Graeme Clark Collection

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Author: Busby, Peter × Author: Dowell, Richard × End date: 1988 × Start date: 1987 × Type: Journal Article × Subject: deafness × Subject: otolaryngology ×

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    The University of Melbourne/Nucleus cochlear prosthesis
    Clark, Graeme M. ; Blamey, P. J. ; Brown, A. M. ; Busby, P. A. ; Dowell, R. C. ; Franz, B. K-H. ; Millar, J. B. ; Pyman, B. C. ; Shepherd, R. K. ; Tong, Y. C. ; Webb, R. L. ; Brimacombe, J. A. ; Hirshorn, M. S. ; Kuzma, J. ; Mecklenburg, D. J. ; Money, D. K. ; Patrick, J. F. ; Seligman, P. M. ( 1988)
    This is a review of research to develop the University of Melbourne/Nucleus cochlear prosthesis for patients with a profound-total hearing loss. A more complete review can be obtained in Clark et al. A prototype receiver-stimulator and multiple-electrode array developed at the University of Melbourne was first implanted in a postlingually deaf adult patient with a profound-total hearing loss on 1 August 1978. A speech processing strategy which could help this patient understand running speech, especially when combined with lipreading was developed in 1978 following initial psychophysical studies. A prototype wearable speech processor was fabricated in 1979, that could provide significant help for the first two patients in understanding running speech when used in combination with lipreading compared with lipreading alone, and it also enabled them to understand some running speech when using electrical stimulation alone. An implantable receiver-stimulator and wearable speech processor embodying the principles of the prototype devices were then produced for clinical trial by the Australian biomedical firm, Nucleus Ltd, and its subsidiaries, Cochlear Pty Ltd and Cochlear Corporation. This cochlear implant was initially clinically trialled on six patients at The Royal Victorian Eye & Ear Hospital in 1982, and shown to give similar results to those obtained with the prototype device. In view of these findings a clinical trial was carried out for a Premarket Approval Application to the US Food and Drug Administration (FDA), and extended to a number of centres in the US, Canada, and West Germany. This clinical trial confirmed that patients could understand running speech when electrical stimulation was combined with lipreading, and that some patients could also understand running speech when using electrical stimulation alone. Today, more than 600 patients world-wide are using cochlear implants developed from the research described in this paper.
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    Audiological assessment of profoundly hearing-impaired children
    Busby, P. A. ; Dowell, R. C. ; Nienhuys, T. G. ; Clark, Graeme M. ( 1987)
    The design of an audiological assessment protocol for profoundly hearing-impaired children may be divided into three areas. First, accurate estimation of hearing loss includes the behavioral measures of unaided and aided thresholds and the objective measures of electrocochleography and auditory brain stem response. The reliability of these measures for the accurate diagnosis of a profound to total hearing loss is discussed. Second, speech perception includes the measure of perception in the audition alone, vision alone, and audition plus vision conditions. Test material should include speech features, words, and sentences. Factors influencing the choice of material are the developmental age of the child, the method of educational instruction, speech and language skills, and vocabulary limits. Third, psychophysical properties of residual auditory skills include measures such as frequency, intensity, and duration difference limens. These skills may be compared to those elicited through other sensory channels, such as visual and tactile. Other important factors that should be considered are the psychological well-being of the child and family, family motivations and expectations, and educational requirements.