Graeme Clark Collection

Permanent URI for this collection

Search Results

Now showing 1 - 10 of 25
  • Item
    Thumbnail Image
    Cochlear pathology following chronic electrical stimulation of the auditory nerve. I: Normal hearing kittens
    Ni, Daofeng ; Shepherd, Robert K. ; Seldon, Lee ; Xu, Shi-Ang ; Clark, Graeme M. ; Millard, Rodney E. ( 1992)
    The present study examines the histopathological effects of long-term intracochlear electrical stimulation in young normal hearing animals. Eight-week old kittens were implanted with scala tympani electrode arrays and stimulated for periods of up to 1500 h using charge balanced biphasic current pulses at charge densities in the range 21-52 µC cm^-2 geom. per phase. Both click and electrically evoked auditory brainstem responses were periodically recorded to monitor the status of the hair cell and spiral ganglion cell populations. In addition, the impedance of the stimulating electrodes was measured daily to monitor their electrical characteristics during chronic implantation. Histopathological examination of the cochleas showed no evidence of stimulus induced damage to cochlear structures when compared with implanted, unstimulated control cochleas. Indeed, there was no statistically significant difference in the ganglion cell density adjacent to the stimulating electrodes when compared with a similar population in implanted control cochleas. In addition, hair cell loss, which was restricted to regions adjacent to the electrode array, was not influenced by the degree of electrical stimulation. These histopathological findings were consistent with the evoked potential recordings. Finally, electrode impedance data correlated well with the degree of tissue growth observed within the scala tympani. The present findings indicate that the young mammalian cochlea is no more susceptible to cochlear pathology following chronic implantation and electrical stimulation than is the adult.
  • Item
    Thumbnail Image
    A physiological investigation of chronic electrical stimulation with scala tympani electrodes in kittens
    Ni, Daofeng ; Shepherd, Robert K. ; Clark, Graeme M. ( 1992)
    A physiological investigation of cochlear electrical stimulation was undertaken in six two-month-old kittens. The scala tympani electrodes were implanted and electrically stimulated using biphasic balanced electrical pulses' for periods of 1000-1500h in four ears. Four ears received implants for same period but without electrical stimulation. The other two ears served as normal control. The results indicated: 1) Chronic electrical stimulation of the cochlea within electrochemically safe limits did not influence the hearing of kittens and the normal delivery of impulses evoked by acoustic and electrical signals on the auditory brainstem pathway. 2) The wave shapes of EABRs were similar to those of ABRs. The aptitudes of EABRs showed a significant increase following chronic electrical stimulation, resulting in a leftward shift in the input/ output function. The absolute latencies and interwave latencies of waves II-III , III -IV and II -IV were significantly shorter than those of ABRs. These results imply that there was no adverse effect of chronic electrical stimulation on the maturing auditory systems of kittens using these electrical parameters and the mechanism of electrical hearing should be further studied.
  • Item
    Thumbnail Image
    Speech processing for cochlear implants
    Tong, Y. C. ; Millar, J. B. ; Blamey, P. J. ; Clark, Graeme M. ; Dowell, R. C. ; Patrick, J. F. ; Seligman, P. M. (JAI Press Ltd, 1992)
    The cochlear implant is a hearing prosthesis designed to replace the function of the ear. The operation of the prosthesis can be described as a sequence of four functions: the processing of the acoustic signal received by a microphone; the transfer of the processed signal through the skin; the creation of neural activity in the auditory nerve; and the integration of the experience of this neural activity into the perceptual and cognitive processing of the implantee.
  • Item
    Thumbnail Image
    The excitability of units in the central nucleus of the inferior colliculus to monaural electrical stimulation
    Lithgow, Brian J. ; Clark, Graeme M. ; Tong, Yit C. ( 1992)
    Single unit responses to electric stimuli can be markedly different to those obtained with comparable acoustic stimuli. For the development of future cochlear implant coding strategies a detailed understanding of the effects of electrical stimulation is required. This study investigated the comparative number of single units exhibiting excitatory responses in the central nucleus of the inferior colliculus to monaural electric versus acoustic stimuli.
