Graeme Clark Collection
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ItemRecent developments with the Nucleus 22-electrode cochlear implant: a new two formant speech coding strategy and its performance in background noise( 1987)A clinical evaluation of speech processing strategies for the Nucleus 22-electrode cochlear implant showed improvements in understanding speech using the new F0F1F2 speech coding strategy instead of the F0F2 strategy. Significant improvement in closed-set speech recognition in the presence of background noise was an additional advantage of the new speech processing strategy.
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ItemSurgical anatomy of the round window with special reference to cochlear implantation(Cambridge University Press, 1987)When the multi-channel cochlear implant electrode is inserted into the scala tympani through the round window the operation is best performed via a posterior tympanotomy. The view of the round window membrane, however, is incomplete because of its orientation and the fact that it has a conical shape. Nevertheless, a good view along the basal turn is obtained after the antero-inferior overhang of the round window niche and the crista fenestrae have been removed. It might be damaging to drill away the postero-superior overhang as the osseous spiral lamina lies extremely close to the round window membrane.
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ItemEffect of experimentally induced otitis media on cochlear implants( 1987)Cat cochleas implanted with scala tympani prostheses were investigated histologically after inoculating the bullae with a suspension of group A streptococci. The prosthesis was passed through the round window membrane in one ear. In the other the prosthesis bypassed the round window via an opening anteroinferior to the round window niche. Before death, horseradish peroxidase was administered as a tracer for possible pathways of infection. Results showed that group A streptococci were pathogenic to the cat and caused inflammation in the bulla. The unimplanted round window membrane and the seals around the electrode entry points prevented infection from entering the cochlea. The seals around electrodes inserted either through the round window membrane or an opening drilled anteroinferior to the niche were equally effective. The horseradish peroxidase tracer studies showed, however, that a gap existed between the electrode and membranous seal, and this could be a potentially vulnerable site under certain conditions. Drilling an anteroinferior opening into the cochlea resulted in bony sequestra entering the cochlea. This can be avoided by blue-lining the opening and removing bone with picks before making an opening through the endosteum.
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ItemRefined surgical technique for insertion of banded electrode array( 1987)A refined electrode insertion technique is presented for the multichannel cochlear implant. It comprises two basic steps. The first step is the removal of the anteroinferior overhang of the round window and crista fenestrae, or alternatively an opening drilled into the scala tympani anteroinferior to the round window. The second is rotation of the electrode during insertion, counterclockwise in the right ear and clockwise in the left ear.
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ItemMiddle ear infection postimplantation: response of the round window membrane to Streptococcus pyogenes( 1987)The seal of the implanted round window membrane to resist Streptococcus pyogenes invasion from the middle ear was investigated in 12 cats. Results showed that the implanted round window membrane is able to form a barrier for S pyogenes starting 1 week postimplantation. Under normal conditions S pyogenes did not pass through the round window membrane, nor through the gap that existed between the membrane and the prosthesis. Mechanical disruption of the round window seal, however, and severe inflammatory response to S pyogenes caused the infection to extend into the inner ear.
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ItemPreliminary results for the Cochlear Corporation multielectrode intracochlear implant in six prelingually deaf patients( 1987)The preliminary results from this study indicate that some prelingually deaf patients may get worthwhile help from a multiple-electrode cochlear implant that uses a formant-based speech processing strategy. It is encouraging that these improvements can occur in young adults and teenagers. The results for two children are also encouraging. A 10-year-old child obtained significant improvement on some speech perception tests. It was easy to set thresholds and comfortable listening levels on a 5-year-old child, and he is now a regular user of the device. There are, however, considerable variations in performance among the prelingual patients, which may be related to the following factors: whether they have had some hearing after birth, the method of education used, the motivation of the patient, and age at implantation.
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ItemA multiple-electrode intracochlear implant for children( 1987)A multiple-electrode intracochlear implant that provides 21 stimulus channels has been designed for use in young children. It is smaller than the adult version and has magnets to facilitate the attachment of the headset. It has been implanted in two children aged 5 and 10 years. The two children both lost hearing in their third year, when they were still learning language. Following implantation, it was possible to determine threshold and comfortable listening levels for each electrode pair. This was facilitated in the younger child by prior training in scaling visual and electrotactile stimuli. Both children are regular users of the implant, and a training and assessment program has been commenced.
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ItemPneumococcal middle ear infection and cochlear implantation( 1987)A limited study for the experimental induction of pneumococcal otitis media is presented. It is a useful model to study the effects of otitis media in the implanted and nonimplanted cochlea of the cat. Pneumococcal otitis media caused minor pathological changes in two nonimplanted cochleas and more widespread changes together with significant loss of neural elements in two implanted cochleas. However, the small number of animals used in this study did not allow us to distinguish between the effects of electrode insertion trauma, infection, or the combination of both.
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ItemPermeability of the implanted round window membrane in the cat: an investigation using horseradish peroxidase( 1984)The round window membrane of seven cats was implanted with a Silastic® prosthesis 5 mm long. The membrane's permeability to horseradish peroxidase was investigated at different stages after implantation. All cats were treated with amoxycillin for a period of one week after the operation. Results showed an increased permeability over a period of approximately two weeks following implantation. Thereafter the round window barrier to horseradish peroxidase returned to normal. In all cases cochlear hair cells and auditory nerve fibres were preserved. In cases of spontaneous infection in the bulla the membrane responded with a proliferation of the subepithelial connective tissue, and the formation of protuberances. In these round windows although the permeability was increased the penetration of horseradish peroxidase into the scala tympani was limited. Horseradish peroxidase always passed through the gap between the membrane and the prosthesis. Particles were taken up, however, by the connective tissue envelope that formed around the prosthesis after one week.
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ItemThe implanted round window membrane in the cat [Abstract](Monash University Press, 1983)In cochlear implants the round window is convenient for the electrode insertion into the scala tympani because the surgical approach is reasonably easy and the inserted electrode lies close to systematically organised nerve fibres in the spiral lamina. However, complications might occur when a poor seal, extensive tissue damage or surgical asepsis are present that lead to a reduction in the nerve fibre population which is needed for electrical stimulation. Published articles available do not describe the role of the window membrane in cochlear implants. Probably this can be referred to the finidng of abundant scar tissue in the window niche and around the electrode giving the impression of a safely implanted electrode. This study performed on seven cats over 5 months was concerned with morphological properties of the implanted window membrane at different stages after implantation. In addition, horseradishperoxydase was used as a tracersubstance to give data concerning the sealing properties of the implanted round window membrane.