implanting large numbers or of offering a clinical service. They saw themselves (and indeed continue to see themselves) as a research team.

Threshold of a New Era

By the end of the 1970s, cochlear implantation was becoming a respectable topic of discussion. Gradually, it was acquiring a degree of credibility in professional otological circles. The results of an independent assessment of House implantees, which showed modest but definite benefit (Bilger et al., 1977), contributed significantly in this respect. Also in 1977, the British department of health invited a group of three experts (two ear surgeons and a neurophysiologist) to review current efforts in the area of electrical stimulation of the inner ear and to make recommendations as to what British commitment to the area should be. In October 1977, these experts visited all active U.S. centers including, as already mentioned, the House group and the Stanford group. Their report (Ballantyne et al., 1978) is in fact critical of the overall effort in a number of respects,11 while nevertheless accepting the promise of the technique. Viewing full-scale clinical provision as premature, Ballantyne, Evans, and Morrison in 1978 thus recommended a cautious approach in Britain, starting with a careful evaluation of the single-channel implant.

In the period 1978–1982, however, industrial corporations were beginning to become interested. A recent analysis of the growth of industrial involvement in cochlear implants speaks of "a period of trial and negotiations between 1978 to 1982 as firms and academicians attempted to enter into licensing agreements" (Garud and van de Ven, 1989). These beginnings of an "inter-organizational field" were not easy, and a number of attempted collaborations soon foundered.12 There is no doubt, however, that by 1982 a new era in the history of cochlear implantation had begun. Ballantyne, Evans, and Morrison bear witness to this. In 1982, these British experts published an update of their earlier report

11  

"There seems to have been inadequate appreciation and application of the basic physiological and psychophysical information already available, on the processing of speech sounds at peripheral levels of the auditory system, by many of those controlling the implant programs. This has meant that the expected information-carrying capabilities of single-channel stimulation (e.g., prosodic and voicing cues) have been but little exploited … It is surprising and extremely disappointing to note that unequivocal quantitative data on the benefits of cochlear implantation [compared to high-powered hearing aids and vibrotactile aids] are as yet not available …".

12  

Thus in 1977 3M was approached by Graeme Clark's group at the University of Melbourne, which was interested in commercializing its cochlear implant technology. This proved abortive and Clark, with major support from the Australian government, turned elsewhere. Between 1978 and 1982 3M worked with Michelson at the University of California, San Francisco. A UCSF-3M device was developed and implanted into two or three individuals in 1980–1981. When this agreement was terminated in 1982, UCSF went elsewhere, while (in 1981) 3M entered into licensing agreements with both House and a group at the University of Vienna.



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