  • Item
    Thumbnail Image
    Results for children and adolescents using the multichannel cochlear prosthesis [Abstract]
    Dowell, Richard C. ; Clark, Graeme M. ; Dettman, Shani J. ; Dawson, Pamela W. ( 1992)
    The first adolescent to use the 22-electrode cochlear prosthesis was Implanted In Melbourne in 1985 and the first child (less than 10 years), the following year. Since then, over 100 children have received the cochlear prosthesis in Australia and over 1200 worldwide. Detailed assessment of 200 children in the U.S.A., Australia and Germany lead to the market approval of the prosthesis by the U.S. Food and Drug Administration in July 1990. The analysis of results for these children has proven to be difficult due to the use of different tests in different places, the lack of appropriate assessment tools for young children, the wide range of performance, and the problems of cooperation for young children. Despite these problems, some trends are beginning to emerge in the speech perception results for implanted children. Children with a greater amount of auditory experience before becoming profoundly deaf tend to perform better, as do children with more experience with the cochlear prosthesis. Those with a greater number of electrodes in use also perform better, a result supported by adult studies. Although older prelinguistically deafened children do not perform as well as postlinguistically deafened adults, there appears to be little difference between results for pre-and post-linguistically deafened young children. These trends In speech perception results will be discussed in more detail.
  • Item
    Thumbnail Image
    Cochlear implants in children, adolescents, and prelinguistically deafened adults: speech perception
    Dawson, Pam. W ; Blamey, Peter J. ; Rowland, Louise C. ; Dettman, Shani J. ; Clark, Graeme M. ; Busby, Peter A. ; Brown, Alison M. ; Dowell, Richard C. ; Rickards, Field W. ( 1992)
    A group of 10 children, adolescents, and prelinguistically deafened adults were implanted with the 22-electrode cochlear implant (Cochlear Pty Ltd) at the University of Melbourne Cochlear Implant Clinic and have used the prosthesis for periods from 12 to 65 months. Postoperative performance on the majority of closed-set speech perception tests was significantly greater than chance, and significantly better than preoperative performance for all of the patients. Five of the children have achieved substantial scores on open-set speech tests using hearing without lipreading. Phoneme scores in monosyllabic words ranged from 30% to 72%; word scores in sentences ranged from 26% to 74%. Four of these 5 children were implanted during preadolescence (aged 5:5 to 10:2 years) and the fifth, who had a progressive loss, was implanted during adolescence (aged 14:8 years). The duration of profound deafness before implantation varied from 2 to 8 years. Improvements were also noted over postoperative data collection times for the younger children. The remaining 5 patients who did not demonstrate open-set recognition were implanted after a longer duration of profound deafness (aged 13:11 to 20:1 years). The results are discussed with reference to variables that may affect implant performance, such as age at onset of loss, duration of profound loss, age at implantation, and duration of implantation. They are compared with results for similar groups of children using hearing aids and cochlear implants.
  • Item
    Thumbnail Image
    The development of the Melbourne/Cochlear multiple-channel cochlear implant for profoundly deaf children
    Clark, Graeme M. ; Busby, Peter A. ; Dowell, Richard C. ; Dawson, Pamella W. ; Pyman, Brian C. ; Webb, Robert L. ; Staller, Steven J. ; Beiter, Anne L. ; Brimacombe, Judith A. ( 1992)
    In 1978-79, a speech processing strategy which extracted the voicing (FO) and second formant (F2) frequencies and presented these as rate and place of stimulation respectively to residual auditory nerve fibres was developed for the University of Melbourne's prototype multiple-channel receiver-stimulator (Clark et aI1977, Clark et a11978, Tong et aI1980). This speech processing strategy was shown to provide post linguistically deaf adults with some open-set speech comprehension using electrical stimulation alone, and considerable help when used in combination with lipreading (Clark et al 1981).
