Graeme Clark Collection

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    A clinical report on receptive vocabulary skills in cochlear implant users
    Dawson, P. W. ; Blamey, P. J. ; Dettman, S. J. ; Barker, E. J. ; Clark, Graeme M. ( 1995)
    Objective: The aim was to measure the rate of vocabulary acquisition for cochlear implant users and compare the pre- and postoperative rates with published data for other groups with normal or impaired hearing. The hypothesis was that the postoperative rate would be greater than the preoperative rate. Design: The Peabody Picture Vocabulary Test (PPVT) was administered to 32 children, adolescents, and prelinguistically deafened adults implanted with the 22-electrode cochlear implant. Age at implantation ranged from 2 y r 6 mo to 20 yr and implant use ranged from 6 mo to 7 yr 8 mo. Results: The group mean postoperative performance at various postoperative intervals was significantly higher than mean preoperative performance. Single-subject data indicated statistically significant gains over time on this test for 13 of the subjects. The mean postoperative rate of vocabulary acquisition of 1.06 times the rate for normally hearing children was significantly greater than the mean preoperative rate of 0.43. Conclusions: These rates of improvement were in accord with previous reports on smaller numbers of implant users, but could not be attributed unambiguously to use of the implant because no control group was used for this clinical work. Variables such as age at implantation, duration of profound deafness, communication mode, and speech perception skill failed to significantly predict rate of improvement on the PPVT.
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    A clinical report on speech production of cochlear implant users
    Dawson, P. W. ; Blamey, P. J. ; Dettman, S. J. ; Rowland, L. C. ; Barker, E. J. ; Tobey, E. A. ; Busby, P. A. ; Cowan, R. C. ( 1995)
    Objective: The aim was to assess articulation and speech intelligibility over time in a group of cochlear implant users implanted at 8 yr or over. The hypothesis was that the postoperative speech production performance would be greater than the preoperative performance. Design: A test of intelligibility using sentences and an articulation test measuring non-imitative elicited speech were administered to 11 and 10 subjects, respectively, who were implanted with the 22-electrode cochlear implant. Nine subjects received both tests. Age at implantation ranged from 8 yr to 20 yr and implant use ranged from 1 yr to 4 yr 5 mo. Results: For both the intelligibility and articulation tests roughly half of the subjects showed significant improvements over time and group mean postoperative performance significantly exceeded preoperative performance. Improvements occurred for front, middle, and back consonants; for stops, fricatives, and glides and for voiceless and voiced consonants. Conclusions: Despite being deprived of acoustic speech information for many childhood years, roughly half of the patients assessed showed significant gains in speech intelligibility and articulation postimplantation. The lack of a control group of non-implanted patients means that we cannot separate out the influence of the implant on speech production from other influences such as training and tactile-kinaesthetic feedback.
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    Cochlear histopatholgic characteristics following long-term implantation: safety studies in the young monkey
    Burton, Martin J. ; Shepherd, Robert K. ; Clark, Graeme M. ( 1996)
    Objective: To evaluate the safety of cochlear implantation in children 2 years of age or younger using a non-human primate model.
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    Electrode position, repetition rate, and speech perception by early-and-late-deafened cochlear implant patients
    Busby, P. A. ; Tong, Y. C. ; Clark, Graeme M. ( 1993)
    Psychophysical and speech perception studies were conducted on eight patients using the 22electrode cochlear implant manufactured by Cochlear Pty. Ltd. Four early-deafened patients became deafened at 1-3 years of age and were implanted at 5-14 years of age. Four late-deafened (postlingual adult) patients became deafened at 38-47 years of age and were implanted at 42-68 years of age. Psychophysical studies measured the discrimination of trajectories with time-varying electrode positions and repetition rates. Speech perception studies measured performance using two speech coding strategies: a multi-electrode strategy which coded the first and second formant frequencies, the amplitudes of the two formants, and the fundamental frequency; and a single-electrode strategy which coded the amplitudes of the first and second formants, and the fundamental frequency. In general, the four late-deafened patients and one early-deafened patient were more successful than the other three early-deafened patients in the discrimination of electrode position trajectories and in speech perception using the multi-electrode strategy. Three of the four late-deafened patients were more successful than the early-deafened patients in the discrimination of repetition rate trajectories. Speech perception performance in the single-electrode strategy was closely related to performance in repetition rate discrimination. The improvement in speech perception performance from the single-electrode to multi-electrode strategy was consistent with successful performance in electrode discrimination.
