance of one of the key mechanisms in the information processing in the brain, namely the temporal coupling of different neural events via coincidence detection.

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The Underlying Mechanism of Preventing Facial Nerve Stimulation by Triphasic Pulse Stimulation in Cochlear Implant Users Assessed With Objective Measure

Abstract: Triphasic pulse stimulation prevents from FNS because of a smaller gradient of EMG input-output function compared with biphasic pulse stimulation. The underlying mechanism can be modeled by differences in spatiotemporal spread of the electrical field.

Cited by 34 publications

References 11 publications

Investigating Facial Nerve Stimulation After Cochlear Implantation in Adult and Pediatric Recipients

Investigating Facial Nerve Stimulation After Cochlear Implantation in Adult and Pediatric Recipients

Ramped pulse shapes are more efficient for cochlear implant stimulation in an animal model

Role of Oscillations in Auditory Temporal Processing: A General Model for Temporal Processing of Sensory Information in the Brain?

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