Graeme Clark Collection

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    Auditory steady-state evoked potential in newborns
    Rickards, Field W. ; Tan, Lesley E. ; Cohen, Lawrence T. ; Wilson, Oriole J. ; Drew, John H. ; Clark, Graeme M. ( 1994)
    Steady-state evoked potential responses were recorded from 337 normal full-term sleeping newborns to combined amplitude and frequency modulated tones. Responses were automatically detected by statistical analysis of the response phase. Responses were most easily and consistently recorded at carrier frequencies of 500 Hz, 1500 Hz and 4000 Hz when the modulation frequency was between 60 Hz and 100 Hz. In this modulation frequency range, the response latencies were found to be between 11 ms and 15 ms, depending on carrier frequency, and the mean response thresholds for the three carrier frequencies were found to be 41.36 dB HL, 24.41 dB HL and 34.51 dB HL respectively. The results of this study suggest that steady-state evoked potentials at modulation rates in excess of 60 Hz may be useful for frequency specific, automated hearing screening in newborns.
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    Evaluation of a new Spectral Peak coding strategy for the Nucleus 22 channel cochlear implant system
    Skinner, Margaret W. ; Clark, Graeme M. ; Whitford, Lesley A. ; Seligman, Peter M. ; Staller, Steven J. ; Shipp, David B. ; Shallop, Jon K. ; Everingham, Colleen ; Menapace, Christine M. ; Arndt, Patti L. ; Antogenelli, Trisha ; Brimacombe, Judith A. ; Pijl, Sipke ; Daniels, Paulette ; George, Catherine R. ; McDermott, Hugh J. ; Beiter, Anne L. ( 1994)
    Sixty-three postlinguistically deaf adults from four English-speaking countries participated in a 17-week field study of performance with a new speech coding strategy, Spectral Peak (SPEAK), and the most widely used strategy, Multipeak (MPEAK), both of which are implemented on wearable speech processors of the Nucleus 22 Channel Cochlear Implant System; MPEAK is a feature-extraction strategy, whereas SPEAK is a filterbank strategy. Subjects' performance was evaluated with an experimental design in which use of each strategy was reversed and replicated (ABAB). Average scores for speech tests presented sound-only at 70 dB SPL were higher with the SPEAK strategy than with the MPEAK strategy. For tests in quiet, mean scores for medial vowels were 74.8 percent versus 70.1 percent; for medial consonants, 68.6 percent versus 56.6 percent; for monosyllabic words, 33.8 percent versus 24.6 percent; and for sentences, 77.5 percent versus 67.4 percent. For tests in noise, mean scores for Four-Choice Spondees at +10 and +5 dB signal-to-noise ratio (S/N) were 88.5 percent versus 73.6 percent and 80.1 percent versus 62.3 percent, respectively; and for sentences at +15 dB, +10, and +5 dB S/N, 66.5 percent versus 43.4 percent, 61.5 percent versus 37.1 percent, and 60.4 percent versus 31.7 percent, respectively. Subjects showed marked improvement in recognition of sentences in noise with the new SPEAK filterbank strategy. These results agree closely with subjects' responses to a questionnaire on which approximately 80 percent reported they heard best with the SPEAK strategy for everyday listening situations.
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    Cochlear pathology following chronic electrical stimulation of the auditory nerve: II Deafened kittens
    Shepherd, R. K. ; Matsushima, J. ; Martin, R. L. ; Clark, Graeme M. ( 1994)
    The present study examines the effects of long-term electrical stimulation of the auditory nerve on cochlear histopathology and spiral ganglion cell survival in young sensorineural deafened cats. Eight kittens were deafened using kanamycin and ethacrynic acid, and implanted with bipolar or monopolar scala tympani electrodes. Following recovery from surgery the animals were unilaterally stimulated using charge balanced biphasic current pulses for 450-1730 hours over implant periods of up to four months. Charge densities varied from 0.6-0.9 µC.cm ^-2 geom. per phase for monopolar electrodes to 12-26 µC.cm ^-2 geom. per phase for the bipolar electrodes. Electrically-evoked auditory brainstem responses (EABRs) were periodically monitored during stimulation to confirm that the stimulus levels were above threshold, and to monitor any change in the response of the auditory nerve. Following completion of the stimulation program cochleae were prepared for histological examination. EABRs exhibited relatively stable thresholds for both stimulated and implanted, unstimulated control cochleae for the stimulus duration. While the growth in response amplitude as a function of stimulus current remained stable for the bipolar control and monopolar stimulated cochleae, the five cochleae chronically stimulated using bipolar electrodes exhibited a moderate to large increase in response amplitude. These increases were associated with a more widespread fibrous tissue response which may have altered the current distribution within these cochleae. Implanted control cochleae exhibited significantly less tissue response within the scala tympani. Importantly, we observed no statistically significant difference in the spiral ganglion cell density associated with chronic electrical stimulation when compared with unstimulated control cochleae. While the present study supports the safe application of cochlear implants in young profoundly deafened children, it does not corroborate previous studies that have reported electrical stimulation providing a trophic effect on degenerating auditory nerve fibres.
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    Department of Otolaryngology
    Clark, Graeme M. ( 1994)
    The Department of Otolaryngology at The University of Melbourne commenced on the 1st of January 1970. It was established because otolaryngology had become a major specialty and one of importance to medical students: 15 per cent of referrals in family medicine can be attributed to conditions of the ear, nose and throat. The Chair was the first in Australasia and was also meant to have a significant role outside The University of Melbourne. Its specific aims were to foster teaching and research in the discipline.
