Article
The Evolution of Neural Response Telemetry
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Published: | May 31, 2005 |
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Outline
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Introduction
Cochlear's NRT™ development arose from research conducted at the University of Iowa in 1990, when Brown and colleagues reported that they could record the neural activity resulting from intra-cochlear electrical stimulation using the percutaneous connector of Ineraid cochlear implant recipients.
Materials and Methods
This work suggested that the threshold neural response might be an objective measure that could assist with programming, and the design of Nucleus® Cochlear Implant (CI24M) was modified to include an NRT measurement capability. The data format of the CI24M radio frequency link is unique among commercial cochlear implant systems, in that the method used to transmit power and data to the implant allows for this transmission to be switched off for short periods, so that the very small neural response signals can be measured without interference from the high level RF link.
Results
Following the introduction of the CI24M series implants in January 1997, the NRT software was developed in close collaboration with the ORL clinic of the University Hospital Zürich. Since 1999, the use of NRT has been explored extensively by clinics around the world. With the recently introduced CI24RE series implants the telemetry circuits have been further refined, increasing the probability of measuring a response and reducing the time it takes for measurement.
Conclusions
In Europe, research into NRT measurement techniques, response interpretation and use has been coordinated through annual NRT workshops, under the leadership of Norbert Dillier. The 11th NRT workshop in Geneva last year attracted more than 100 participants. Several clinical algorithms have been developed, to accelerate and simplify the fitting process, moving toward the goal to provide an initial MAP based on objective measures in only a few minutes.