Brainstem auditory pathway degeneration associated with chronic cochlear implants in the monkey.

The form and pattern of first-order and transsynaptic degeneration in the central auditory pathway was studied in monkeys following inner ear stimulation by a cochlear implant. Multielectrode, scala tympani, and modiolar systems were implanted; in some cases, neomycin was perfused into the cochlea to destroy the organ of Corti at the time of implantation. The monkeys were maintained chronically for 5 to 120 weeks, then the cochleas and brainstems were examined histologically. The extent of spiral ganglion cell loss across animals showed variability, reflecting the different procedures and devices used. The degree and distribution of spiral ganglion cell loss was related to the degree and distribution of neural degeneration seen in the cochlear nucleus in all cases. Peripheral damage progressed toward the cochlear apex as survival time increased, and this progression was reflected in the cochlear nucleus by a ventrolateral shift in the locus of degeneration over time. In addition, evidence for transneuronal degeneration was seen at the superior olive, the lateral lemniscus and the inferior colliculus. Our findings indicate that several factors inherent in the use of a cochlear prosthesis, i.e., insertion trauma, host reaction, and/or electrical stimulation, may be associated with a long-term, continuing process of central degeneration visible at several levels of the auditory system.