Graeme Clark Collection

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Author: Clark, Graeme × Author: PYMAN, BRIAN × End date: 1991 × Start date: 1991 × Type: Journal Article ×

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    Surgical complications with the cochlear multiple-channel intracochlear implant: experience at Hannover and Melbourne
    Webb, Robert L. ; Lehnhardt, Ernst ; Clark, Graeme M. ; Laszig, Roland ; Pyman, Brian C. ; Franz, Burkhard K-H. G. ( 1991)
    The surgical complications for the first 153 multi-channel cochlear implant operations carried out at the Medizinische Hochschule in Hannover and the first 100 operations at The University of Melbourne Clinic, The Royal Victorian Eye and Ear Hospital, are presented. In the Hannover experience the major complications were wound breakdown, wound infection, electrode tie erosion through the external auditory canal, electrode slippage, a persistent increase in tinnitus, and facial nerve stimulation. The incidence of wound breakdown requiring removal of the package was 0.6% in Hannover and 1.0% in Melbourne. The complications for the operation at both clinics were at acceptable levels. It was considered that wound breakdown requiring implant removal could be kept to a minimum by making a generous incision and suturing the flap without tension.
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    Revised selection criteria for the multiple-channel cochlear implant
    Pyman, Brian C. ; Dowell, Richard C. ; Brown, A. M. ; Clark, Graeme M. ; Webb, Robert L. ; Franz, Burkhard K.-H. G. ; Dettman, Shani J. ; Rowland, L. C. ; Blamey, Peter J. ( 1991)
    The criteria of suitability for a cochlear implant have been extended from total deafness to include some individuals with residual hearing. The aim of the initial hearing evaluation is to define whether the speech discrimination is good enough to justify perseverance with a hearing aid. In adults, usually the pure tone audiogram and speech audiometry are accurate and consistent. In children, however, to achieve accuracy, free field testing must be complemented by repeated aided conditioned responses and objective evoked response audiometry. When a child has residual hearing it is more difficult to assess the potential for habilitation using an aid. For both adults and children, it is necessary to make a selection from a battery of tests on the basis of the subjects experience. This development highlights the need for otologists and audiologists to become familiar with the battery of tests used in evaluating severe deafness (Plant 1984) and to review decisions made about the management of people with severe to total deafness. In suitable people, the aim of treatment with the Cochlear multichannel implant and its multipeak speech processor is a significant score for open set speech discrimination tests using hearing alone. This cannot always be achieved but as long as the evaluation protocol has been used to warn patients before the operation, they will be satisfied with a result where the implant complements lip reading resulting in discrimination of running speech and detection of environmental sounds.