  • Item
    Thumbnail Image
    The development of speech processing strategies for the University of Melbourne/cochlear multiple channel implantable hearing prosthesis.
    Clark, Graeme M. ( 1992)
    The speech processing strategies that have been used with the University of Melbourne/Cochlear multiple channel implantable hearing prosthesis have been developed systematically from the inaugural one that extracted the second formant and presented this on a place coding basis and the voicing frequency which determined the rate of stimulation. Speech processing has also depended heavily on biological research to ensure that the stimulus parameters used or the operative approach did not damage the spiral ganglion cells it was hoped to stimulate. The advances in speech processing from Melbourne primarily have been to extract more features and spectral information and present this on a place coding basis. This has led to a progressive improvement in speech perception, and a small number of patients can achieve nearly 100% correct scores for open sets of phonetically-balanced words using electrical stimulation alone.
  • Item
    Thumbnail Image
    Psychophysical studies using a multiple-electrode cochlear implant in patients who were deafened early in life.
    Busby, P. A. ; Tong, Y. C. ; Clark, Graeme M. ( 1992)
    Psychophysical studies were conducted on 10 cochlear implant patients, between 5 and 23 years of age at the time of surgery, who were deafened prior to 4 years of age. The multiple-electrode prosthesis manufactured by Cochlear Ltd. was used. Identification studies, the recognition of 2-4 stimuli after some training, were conducted on 3 of the 10 patients. For currentlevel and repetition rate identification, performance was comparable to that observed for postlingual adult patients. For electrode position identification, however, performance was much poorer than that observed for postlingual adults. In general, the difference limens for current level, repetition rate and duration, and the gap detection thresholds were similar to those observed for postlingual adults. For 3 patients whose etiology was Usher's syndrome, the repetition rate limens at higher rates were larger than those of the other patients. The limens for electrode position, measured in a discrimination task, were 1-3 electrodes for most patients. However, for 3 patients, limens of 6-10 electrodes were recorded. For numerosity judgements, the counting of stimuli in a temporal series as a function of the rate of presentation, the patients were less successful at counting for rates of 3-8/s than for lower rates (1-2/s).
  • Item
    Thumbnail Image
    Cochlear implants in children, adolescents, and prelinguistically deafened adults: speech perception
    Dawson, Pam W. ; Blamey, Peter J. ; Rowland, Louise C. ; Dettman, Shani J. ; Clark, Graeme M. ; Busby, Peter A. ; Brown, Alison M. ; Dowell, Richard C. ; Rickards, Field W. ( 1992)
    A group of 10 children, adolescents, and prelinguistically deafened adults were implanted with the 22-electrode cochlear implant (Cochlear Ply Ltd) at the University of Melbourne Cochlear Implant Clinic and have used the prosthesis for periods from 12 to 65 months. Postoperative performance on the majority of closed-set speech perception tests was significantly greater than chance, and significantly better than preoperative performance for all of the patients. Five of the children have achieved substantial scores on open-set speech tests using hearing without lipreading. Phoneme scores in monosyllabic words ranged from 30% to 72%; word scores in sentences ranged from 26% to 74%. Four of these 5 children were implanted during preadolescence (aged 5:5 to 10:2 years) and the fifth, who had a progressive loss, was implanted during adolescence (aged 14:8 years). The duration of profound deafness before implantation varied from 2 to 8 years. Improvements were also noted over postoperative data collection times for the younger children. The remaining 5 patients who did not demonstrate open-set recognition were implanted after a longer duration of profound deafness (aged 13:11to 20:1 years). The results are discussed with reference to variables that may affect implant performance, such as age at onset of loss, duration of profound loss, age at implantation, and duration of implantation. They are compared with results for similar groups of children using hearing aids and cochlear implants.