Graeme Clark Collection
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ItemChronic electrical stimulation of the auditory nerve at high rates: I. Effect on residual hearing [Abstract]( 1996)In addition to direct excitation of auditory nerve fibres, cochlear implant patients with small amounts of residual hearing may receive important additional auditory cues via electrophonic activation of hair cells 1. Before incorporating electrophonic hearing into speech processing strategies, the extent of hair cell survival following cochlear implantation must first be determined. We have recently demonstrated widespread survival of hair cells apical to electrode arrays implanted for periods of up to three years, the present report describes the effects of chronic electrical stimulation on hair cell survival.
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ItemChronic electrical stimulation of the auditory nerve at high rates: II. Cochlear pathophysiology [Abstract]( 1996)A major factor in the improved performance of cochlear implant patients has been the use of high stimulus rate speech processing strategies. While these strategies show clear clinical advantage, we know little of their long-term safety. Indeed, recent studies have indicated that high stimulus rates at intensities above clinical limits, can result in neural damage as a result of prolonged neuronal hyperactivity. The present study was designed to evaluate the effects of chronic electrical stimulation of the auditory nerve at high rates, using intensities within clinical limits.
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ItemSpatial representation of the cochlea within the inferior colliculus of neonatally deafened kittens following chronic electrical stimulation of the auditory nerve [Abstract]( 1995)The orderly tonotopic representation of the cochlea is accurately reproduced within the central auditory system of normal hearing animals. Any degradation of this representation as a result of a neonatal hearing loss or chronic electrical stimulation during development could have important implications for the use of multichannel cochlear implants in young children. In the present study we have used 2-deoxyglucose autoradiography (2-00) to examine the topographic representation of the cochlea within the inferior colliculus (IC) of neonatally deafened kittens following periods of chronic intracochlear electrical stimulation.
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ItemIntracellular responses of anteroventral cochlear nucleus neurones to intracochlear electrical stimulation in the rat [Abstract]( 1996)The anterior division of the ventral cochlear nucleus (AVCN) is the first relay station of the auditory pathway. Currently little is known about the intracellular physiological responses of neurones in the AVCN to electrical stimulation of the cochlea. We investigated the effect of cochlear electrical stimulation in the rat AVCN using in vivo intracellular recordings. Male rats were anaesthetised with urethane (1.3g/kg i.p), placed in a stereotaxic frame, the crania and dura removed and the cochlear nucleus exposed.
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ItemElectrophonically driven single unit responses of the anteroventral cochlear nucleus in cat [Abstract]( 1996)Electrical stimulation of the cochlea results in both direct and electrophonic excitation of auditory nerve fibres. It has been proposed that electrophonic stimulation results from the creation of a mechanical disturbance on the basilar membrane which has properties similar those resulting from acoustic stimuli. Auditory nerve compound action potential (CAP) forward masking studies1 show the level of frequency specific electrophonic stimulation is highly correlated with the spectral energy of the electrical stimulus waveform. The level of spectral energy in pulsatile biphasic electrical stimuli decreases toward low frequencies suggesting the level of electrophonic stimulation will be diminished in the low frequency region of the cochlea.
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ItemThe pitch of amplitude-modulated electrical stimuli in cochlear implantees [Abstract]( 1993)The ability of cochlear implantees to detect amplitude modulation of pulsatile electrical stimulation, suggests that some speech feature information may be conveyed effectively by this means. For example, modulations at the fundamental frequency of speech may provide a voice pitch percept to implantees, particularly in speech processing strategies which generate constant-rate stimulation. The pitch evoked by sinusoidally modulated current pulse trains on a single electrodes has been studied. Modulation frequencies of 100, 150 and 200Hz, and carrier pulse rates varying from 200 to 1200Hz, were used. The results showed that the pitch of the stimulation was related to the modulation frequency, provided that either the carrier rate was a multiple of the modulation frequency, or the carrier rate was sufficiently high (at least four times the modulation frequency for the stimuli studied here). Furthermore, when the modulated stimuli were matched in pitch to non-modulated pulse trains, it was. found that the rate of the matched non-modulated stimuli was close to but somewhat higher than the modulation frequency. This difference depended on the carrier rate and varied among subjects.
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ItemA "Combionic Aid": Combined speech processing for a cochlear implant in one ear and speech processing hearing aid in the other ear [Abstract]( 1993)Independent use of a cochlear implant in one ear and a hearing aid in the other is not acceptable for many implant users with some residual hearing. Psychophysical evidence suggests that there are substantial interactions between acoustic and electrical signals including masking and loudness summation. These effects may contribute to the difficulty in using two independent devices and it is desirable to control the parameters of the electrical and acoustical signals far more accurately than is possible with two independent devices with separate microphones. In order to achieve this control we have developed a Combionic aid incorporating an implant and an 'in1planlcompatible' hearing aid controlled from the same speech processor. The new processor is particularly flexible and can implement a wide variety of speech processing strategies for combined acoustic and electrical stimulation. A benchtop prototype has been tested with five patients using a range of different speech tests. In general, patients do better when they use acoustic and electrical information simultaneously than they do with either alone. Some patients on some tests perform significantly better with the bimodal aid than they do with independent hearing aids and implant processors worn together. Wearable devices have now been built and evaluations of these devices are continuing.
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ItemComparison and alternate designs for peri-modiolar electrode arrays: insertion trauma and position [Abstract]( 1997)While it has been shown that the straight but flexible banded electrode array can be safely inserted into the scala tympani of the human cochlea, histological studies have revealed that the array lies along the outer walll.2. Since a profound total hearing loss is generally associated with a moderate to complete degeneration of the spiral ganglion peripheral process, these electrodes lie some distance from their target neural population -the spiral ganglion soma -located within Rosenthal's canal.
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ItemThe use of click-ABR and steady state evoked potentials for hearing assessment in young cochlear implant candidates [Abstract]( 1997)The accurate assessment of hearing thresholds in prospective cochlear implant candidates is essential. As the minimum age of implantation has reduced, audiologists have been faced with the complicated task of obtaining precise audiometric information in children whose immaturity may severely restrict the assessment process. Clearly for these young candidates, there is a place for a reliable, objective measure of residual hearing in the pre-operative test battery. This paper examines the degree of accuracy with which the click-ABR and the steady-state evoked potential (SSEP) techniques can provide estimates of hearing level in subjects with several profound hearing loss.
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ItemImplantation of the new nucleus C1-3 receiver stimulator and electrode array [Abstract]( 1997)There is an important need to fix the cochlear implant electrode array at a site close to the cochlea, so that the electrode will not slide out, or be subject to differential movement with growth changes. Fixation sites have been in the region of the posterior root of the zygoma and the floor of the antrum. Fixation has been by Dacron mesh ties platinum wire ties, or clips inserted with-special instruments. Biological cements have previously been tried but found to be toxic. The most ideal site is in the region of the cochleostomy.