Graeme Clark Collection
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ItemOptimizing dynamic range in children using the nucleus cochlear implant(LIPPINCOTT WILLIAMS & WILKINS, 2004-06)OBJECTIVE: The aim of this study was to investigate the benefits of the preprocessing scheme "Adaptive Dynamic Range Optimization" (ADRO) in children using Nucleus cochlear implants. Previous research with adults indicates improved speech perception in quiet and improved sound quality in everyday listening environments with the ADRO scheme. DESIGN: Children were given 4 wk of take-home experience with ADRO, with a minimum of 2 wk in which ADRO was "locked-in." After 1 wk of ADRO use and again after 4 wk of ADRO use, Bench-Kowal-Bamford (BKB) sentence perception in quiet at a low input level of 50 dB SPL (unweighted root mean square) and sentence perception in noise were compared with the child's everyday (Standard) program and the ADRO program. Children also rated the loudness of a variety of environmental sounds and indicated which program provided the best hearing in a variety of everyday listening situations. RESULTS: On average, BKB sentence perception in quiet at 50 dB SPL was significantly better with the ADRO program compared with the Standard program. The group mean improvement was 8.60%. Similarly, group mean scores for BKB sentences presented at 65 dB SPL in multitalker babble were significantly higher with the ADRO program (an improvement of 6.87%). The ADRO program was the preferred program in 46% of the listening situations, whereas the Standard program was preferred in 26% of situations. Everyday sounds were not unacceptably loud with ADRO. CONCLUSIONS: There was an ADRO benefit for this group of children in quiet and in noise. These findings suggest that young children would benefit from the ADRO programming option being locked in along with other processor settings in the SPrint processor once their MAP levels have stabilized. Some older children and teenagers may choose to use ADRO selectively for specific listening situations.
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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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ItemCalculation of interspike intervals for integrate-and-fire neurons with Poisson distribution of synaptic inputs( 2000)We present a new technique for calculating the interspike intervals of integrate-and-fire neurons. There are two new components to this technique. First, the probability density of the summed potential is calculated by integrating over the distribution of arrival times of the afferent postsynaptic potentials (PSPs), rather than using conventional stochastic differential equation techniques. A general formulation of this technique is given in terms of the probability distribution of the inputs and the time course of the postsynaptic response. The expressions are evaluated in the gaussian approximation, which gives results that become more accurate for large numbers of small-amplitude PSPs. Second, the probability density of output spikes, which are generated when the potential reaches threshold, is given in terms of an integral involving a conditional probability density. A.N. Burkitt and G.M. Clark, 'Calculation of Interspike Intervals for Integrate and Fire Neurons with Poisson Distribution of Synaptic Inputs ', Neural Computation, 12:8 (August, 2000), pp. 1789-1820. © 2000 by the Massachusetts Institute of Technology. http://www.mitpressjournals.org.ezp.lib.unimelb.edu.au/toc/neco/12/8
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ItemCritical bands following the selective destruction of cochlear inner and outer hair cells( 1979)Critical bandwidths and absolute intensity thresholds were measured in cats before and after kanamycin treatment which induced selective inner and outer hair cell losses. Hair cell losses were measured from cochleograms constructed from surface preparations of the organ of Corti. Results suggested that, for the test frequencies and stimulus intensities employed, critical bandwidths were not affected for frequencies tonotopically located in cochlear regions where only outer hair cells were lost. Critical bands were widened or not measurable only when inner hair cell losses exceeding 40% were also associated with complete loss of outer hair cells. The experiment suggests that cochlear frequency selectivity can be mediated by inner hair cells alone.
