Graeme Clark Collection
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ItemElectrode discrimination by early-deafened subjects using the Cochlear Limited multiple electrode cochlear implant( 2000)Objective: The aims of this study were to determine whether electrode discrimination by early-deafened subjects using the Cochlear Limited prosthesis varied at different locations on the electrode array, was influenced by the effects of auditory deprivation and experience with electric stimulation, and was related to speech perception. Design: Difference limens for electrode discrimination were measured in 16 early-deafened subjects at three positions on the array: electrodes 18 (apical), 14 (mid), and 8 (basal). Electrodes were stimulated using random variations in current level to minimize the influence of loudness cues. Assessed were correlations between the difference limens, subject variables related to auditory deprivation (age at onset of deafness, duration of deafness, and age at implantation) and auditory experience (duration of implant use and the total time period of auditory experience), and speech perception scores from two closed-set and two open-set tests. Results: The average difference limens across the three positions were less than two electrodes for 75%, of subjects, with average limens between 2 and 6.5 electrodes for the remaining 25% of subjects. Significant differences across the three positions were found for 69% of subjects. The average limens and those at the basal position positively correlated with variables related to auditory deprivation, with larger limens for subjects implanted at a later age and with a longer duration of deafness. The average limens and those at the apical position negatively correlated with closed-set speech perception scores, with lower scores for subjects with larger limens, but not with open-set scores. Speech scores also negatively correlated with variables related to auditory deprivation. Conclusions: These findings showed that early-deafened subjects were generally successful in electrode discrimination although performance varied across the array for over half the subjects. Discrimination performance was influenced by the effects of auditory deprivation, and both electrode discrimination and variables related to auditory deprivation influenced closed-set speech perception.
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ItemPitch estimation by early-deafened subjects using a multiple-electrode cochlear implant( 2000)Abstract not available due to copyright.
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ItemThe development of speech perception in children using cochlear implants: effects of etiologic factors and delayed milestones( 2000)Hypothesis: Speech perception outcomes for cochlear implantation of children vary over a wide range, and it is hypothesized that central pathologic states associated with certain causes of hearing impairment account for a substantial part of the variance. Study Design: A retrospective analysis was carried out to ascertain the relationships between speech perception, etiologic factors, and central pathologic states as indicated by preoperative delayed motor milestones and/or cognitive delays. Setting: Data were obtained from the pre-and postoperative records of patients attending a hospital cochlear implant clinic. Patients: Results for 75 consecutive patients up to age 5 years who underwent implantation were included in the study. Intervention: Patients received a 22-electrode cochlear prosthesis and were seen by the clinic for regular tune-up and assessments. Home-and school-based habilitation was recommended by the clinic. Main Outcome Measures: Speech perception measures were classified on a five-point scale to allow for different evaluation procedures at different ages and developmental stages. Results: The incidence of motor and cognitive delays were fairly evenly spread across etiologic factors, except for cytomegalovirus, which had a much higher than average incidence. Children with motor and/or cognitive delays were significantly slower than other children in the development of speech perception skills after implantation. Etiologic factors did not have a statistically significant effect on speech perception outcome. Conclusions: It is likely that central pathologic states account for a substantial part of the variance among children using cochlear implants. Specific indicators of central pathologic states should be used to assess a child's prognosis in preference to less specific information based on etiologic factors alone.
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ItemThe relationship between speech perception and electrode discrimination in cochlear implantees( 2000)Abstract not available due to copyright.
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ItemElectrode discrimination and speech perception in young children using cochlear implants( 2000)Objective: The aim was to determine the efficacy of a child-appropriate procedure to assess electrode discrimination ability in young children using cochlear implants and to investigate the relationship of electrode discrimination ability and speech perception performance in children implanted at a young age. Design: An adaptation of the play audiometry procedure was used to assess electrode discrimination in seventeen 4- to 10-yr-old children. The children were required to respond with a game-like motor response when a repeating stimulation on a reference electrode “changed” to a different electrode. They were also assessed on a speech feature discrimination test, a closed-set word recognition test and a nonverbal intelligence task. Results: Sixty-five percent of subjects demonstrated ability to discriminate adjacent electrodes in mid and apical regions of the cochlea, whilst the remaining subjects needed electrode separations of between two and nine electrodes for successful discrimination. In a forward stepwise regression analysis electrode discrimination ability was found to be the strongest factor in accounting for variance in the speech perception scores. Subject variables such as duration of deafness, nonverbal intelligence and implant experience did not significantly account for further variance in the speech perception scores for this group of children. Conclusions: Electrode discrimination ability was the strongest factor in predicting performance on speech perception measures in a group of children using cochlear implants.
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ItemThe cochlear implant: a search for answers( 2000)In 1967, when I commenced cochlear implant research, there was little that could be done to help profoundly deaf people. With normal hearing, sound vibrations are converted by hair cells in the inner ear into electrical signals. These produce temporal and spatial patterns of electrical responses in the auditory pathways. With a profound hearing loss the hair cells are absent, and amplifying sound with a hearing aid provides little help.
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ItemBuilding the bionic ear( 2000)When I began my cochlear-implant research in 1967, one could do nothing to help profoundly deaf people hear. In normal hearing, hair cells in the cochlea, the snail-shaped inner ear, transduce sound vibrations into electrical signals. These signals produce patterns of electrical responses in the auditory pathways that convey the frequency and intensity of the sound to the brain. The profoundly deaf, however, have lost their hair cells, so even amplifying sound with a hearing aid fails to transmit information that the brain can interpret as sound.
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ItemPost mortem study of the intracochlear position of the nucleus standard 22 electrode array( 2000)The final position of an intracochlear cochlear implant electrode array can vary depending on the pathology, the insertion technique used and the type of electrode array used. The distance of the electrodes from the target neural elements and the presence of intracochlear fibrous tissue or new bone formation are believed to affect the performance of the device. A post mortem study was conducted to assess these factors.
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ItemPhase-contrast radiography: a new x-ray technique for cochlear implant research(Moduzzi Editore, 2000)This study examines the application of a new x-ray modality, phase contrast radiography, in temporal bone (TB) imaging. Preliminary results from TB samples have shown that phase-contrast imaging offers greater contrast for edge-type features and weakly absorbing soft-tissue resulting in improved visualization of anatomic details of inner ear and microelectrode structures. This is potentially valuable in the development of new electrode arrays for cochlear implants.
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ItemPhysiological and histopathological effects of chronic monopolar high rate stimulation on the auditory nerve( 2000)Speech processing strategies based on high rate electrical stimulation have been associated with improvements in speech perception among cochlear implant users. The present study was designed to evaluate the electrophysiological and histopathological effects of long-term intracochlear monopolar stimulation at the maximum stimulus rate of the current Nucleus Cochlear implant system (14493 pulses/s) as part of our ongoing investigations of safety issues associated with cochlear implants