Cochlear Implants: Fundamentals and Applications , Graeme Clark AIP Press/Springer-Verlag, New York, 2003. $129.00 (830 pp.). ISBN 0-387-95583-6
In the late 1950s, a small group of physicians and engineers proposed the idea that hearing might be restored in profoundly deaf individuals through direct electrical stimulation of the auditory nerve. At that time, however, the otology establishment was quite skeptical about the possibility of restoring hearing through electrical stimulation.
But Graeme Clark, author of Cochlear Implants: Fundamentals and Applications, was one of those early pioneers who was not discouraged by the establishment’s criticisms or by initial failures. His lifetime of work has had enormous impact on the development and design of cochlear prostheses. Thus, Clark is well positioned to tell a wonderful success story that begins with some rudimentary hearing sensations evoked by electrical stimulation and ends with accounts of excellent speech perception by many cochlear-implant users.
In his 830-page book, Clark describes in great detail the development of cochlear prostheses and covers all aspects of cochlear implantation. The first chapter provides a good historical summary. It begins with a vivid description of Alessandro Volta’s 1799 current-injection experiment and follows with the competitive efforts that have led to commercial implants that are able to restore usable hearing to individuals who are severely to profoundly hearing impaired. Readers will certainly notice that the research contributions by Clark’s group in Melbourne, Australia, are highlighted in the chapter titled “A History.”
In the remaining chapters, Clark provides a basis for understanding the challenges researchers face regarding the coding and transmission of acoustic information to the auditory nerve using electrical stimulation. These chapters address subjects including neurobiology, electrophysiology, psychophysics, speech and sound processing, engineering, surgical anatomy, and surgical pathology. The author describes in detail cochlear-implant surgery and the impact of the devices on patients’ lives after implantation. The book concludes with his vision about important remaining questions and ideas for future research.
In some ways, Cochlear Implants is easy to criticize. Although the book covers a number of subjects, the quality of information presented in each chapter varies. The clinically related topics and the description of the cochlear-implant electrodes are well organized. In contrast, the chapters on basic science would have benefited from having experts in those fields edit or offer their contributions to those chapters. It is unclear why some topics are not covered or are covered only superficially, or why Clark uses so many case reports instead of simply summarizing results. Moreover, the repetition of details and frequently used jargon challenge a broad audience. The book would have benefited from a good editor who could have condensed the writing and thereby shorten the text.
These criticisms, though, fail to capture the real essence of Clark’s book. His true mission is not to turn readers into experts but, rather, make them fall in love with the subject. Through his personal recollections, the author seeks to excite readers by allowing them to participate in the experiences of the early pioneers.
Few books are available today that summarize the field and can be used to educate a broad audience or to teach audiology and otology students, and most are proceedings from scientific conferences. Only a few books like Clark’s have made an attempt to cover the entire field. Examples of such excellent texts are Cochlear Implants (College-Hill Press, 1985), edited by Roger Gray, and Cochlear Implants: Principles & Practices (Lippincott Williams & Wilkins, 2000) edited by John Niparko and others. Compared with those earlier books, Clark adds little new knowledge except for the many case reports and detailed descriptions of the development of cochlear implants and cochlear implantation in Australia.
Cochlear Implants: Fundamentals and Applications, a vivid recollection by one of the pioneers in cochlear implantation, gives insight into the struggles of implementing new technologies to help hearing-impaired individuals. It also colorfully documents how the development of new technologies affects a field and its success.