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    Cochlear implants for congenitally deaf adolescents: is open-set speech perception a realistic expectation?
    Sarant, J. Z. ; Cowan, R. S. C. ; Blamey, P. J. ; Galvin, K. L. ; Clark, Graeme M. ( 1994)
    The prognosis for benefit from use of cochlear implants in congenitally deaf adolescents, who have a long duration of profound deafness prior to implantation, has typically been low. Speech perception results for two congenitally deaf patients implanted as adolescents at the University of Melbourne/Royal Victorian Eye and Ear Hospital Clinic show that, after 12 months of experience, both patients had significant open-set speech discrimination scores without lipreading. These results suggest that although benefits may in general be low for congenitally deaf adolescents, individuals may attain significant benefits to speech perception after a short period of experience. Prospective patients from this group should therefore be considered on an individual basis with regard to prognosis for benefit from cochlear implantation.
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    Neural processes in the dorsal cochlear nucleus of the anaesthetised cat investigated from unit responses to electrical stimulation of the auditory nerve
    O'Leary, S. J. ; Tong, Y. C. ; Clark, Graeme M. ( 1994)
    Extracellular responses of dorsal cochlear nucleus single units were recorded in response to biphasic, bipolar electrical stimulation of spiral ganglion cells and their peripheral processes using a banded electrode array in the scala tympani of the barbiturate anaesthetised cat. The DCN responses to this stimulus were the result of excitatory and suppressive (including inhibitory) processes. The excitatory responses from DCN units were usually within a range of 1.8-2.8 ms and these responses were probably the result of monosynaptic input from the auditory nerve. Latencies > 2.8 ms were most likely due to activation of di- and poly-synaptic pathways from auditory nerve fibres, except that latencies between 3.5-4.75 in hearing animals could have arisen from electrophonic mechanisms. Suppression of spontaneous activity was usually long acting, lasting > 70 ms following each pulse of the pulse train, but short acting suppression with a latency of 3.5-4.75 ms and a duration of < 10 ms was occasionally observed. These suppressive responses probably resulted from synaptic inhibitory input, but neural membrane properties may have contributed. In hearing animals, excitatory latencies within the range 1.8-5.2 ms were similar for units with different response area types or different PSTH patterns in response to acoustic CF tones or noise.
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    Speech processing for multichannel cochlear implants: variations of the Spectral Maxima Sound Processor strategy
    McKay, Colette M. ; Vandali, Andrew E. ; McDermott, Hugh J. ; Clark, Graeme M. ( 1994)
    The Spectral Maxima Sound Processor (SMSP) incorporates a bank of 16 band-pass filters which are assigned to 16 intracochlear electrodes. In each stimulation period 6 electrodes are activated, based on the outputs of the filters with the largest amplitudes. The SMSP has previously been compared with the present MSP (MULTIPEAK) processor and found to improve speech comprehension results. The SMSP speech processing scheme has recently been implemented successfully in a new speech processor, also developed at the University of Melbourne, which utilises digital signal processing techniques. The programming flexibility of this processor has facilitated the investigation of variations of the SMSP strategy which might provide further enhancement of speech perception. Three variations have been investigated: firstly, increasing the constant pulse rate from the usual 250 Hz to 400 Hz; secondly, changing the number of electrodes selected in each stimulation period from 6 to numbers between 4 and 8; thirdly, sharpening the spectral peaks prior to selection of the active electrodes. The results of these studies showed that all three variations had minimal effect on speech perception in quiet, but that increasing the number of electrodes selected for stimulation to 8, or increasing the rate of stimulation, was advantageous for some subjects when listening in background noise.
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    Pitch perception for different modes of stimulation using the Cochlear multiple-electrode prosthesis
    Busby, P. A. ; Whitford, L. A. ; Blamey, P. J. ; Richardson, L. M. ; Clark, Graeme M. ( 1994)
    Abstract not available due to copyright.
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    Partial hearing loss in the macaque following the co-administration of kanamycin and ethacrynic acid
    Shepherd, R. K. ; Xu, S. A. ; Clark, Graeme M. ( 1994)
    Co-administration of kanamycin (KA) with the loop diuretic ethacrynic acid (EA) rapidly produces a profound hearing loss in the cat while maintaining normal renal function [Xu et al., Hear. Res. 70, 205-215 (1993)]. In the present paper we have applied this deafening procedure to the old world monkey Macaca fascicularis (macaque). Following the co-administration of KA and EA, the hearing loss in the macaque developed far slower than we observed in the cat. Moreover, unlike the cat, there was evidence of a partial recovery in the animal’s hearing, resulting in a bilaterally symmetrical high frequency hearing loss. The extent of this hearing loss was dependent on the dose of the EA administered. Finally, the most unexpected result of the present study was the degree of acute nephrotoxicity experienced by these animals following the drug administration. The sensitivity of this species to renal failure restricted the dose of EA that could be safely administered. In conclusion, the co-administration of KA and EA cannot reliably produce a profound hearing loss in the macaque. While it can produce a dose dependent high frequency hearing loss the animal will also experience acute renal failure that requires careful management.
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    Pitch percepts associated with amplitude-modulated current pulse trains in cochlear implantees
    McKay, Colette M. ; McDermott, Hugh J. ; Clark, Graeme M. ( 1994)
    Abstract not available due to copyright.