Graeme Clark Collection
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ItemEffects of intracochlear factors on spiral ganglion cells and auditory brain stem response after long-term electrical stimulation in deafened kittens( 2000)Using an animal model, we have studied the response of the auditory brain stem to cochlear implantation and the effect of intracochlear factors on this response. Neonatally, pharmacologically deafened cats (100 to more than 180 days old) were implanted with a 4-electrode array in both cochleas. Then, the left cochlea of each cat was electrically stimulated for total periods of up to 1000 hours. After a terminal 14C-2-deoxyglucose (2DG) experiment, the fraction of the right inferior colliculus with a significant accumulation of 2DG label was calculated. Using 3-dimensional computer-aided reconstruction, we examined the cochleas of these animals for spiral ganglion cell (SGC) survival and intracochlear factors such as electrode positions, degeneration of the organ of Corti, and the degree of fibrosis of the scala tympani. The distribution of each parameter was calculated along the organ of Corti from the basal end. There was a positive correlation between SGC survival and the level of fibrosis in the scala tympani, and a negative correlation between SGC survival and the degree of organ of Corti degeneration. Finally, there was a negative correlation between the 2DG-labeled inferior colliculus volume fraction and the degree of fibrosis, particularly in the 1-mm region nearest the pair of electrodes, and presumably in the basal turn.
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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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ItemThe effects of electrode position and stimulus period on the hearing sensations in a multiple-channel cochlear implant patient [Abstract]( 1981)Abstract not available due to copyright.
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ItemA multiple-channel cochlear implant: evaluation using speech tracking( 1981)Two totally deaf patients who had received multiple-channel cochlear implants were tested using a speech "tracking" procedure in which they had to repeat verbatim passages of connected discourse. Their performance was assessed by calculating the tracking rate (words per minute) each session. Testing was carried out under two conditions - lipreading along and lipreading in conjunction with a multiple-channel cochlear implant and laboratory speech processor. Lipreading with the cochlear implant increased the tracking rates by a factor of four for one patient and by a factor of two for the other when compared with lipreading alone.
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ItemVowel perception and hearing impairment( 1981)The perception of vowels by young hearing-impaired and normal-hearing children was investigated in two experimental versions, one which required the child ~o make discriminations among minimal pairs, the other which was based on free choice. Each version focused on three lists which comprised monosyllabic real word-pairs whose initial and final consonants were identical. These lists were constructed around high and low frequency components of vowel spectra in order to explore those acoustic aspects which have been hypothesized (Ling, 1978) as being maximally problematic in high-frequency hearing loss. Results indicated that the normal-hearing children, in contrast to the hearing-impaired, made virtually no errors in either task. The hearing-impaired children made significantly more errors in the free-choice task and in the lists whose vowels contained the highest frequency spectra and among those word-pairs which commenced with nonstops.....
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ItemPerceptual dissimilarity and discrimination studies using two-electrode stimulation with a multiple-channel cochlear implant patient [Abstract]( 1981)Abstract not available due to copyright.
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ItemA multiple-channel cochlear implant: an evaluation using nonsense syllables( 1981)A study using nonsense syllables has shown that a multiple-channel cochlear implant with speech processor is effective in providing information about, voicing and manner and to a lesser extent place distinctions. These distinctions supplement lipreading cues. Furthermore, the average percentage improvements in overall identification scores for multiple-channel electrical stimulation and lipreading compared to lipreading alone were 71% for a laboratory-based speech processor and 122 % for a wearable unit.
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ItemA multiple-channel cochlear implant: an evaluation using an open-set word test( 1981)Multiple-channel electrical stimulation of the hearing nerve in conjunction with speech reading has helped two post-lingually deaf patients with total hearing losses understand running speech in every day situations. This has been confirmed using open-set phonetically balanced word tests, where the patients achieved 60% and 40% scores with isolated-words and 80% and 73% for phonemes-in-isolated words. The tests also showed that the cochlear implant improved word recognition by a factor of four in one patient and two in another compared with speechreading alone. The speech processor used extracted the voicing frequency and energy and the frequency and energy of the dominant spectral peak in the mid-frequency range. The parameters for voicing determined the rate of stimulation for all electrodes, and the parameters for the dominant spectral peak in the midfrequency range determined the site of electrode stimulation and current level.
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ItemA multiple-channel cochlear implant. An evaluation using closed-set spondaic words(Cambridge University Press, 1981)Two post-lingually deaf patients with total hearing losses have had help in communicating, using a multiple-channel cochlear implant(Tong et al., in press; Tong and Clark, 1980). Single-channel implants have also been shown to be of value (House et al., 1976; Fourcin et al., 1979). As the multiple-channel device, however, requires an intra-cochlear electrode array it was considered worthwhile comparing the closed-set spondaic word test results obtained from our patients with those from intra-cochlear single-channel implants (Bilger et al., 1977). Using the multiple-channel device speech was processed by extracting the voicing frequency and energy, and the frequency and energy of the dominant spectral peak in the mid-frequency range. The parameters for voicing determined the rate of stimulation for all electrodes, and the parameters for the dominant spectral peak in the mid-frequency range determined the site of electrode stimulation and current level. On the other hand, with the single-channel implant (House et al., 1976) the speech wave amplitude modulated a 16 kHz carrier frequency, and this in tum stimulated the auditory nerve.
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ItemA multiple-channel cochlear implant: an evaluation using open-set CID sentences( 1981)A multiple-channel cochlear implant and speech processor have been used in two postlingually deaf adult patients with a total hearing loss, to enable them to perceive varying degrees of running speech. The results have been confirmed with open-set CID everyday sentence tests. Using the implant alone, the patients obtained 8% and 14% scores with pre-recorded material, and 34% and 36% scores for "live" presentations. This was equivalent to the perception of 35% of connected discourse. When the implant was used in conjunction with lipreading, improvements of 188% and 386% were obtained over lipreading alone, and the scores were 68% and 98% which were equivalent to the perception of 60% and 95% of connected discourse.