Electrococleography
Dr. Hallowell Davis, my Professor of Neurophysiology, was the father of electrical response audiometry.
In 1955 he invited Jerome C. Cox to join the Research Department of the Central Institute for the Deaf as an acoustic engineer, and pointed him in the direction of an average response calculator to detect electroencephalographic responses. With the help of his student Maynard Engebretson, Jerry Cox designed and constructed a special digital computer that was named HAVOC – Histogram, Average and Ojive Calculator, which started electric response audiometry. He also developed methods for bioelectric signals, mathematical analysis of the averaging process and sample statistics of the evoked responses. Jerry Cox eventually became the Chairman of the Computer Laboratories of Washington University in Saint Louis.
When I visited Saint Louis in 1964, Dr. Davis was already recording the vertex potentials of the CID children. These children knew the researchers, who always treated them kindly, and were very cooperative for all audiological researches; therefore their vertex potentials were recorded without any difficulties. The attempts to record these potentials in children referred from different hospitals, however, did not go well, and it was soon discovered that sedation or anesthesia would block the responses.
Gradually other electric responses began to be recorded, including electrocochleography (EcochG), that was developed almost simultaneously by Nobuo Yoshie, in Japan, Jean Marie Aran, in France, and Moshe Feinmesser, in Israel. ECochG was excellent for estimating hearing thresholds and began to be employed to evaluate children with suspected hearing problems. It should be mentioned that Yoshie worked with Dr. Davis and with HAVOC in Saint Louis before his discovery of ECochG.
In 1974 I became interested in beginning to study auditory electrical responses and wrote a project that was sent to FAPESP – the State of Sao Paulo Research Foundation. As usual, the Foundation sent the project to two physicians working in the same area in order to obtain an opinion on the merits of the research. Since at the time there were only three Medical Schools in Sao Paulo, I assumed that the project had been sent to one physician of each of the other two institutions. As you will see in a while, this assumption proved correct.
Approximately a month later I received a letter from FAPESP telling me that both of the evaluators had stated very clearly that this research was of no value. And a week later, to my surprise, I received another letter stating that the project had been approved.
For many years I did not know what had happened. Then, one day, I was examining a candidate for the title of Privat Dozent and one of the other examiners was Prof. William Saad Hossne, an eminent physician who pioneered Bio-Ethics in Brazil. In 1974 he was the Scientific Director of FAPESP. He told me, then, that my project was the first one in the area of Otolaryngology, and that for this reason he decided to approve it, in spite of the negative evaluations.
So we got the ECochG system. Jean Marie Aran came from Bordeaux and taught my friend Yotaka Fukuda and I how to use it. And Yotaka and I pioneered the diagnosis of Menière’s Disease * and Mondini Dysplasia ** by means of ECochG, besides examining many, many children and a smaller number of adults.
About three months after we received our equipment the two other Medical Schools in Sao Paulo received identical systems – same make, same model, everything exactly the same. Coincidence?
I do not believe in coincidences.
* Mangabeira-Albernaz PL, Fukuda Y, Ganança MM. Menière’s Disease. ORL J Otorhinolaryngol Relat Spec (Basel). 1980;42:91-100.
** Mangabeira-Albernaz PL, Fukuda Y, Chammas F, Ganança MM. The Mondini Dysplasia – a clinical study. ORL J Otorhinolaryngol Relat Spec (Basel). 1981;43:131-52.
In 1955 he invited Jerome C. Cox to join the Research Department of the Central Institute for the Deaf as an acoustic engineer, and pointed him in the direction of an average response calculator to detect electroencephalographic responses. With the help of his student Maynard Engebretson, Jerry Cox designed and constructed a special digital computer that was named HAVOC – Histogram, Average and Ojive Calculator, which started electric response audiometry. He also developed methods for bioelectric signals, mathematical analysis of the averaging process and sample statistics of the evoked responses. Jerry Cox eventually became the Chairman of the Computer Laboratories of Washington University in Saint Louis.
When I visited Saint Louis in 1964, Dr. Davis was already recording the vertex potentials of the CID children. These children knew the researchers, who always treated them kindly, and were very cooperative for all audiological researches; therefore their vertex potentials were recorded without any difficulties. The attempts to record these potentials in children referred from different hospitals, however, did not go well, and it was soon discovered that sedation or anesthesia would block the responses.
Gradually other electric responses began to be recorded, including electrocochleography (EcochG), that was developed almost simultaneously by Nobuo Yoshie, in Japan, Jean Marie Aran, in France, and Moshe Feinmesser, in Israel. ECochG was excellent for estimating hearing thresholds and began to be employed to evaluate children with suspected hearing problems. It should be mentioned that Yoshie worked with Dr. Davis and with HAVOC in Saint Louis before his discovery of ECochG.
In 1974 I became interested in beginning to study auditory electrical responses and wrote a project that was sent to FAPESP – the State of Sao Paulo Research Foundation. As usual, the Foundation sent the project to two physicians working in the same area in order to obtain an opinion on the merits of the research. Since at the time there were only three Medical Schools in Sao Paulo, I assumed that the project had been sent to one physician of each of the other two institutions. As you will see in a while, this assumption proved correct.
Approximately a month later I received a letter from FAPESP telling me that both of the evaluators had stated very clearly that this research was of no value. And a week later, to my surprise, I received another letter stating that the project had been approved.
For many years I did not know what had happened. Then, one day, I was examining a candidate for the title of Privat Dozent and one of the other examiners was Prof. William Saad Hossne, an eminent physician who pioneered Bio-Ethics in Brazil. In 1974 he was the Scientific Director of FAPESP. He told me, then, that my project was the first one in the area of Otolaryngology, and that for this reason he decided to approve it, in spite of the negative evaluations.
So we got the ECochG system. Jean Marie Aran came from Bordeaux and taught my friend Yotaka Fukuda and I how to use it. And Yotaka and I pioneered the diagnosis of Menière’s Disease * and Mondini Dysplasia ** by means of ECochG, besides examining many, many children and a smaller number of adults.
 |
| A normal ECochG |
About three months after we received our equipment the two other Medical Schools in Sao Paulo received identical systems – same make, same model, everything exactly the same. Coincidence?
I do not believe in coincidences.
* Mangabeira-Albernaz PL, Fukuda Y, Ganança MM. Menière’s Disease. ORL J Otorhinolaryngol Relat Spec (Basel). 1980;42:91-100.
** Mangabeira-Albernaz PL, Fukuda Y, Chammas F, Ganança MM. The Mondini Dysplasia – a clinical study. ORL J Otorhinolaryngol Relat Spec (Basel). 1981;43:131-52.
Comments
Post a Comment