Graeme Clark Collection

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    Cochlear implants in children: the value of cochleostomy seals in the prevention of labyrinthitis following pneumococcal otitis media
    Dahm, M. C. ; Webb, R. L. ; Clark, Graeme M. ; Franz, B. K-H. ; Shepherd, R. K. ; Burton, M. J. ; ROBINS-BROWNE, R. ( 1995)
    Cochlea implantation at an early age is important in rehabilitating profoundly hearing impaired children. Given the incidence of pneumococcal otitis media in young children, there has been concern that cochlear implantation could increase the possibility of otitis media, leading to labyrinthitis in this age group. Clinical experience has not indicated an increase in the frequency of otitis media and labyrinthitis in implanted adults or children over two years. However, labyrinthitis has occurred in implanted animals with otitis media. In order to assess the impact of cochlear implants on the occurrence of labyrinthitis, pneumococcal otitis media was induced in 21 kittens. Thirty-two kitten cochleas were implanted, of which 9 had a fascial graft and 9 a Gelfoam® graft. Nine control cochleas were unimplanted. Labyrinthitis occurred in 44% of unimplanted controls. 50% of implanted ungrafted cochleas, and 6% of implanted grafted cochleas. There was no statistically significant difference between the incidence of labyrinthitis in the implanted cochleas and the unimplanted controls. However there was a statistically significant difference between the ungrafted and grafted cochleas, but not between the two types of graft.
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    Cochlear implantation in young children: histological studies on head growth, leadwire design, and electrode fixation in the monkey model
    Burton, M. J. ; Shepherd, R. K. ; Xu, S. A. ; Xu, J. ; Franz, B. K-H. G. ; Clark, Graeme M. ( 1994)
    For safe cochlear implantation in children under 2 years of age, the implant assembly must not adversely affect adjacent tissues or compromise head growth. Furthermore, growth changes and tissue responses should not impair the function of the device. Dummy receiver-stimulators, interconnect plugs, and leadwire-lengthening systems were implanted for periods of 36 months in the young monkey to effectively model the implantation of the young child. The results show that implanting a receiver-stimulator package has no adverse effects on skull growth or the underlying central nervous system. The system for fixing the electrode at the fossa incudis proved effective. There was marked osteoneogenesis in the mastoid cavity, resulting in the fixation of the leadwire outside the cochlea. This study provides evidence for the safety of cochlear implantation in young subjects.
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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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    Recent developments with the Nucleus 22-electrode cochlear implant: a new two formant speech coding strategy and its performance in background noise
    Franz, Burkhard K-H. G. ; Dowell, Richard C. ; Clark, Graeme M. ; Seligman, Peter M. ; Patrick, James F. ( 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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    A multiple-electrode intracochlear implant for children
    Clark, Graeme M. ; Blamey, Peter J. ; Busby, Peter A. ; Dowell, Richard C. ; Franz, Burkhard K-H. ; Musgrave, Gaye Nicholls ; Nienhuys, Terry G. ; Pyman, Brian C. ; Roberts, Susan A. ; Tong, Yit C. ; Webb, Robert L. ; Kuzma, Januz A. ; Money, David K. ; Patrick, James F. ; Seligman, Peter M. ( 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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    The implanted round window membrane in the cat [Abstract]
    Franz, B. ; Clark, Graeme M. ; Ng, J. ; Bloom, D. (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.