Graeme Clark Collection
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ItemThe evolution continues: the clinical trials of the SPEAK strategy in Nucleus 22 channel cochlear implant users [Abstract]( 1994)Research in the field of cochlear implants continues in centres around the world. The aim of all centres is to improve the speech perception abilities of those children and adults fitted with a cochlear implant. Most recently the work of Hugh McDermott and Colette McKay (Melbourne University, Department of Otolaryngology) in developing and researching the SMSP (Spectral Maxima Sound Processor) has greatly enhanced the speech understanding abilities of a number of subjects implanted with the Nucleus 22 Channel Cochlear Implant.
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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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ItemCombined electrical and acoustical stimulation using a bimodal prosthesis( 1993)A new device incorporating a cochlear implant speech processor and a speech-processing hearing aid for the un-implanted ear has been designed and tested with four severely hearing-impaired patients. The aim of the device is to provide a more acceptable and effective combination of electrical and acoustic signals to the two ears. When used monaurally, and binaurally in conjunction with the cochlear implant, the speech-processing hearing aid mean scores for open-set sentences, words, and consonants were as good as or better than the mean scores for the patients' own conventional hearing aids. Some patients improved much more than did others. Although not conclusive, these results are encouraging, especially as they were achieved with a laboratory prototype that did not allow the patients to become accustomed to the processor in everyday situations.
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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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ItemEvaluation of a two-formant speech-processing strategy for a multichannel cochlear prosthesis( 1987)Initial results with the two-formant speech-processing strategy (F0FIF2) confirm the advantage of a multichannel cochlear prosthesis capable of stimulating at different sites within the cochlea. The successful presentation of two spectral components by varying the place of stimulation leads to the possibility of presenting further spectral information in this manner. Because virtually all multichannel implant patients demonstrate good "place" (electrode site) discrimination, these more refined coding strategies should lead to benefits for the majority of implantees. Already, with the F0FIF2 strategy, we have a system that appears to provide some effective auditory-alone communication ability for the average patient.
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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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ItemInitial results for six patients with a multiple-channel cochlear prosthesis(Monash University Press, 1983)A total of eight patients have been assessed with the multi-channel cochlear prosthesis at the University of Melbourne. The first two patients were implanted with a prototype device in 1978 and 1979, and their results with various speech evaluation procedures have been reported and summarized in detail elsewhere (Clark & Tong, 1982). Briefly, these results indicated that some very significant benefit could be obtained for these patients when using the cochlear prosthesis with external speech processing, particularly when using the device in conjunction with lipreading. It was also shown that some significant understanding of speech was possible without lipreading (open-set) for both patients, although this was fairly limited.
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ItemClinical trial of a multiple-channel cochlear prosthesis: an initial study in four patients with profound total hearing loss( 1983)The clinical trial of a multiple-channel cochlear prosthesis was undertaken in four patients with postlingual deafness and profound total hearing loss. The results of open-set speech tests confirmed that, using electrical stimulation alone, one patient could have a meaningful conversation with resorting to lipreading (for example, this patient uses the prosthesis to converse with her husband on the telephone). The results of closed-set speech tests also suggested that a multiple-channel stimulator is more effective than a single-channel one in conveying speech information. The cochlear prosthesis was especially effective in all four patients when it was used in conjunction with lipreading, and speech-tracking tests showed that the patients could combine the information obtained from both electrical stimulation and lipreading.
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ItemThe preliminary clinical trial of a multichannel cochlear implant hearing prosthesis( 1983)Abstract not available due to copyright.