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    Results for two children using a multiple-electrode intracochlear implant
    Busby, P. A. ; Tong, Yit C. ; Roberts, S. A. ; Altidis, P. M. ; Dettman, S. J. ; Blamey, Peter J. ; Clark, Graeme M. ; Watson, R. K. ; Rickards, Field W. ( 1989)
    Abstract not available due to copyright.
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    Surgery for an improved multiple-channel cochlear implant
    Clark, Graeme M. ; Pyman, Brian C. ; Webb, Robert L. ; Bailey, Quentin E. ; Shepherd, Robert K. ( 1984)
    An improved multiple-channel cochlear implant has been developed. The titanium container with enclosed electronics, the receiver coil and the connector are embedded in medical-grade Silastic. The upper half of the implant has a diameter of 35 mm and a height of 4.5 mm. and the lower half a diameter of 23 mm and a height of.5 mm. The electrode array has also been designed to reduce the possibility of breakage due to repeated movements over many years. The surgery involves drilling a bed in the mastoid bone for the receiver-stimulator, and fixing the proximal electrode under the mastoid cortex. Gentle insertion of the electrode array through the round window and along the seala tympani is achieved with a specially designed microclaw.
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    A multiple electrode cochlear implant
    Clark, Graeme M. ; Tong, Y. C. ; Black, R. ; Forster, I. C. ; Patrick, J. F. ; Dewhurst, D. J. (Cambridge University Press, 1977)
    It is generally agreed that if a cochlear implant hearing prosthesis is to enable a patient to understand speech, it must be a multiple-electrode system. In addition, stimulation of the auditory nervous system should approximate the patterns of neural excitation occurring in people with normal hearing, and this is especially important when a patient has previously experienced hearing. For this reason the correct application of electrophysiological principles to the design of a hearing prosthesis is desirable, and is discussed in this paper with special reference to a device developed in the Departments of Otolaryngology and Electrical Engineering at the University of Melbourne (UMDOLEE).
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    The clinical assessment of cochlear implant patients
    Clark, Graeme M. ; O'Loughlin, J. O. ; Rickards, Field W. ; Tong, Y. C. ; Williams, A. J. (Cambridge University Press, 1977)
    This paper is a discussion of the clinical assessment routine adopted following experience gained over the last three years from evaluating 27 patients with severe sensori-neural deafness to determine whether they are suitable for the cochlear implantation of a multiple-electrode receiving and stimulating device developed jointly in the Departments of Otolaryngology and Electrical Engineering at the University of Melbourne.
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    A multiple-electrode array for a cochlear implant
    Clark, Graeme M. ; Hallworth, Richard J. (Cambridge University Press, 1976)
    It is becoming increasingly evident from experimental work on animals and humans that if cochlear implants are going to help patients understand speech, they must be designed to stimulate a number of different groups of auditory nerve fibres.
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    Histopathological findings in cochlear implants in cats
    Clark, Graeme M. ; Kranz, Howard G. ; Minas, Harry ; Nathar, J. M. (Cambridge University Press, 1975)
    If cochlear implants are to be used on patients, it is important that experimental studies should be carried out on animals so that tissue tolerance and other long term effects of electrode implantations can be assessed. Consequently, an experimental study by Simmons (1967) is of interest, as it has shown that a stainless steel electrode inserted into the basal turn of the cochlea through the round window can be tolerated, and not lead to permanent damage unless infection supervenes. Furthermore, in a study by Axelsson and Hallen (1973) it has been demonstrated that drilling an opening in the cochlea will usually only lead to localized damage of the cochlear structures, and that the opening in the bone normally heals.