Graeme Clark Collection
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ItemSpeech perception for children with different levels of residual hearing using the cochlear 22-channel cochlear prosthesis [Abstract[( 1996)Over the past 10 years, since the implantation of the first children with the Nucleus 22-channel cochlear prosthesis in Melbourne, the number of profoundly deaf children using this implant system has rapidly expanded. Longer-term experience with implanted children has led to improvements in paediatric assessment and management. Speech processing strategies have also been improved, resulting in a series of increases in speech perception benefits. Results of comparative studies of Speak and Multipeak speech processing strategies have shown that open-set word and sentence scores for a group of thirteen children evaluated over a two year period showed an advantage with the Speak speech processing strategy. The increases were noted particularly in speech perception in poor signal-to-noise conditions. Analysis has shown that consonant perception was significantly increased, due to an improved place perception. Given current speech perception scores for implanted children, it has been suggested that severely-to-profoundly deaf children currently using hearing aids could in fact benefit more from a cochlear implant. Preliminary investigation of results for children in the Melbourne and Sydney cochlear implant programs has shown that children with higher levels of preoperative residual hearing as a group do score significantly on open-set word and sentence perception tests using the implant alone. In children with lower levels of residual hearing, results were variable across the group.
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ItemChronic middle ear disease and cochlear implantation( 1995)Profound or total hearing loss can occur in the setting of chronic suppurative otitis media (CSOM), either coincidentally or secondary to the disease process. Obviously, inserting a foreign body through a potentially infected field into a space that communicates intracranially presents a challenging management problem. This paper presents the experience from the Melbourne Cochlear Implant Clinic (CIC) in implanting patients with bilateral CSOM. This is certainly not a common problem, as there have been only 3 cases from 121 implanted adults. However, we feel that it is an important issue with potentially devastating consequences. In addition, there are many countries in which bilateral CSOM is a more common problem and cause of profound or total 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.
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ItemSpeech perception results for children changing from multipeak to SPEAK speech processing strategy [Abstract]( 1996)In mid-1994, a new speech processing strategy termed SPEAK was introduced for the Nucleus Spectra-22 cochlear prostheses. To compare benefits in implanted children changing to the SPEAK strategy, speech perception in a group of twelve children from Melbourne and Sydney was evaluated. The children were assessed in quiet and in background noise.
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ItemFactors affecting speech perception in children cochlear 22-channel cochlear prosthesis [Abstract]( 1996)Since the implantation of the first children with the Nucleus 22-channel cochlear prosthesis in Melbourne in 1985, there have been rapid expansion world-wide in the number of children using this implant system. Longer-term experience with implanted children has led to improvements in paediatric assessment and management. Speech processing strategies have also been improved, resulting in a series of increases in speech perception benefits.
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ItemSpeech perception results for implanted children with different levels of preoperative residual hearing [Abstract]( 1996)Many reports have established that hearing-impaired children using the Nucleus 22-channel cochlear implant may show both significant benefits to lipreading, and significant scores on open-set words and sentences using electrical stimulation only. These findings have raised suggestions that severely or severely-to-profoundly deaf children might benefit more from a cochlear implant than conventional amplification.
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ItemMulticenter evaluations of speech perception in adults and children with the nucleus (cochlear) 22-channel cochlear implant(Kugler, 1996)The Nucleus 22-channel cochlear implant has been implanted in over 10,500 patients in 79 countries. and used for more than 25 languages. It arose as a result of our early physiological, behavioral and biological research on experimental animals. The historical development of the Nucleus device has been outlined in detail by Clark. Our ongoing research has led to improvements in the way speech is processed with the 22-channel device that are now resulting in improved speech perception for profoundly totally deaf people that is, on average, better than the speech perception obtained by many deaf people with hearing aids. The multiple-channel cochlear implant was first approved by the US Food and Drug Administration (FDA) for use in postlinguistically deaf adults in 1985. It was subsequently approved for use in children in 1990. The proportion of children (18 years of age and under) to have now received it is approximately 439C (4,500 out of 10.500). In evaluating improvements in speech processing it is important to design well-controlled studies, and a number of important ones which have previously been published are summarized in this paper. In addition, speech perception results for all the Nucleus speech processing strategies have been obtained four to six months postoperatively from unselected patients presenting to the Cochlear Implant Clinic at the Royal Victorian Eye & Ear Hospital (RVEEH), Melbourne, and are presented in this paper. As results can vary greatly with different durations of experience it is essential to make comparisons at the same time postoperatively. These clinical data are the most complete to date for comparing the Nucleus speech processing strategies.
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ItemSpeech perception benefits for implanted children with preoperative residual hearing [Abstract]( 1995)Since the implantation of the first children with the Nucleus 22-channel cochlear prosthesis in Melbourne in 1985, there has been rapid expansion in the number of implanted children world-wide. Improved surgical technique and experience in paediatric assessment and management have contributed to a trend to implant very young children. At the same time there has also been continuing development of improved speech processing strategies resulting in greater speech perception benefits.