Graeme Clark Collection
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ItemPaediatric cochlear implant surgery [Abstract]( 1992)The operation in children is similar to that in adults, but special care needs to be taken with the skin flap, the anchoring of the electrode array and the sealing of .the cochleostomy. Research into the effects of head growth and otitis media in an implanted ear indicates that these should not be a problem. Surgical complications are also similar to those in adults, with the most common being related to the skin flap. The major complication rate at 4 % is slightly less than that in adults and most of these get effective implant function.
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ItemThe development of auditory comprehension in children after receiving a cochlear multiple-channel implant( 1992)Since late 1989, half the cochlear implant patients at the Royal Victorian Eye and Ear Hospital have been young children. There is a gradual improvement of auditory comprehension in most cases using the criteria of environmental sound detection, as well as, prosody, high frequency phoneme and word discrimination. The rate of improvement and final result depend on the duration of deafness, presence of residual hearing, and quality of auditory-oral habilitation. Younger children usually progress more quickly than older children. Some adolescents who use Total Communication and who have no residual hearing, achieve assistance with lipreading. Children with Usher's Syndrome should be actively encouraged to participate in auditory-oral habilitation should they become totally deaf or blind.
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ItemThree-Dimensional reconstruction of the cochlea and temporal bone [Abstract]( 1992)In the preoperative evaluation of prospective cochlear implant patients high resolution computed tomography is routinely performed in our cochlear implant clinic. The sectional images provide the surgeon with essential information about cochlear and mastoid pathology, and are import for planning surgery. Three-dimensional reconstruction can help to visualize the complex anatomy in the temporal bone. We have examined the value of pre-and postoperative three-dimensional reconstruction on our own personal computer based image analysis system. The accuracy of this procedure has been demonstrated by reconstructing seven cadaver temporal bones (including one with an implanted cochlea), and making measurements that were compared with identical ones on the same bones when dissected. The comparison of the data showed good statistical correlation. We examined the CT-scan series of eight children prior to cochlear implantation and one of these postoperateivley (a seven year old girl with a Mondini deformity). It showed in the intracochlear position of the electrode array following the basal turn of the rudimentary cochlea. By its ability to extract certain features from the existing CT-scans and selectively displaying them at any preferred angle and level, our three-dimensional reconstruction programme provides and important tool for the implanting surgeon, helping her/him conceptualize the patients anatomy and plan the operation.
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ItemPreliminary speech perception results for children with the 22-electrode Melbourne / cochlear hearing prosthesis( 1992)The Cochlear 22-electrode cochlear prosthesis was first implanted in a child at the Cochlear Implant Clinic at the University of. Melbourne and Royal Victorian Eye & Ear Hospital in 1985. Since that time 42 children have received the device in Melbourne. Analysis of patient details shows that the majority of these children have a congenital as opposed to on acquired aetiology of hearing loss. In all but 3 cases, the children use 15 or more electrodes. In order to assist with evaluation of, benefits to speech perception across the very heterogeneous group of children, a six level hierarchical classification scheme for speech perception performance levels was created. All of the children achieved a minimum of Category 2 (discrimination of suprasegmental information). In total, 59 % of the children achieved Category 5 or 6 (open set recognition for unfamiliar materials). Analysis showed that the majority of these children had more than one year of experience. In contrast, the majority of children in Category 2 are those with less than one year of experience with the device.
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Item3D reconstruction of the temporal bone in cochlear implant surgery [Abstract]( 1991)High resolution CT-imaging is a routine part of the preoperative evaluation of prospective cochlear implant patients. We have used image analysis techniques to produce three-dimensional (3D) reconstruction of the temporal bone from serial CT-scans. These images have proved very useful in the examination of the temporal bone prior to implant surgery.