Inserting the speech signal above the cochlea: How can this work?

Abstract

Although cochlear implants (CIs) have successfully restoring hearing to many deaf people, there remains a subgroup who cannot benefit from them due to malformation of the cochlea or damage to the cochlear nerve. Auditory brainstem implants (ABIs) and auditory midbrain implants (AMIs) aim to restore hearing to this group. ABIs stimulate the surface of the cochlear nucleus (CN). Despite some ABI users gaining benefit similar to a CI, the majority achieve poor speech understanding with the device alone. The reasons for poor outcomes are not fully understood but include tumor damage to particular cells in the cochlear nucleus, surgical approach, and placement of the electrodes. One factor in poor outcome is the difficulty of stimulating specific tonotopic planes within the CN. This factor and tumor damage to the CN were reasons for the development of the AMI, which directly stimulates the tonotopic layers of the inferior colliculus (IC) using a shank electrode. Psychophysics and physiological studies have thr...