Cochlear implants: histopathologic findings related to performance in 16 human temporal bones.

This paper presents results of a histologic study of 16 temporal bones with cochlear implants from 13 subjects. Damage caused by electrode insertion in the basal turn of the cochlea was evaluated. Dendrite and spiral ganglion cell populations were compared to clinical performance scores to determine structures necessary for stimulation and the minimum number needed for electrical stimulation. Results show that damage from insertion of long electrodes was located mainly at the most anterior part of the basal turn; that despite total degeneration of dendrites in the area near the electrode, some spiral ganglion cells remained; and that spiral ganglion cells or possibly axons are the stimulated structures and that fewer of them than previously thought are necessary to achieve a hearing sensation from electrical stimulation.