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A Prosthesis for the Deaf Based on Cortical Stimulation

The feasibility of developing a functional auditory prosthesis, or “artificial ear” to restore hearing to the totally deaf is discussed. The approach taken involves connecting electrodes to the auditory cortex of the brain. Previous work by other groups has concentrated on stimulation of the cochlea or auditory nerve. However, stimulation of auditory cortex bypasses the entire peripheral auditory system and this approach may thus be applicable to a wider group of people, including those with hearing loss caused by lesions of the auditory nerve, or even central pathways. Establishment of the feasibility of any such sensory prosthesis requires demonstration of meaningful information transfer in human subjects, demonstration that chronic implantation and stimulation can be achieved without damaging the brain, and the demonstration of engineering feasibility at reasonable cost. Each of these areas is discussed separately. Although progress to date gives reason for optimism, it must be stressed that large amounts of work remain to be done and the successful development of such a system may take many years. One principal limitation is the small number of patients suitable for experimentation. Other investigators are accordingly encouraged to take advantage of the rare clinical opportunities which permit progress in such areas.