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ItemElectrical network properties and distribution of potentials in the cat cochlea [Abstract](Australian Physiological and Pharmacological Society, 1978)The-patterns of electrical resistance and capacitance in the cochlea formed by the anatomical organisation of the tissue structures and fluids are important in determining the distribution of electrical potentials which arise during normal acoustic stimulation (von Bekesy,1951). Cochlear potential distributions have in the past been measured by recording from the scalar fluids both the spread of cochlear microphonics and also potentials due to electrical stimulation. However, similar distributions in the hair cell-nerve ending region of the organ of Corti may not necessarily occur because of current shunting effects due to the electrical network patterns. To examine these current shunting effects, a three dimensional mathematical model of the electrical properties of the cat cochlea was constructed. This was formed from a two dimensional cochlear cross-section model similar to that proposed by Johnstone et al., (1966) for the guinea pig. Sixteen such sections were resistively coupled to form the three dimensional model. Results derived from this model predict that during electrical stimulation of the cochlea, the current in the organ of Corti region attenuates quite differently to the scalar voltage by a degree which depends on the stimulus electrode configuration.
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ItemMeningitis after cochlear implantation: the risk is low, and preventive measures can reduce this further( 2007)Since the 1980s, more than 80 000 people have received cochlear implants worldwide. These implants are designed to enable people who are severely or profoundly deaf to experience sound and speech. Since 1990, implantation has become standard treatment for people who cannot communicate effectively despite well fitted hearing aids. Children who are deaf when they are born can perceive sound and learn to speak if they receive cochlear implants at a young age (ideally under 18 months). The use of cochlear implants has been thought to be safe. But since 2002 the number of patients with meningitis related to cochlear implantation has increased worldwide. Mortality and neurological complications after meningitis are high. We need to investigate the reasons for this and look at measures to reduce them.
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ItemThreshold shift: effects of cochlear implantation on the risk of pneumococcal meningitis( 2007)Unavailable due to copyright.
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ItemEffects of inner ear trauma on the risk of pneumococcal meningitis( 2007)Objective: To examine the risk of pneumococcal meningitis in healthy rats that received a severe surgical trauma to the modiolus and osseous spiral lamina or the standard insertion technique for acute cochlear implantation. Design: Interventional animal studies. Subjects: Fifty-four otologically normal adult Hooded- Wistar rats. Interventions: Fifty-four rats (18 of which received a cochleostomy alone; 18, a cochleostomy and acute cochlear implantation using standard surgical techniques; and 18, a cochleostomy followed by severe inner ear trauma) were infected 4 weeks after surgery with Streptococcus pneumoniae via 3 different routes (hematogenous, middle ear, and inner ear) to represent all potential routes of bacterial infection from the upper respiratory tract to the meninges in cochlear implant recipients with meningitis. Results: Severe trauma to the osseous spiral lamina and modiolus increased the risk of pneumococcal meningitis when the bacteria were given via the middle or inner ear (Fisher exact test, P<.05). However, the risk of meningitis did not change when the bacteria were given via the hematogenous route. Acute electrode insertion did not alter the risk of subsequent pneumococcal meningitis for any route of infection. Conclusions: Severe inner ear surgical trauma to the osseous spiral lamina and modiolus can increase the risk of pneumococcal meningitis. Therefore, every effort should be made to ensure that cochlear implant design and insertion technique cause minimal trauma to the bony structures of the inner ear to reduce the risk of pneumococcalmeningitis.
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ItemAssessment of the protective effect of pneumococcal vaccination in preventing meningitis after cochlear implantation( 2007)Objectives: To examine if a 23-valent pneumococcal capsular polysaccharide vaccine (PPV23) reduces the risk of meningitis in healthy rats after cochlear implantation. Design: Interventional animal study. Interventions: Thirty-six rats (18 immunized and 18 unimmunized) received cochlear implantations and were then infected with Streptococcus pneumoniae via 3 different routes (hematogenous, middle ear, and inner ear) in numbers sufficient to induce meningitis. Results: The rats with implants that received PPV23 were protected from meningitis when the bacteria were delivered via the hematogenous and middle-ear routes (Fisher exact test P<.05). However, the protective effect of the vaccine in the rats with implants was only moderate when the bacteria were inoculated directly into the inner ear. Conclusions: Our animal model clearly demonstrates that immunization can protect healthy rats with a cochlear implant from meningitis caused by a vaccine-covered serotype. This finding supports the notion that all current and future implant recipients should be vaccinated against S pneumoniae.