The early history of the cochlear implant: a retrospective.

Importance: Histories of cochlear implant (CI) technology have often been inaccurate owing to the confusion of terms and anatomical situations or to biased reporting. This retrospective, published shortly after the death of inventor William F. House-and more than 50 years after placement of the first CI-offers a precise account of the early experimental period.

Objective: To clarify the first steps in the development of the CI, ie, an electrical stimulating device partially inserted into the cochlea.

Evidence Review: Literature review based on published data, oral history material, interviews, and written contact with protagonists.

Findings: The first CI was implanted by William House and John Doyle of Los Angeles, California, in 1961. In 1964, Blair Simmons and Robert White of Stanford University, Stanford, California, placed a 6-channel electrode through the promontory and vestibule directly into the modiolus. The next step in the development of the CI was its clinical trial on a cohort of patients. Robin Michelson, Robert Schindler, and Michael Merzenich at the University of California, San Francisco, conducted these experiments in 1970 and 1971. In 1973, the first international conference on the "electrical stimulation of the acoustic nerve as a treatment for profound sensorineural deafness in man" was organized in San Francisco. At the same time, Claude Henry Chouard in France and Graeme Clark in Australia began their research. The final step in the establishment of CI as a clinically feasible technology involved the independent evaluation of implant users. The first such evaluation-the result of a 1975 request from the National Institutes of Health-was published in 1977 by Robert Bilger and coworkers at the University of Pittsburgh, Pittsburgh, Pennsylvania.

Conclusions And Relevance: Inspired by French experiments with electrode implantation at the VIII nerve, the initial practical development of the CI is nonetheless a Californian story, divided between the House group at Los Angeles and teams at Stanford University and UCSF.