Graeme Clark Collection
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ItemAdults with a severe-to-profound hearing impairment: investigating the effects of linguistic context on speech perception( 1998)Linguistic context is known to influence speech perception abilities in adults with normal hearing. Recent reports question the importance of context for adults with a severe-to-profound hearing impairment. The severe reduction and distortion in acoustic input may result in the listener perceiving insufficient acoustic-phonetic cues to allow access to higher level linguistic processing. To investigate this further, a detailed study of the speech recognition of adults with a severe-to-profound hearing impairment (N=34) was undertaken. A series of aided speech recognition tasks, sequentially examined the different levels of processing in the speech perception chain. The investigation concluded that the effects of severe-to-profound hearing impairment did not reduce the listener's ability to take advantage of contextual cues. There was, however, wide variability between participants in the utilisation of contextual processing. This indicates that to estimate "real-life" speech perception skills, an evaluation of contextual processing ability is required.
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ItemApplication of MEMS to cochlear implants( 1998)A cochlear implant restores some hearing by electrically stimulating residual auditory nerve fibers in the cochlea. The cochlear implant represents a major scientific and technological breakthrough and is now providing hearing for thousands of profoundly and totally deaf people around the world. In this paper, we review the present multiple-channel cochlear implant technology and explores potential applications of micro-electro-mechanical system (MEMS) technology. A new generation of electrode arrays based on the silicon micromachining technology is presented. Approaches in the use of MEMS technology for a middle ear acoustic sensor in a totally implantable prosthesis is also discussed, with key issues for its development highlighted.
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ItemSpeech perception and spoken language in children with impaired hearing( 1998)Fifty seven children with impaired hearing aged 4-12 years were evaluated with speech perception and language measures as the first stage of a longitudinal study. The Clinical Evaluation of Language Fundamentals (CELF) and Peabody Picture Vocabulary Test (PPVT) were used to evaluate the children's spoken language. Regression analyses indicated that scores on both tests were significantly correlated with chronological age, but delayed relative to children with normal hearing. Performance increased at 45% of the rate expected for children with normal hearing for the CELF, and 62% for the PPVT. Perception scores were not significantly correlated with chronological age, but were highly correlated with results on the PPVT and CELF. The data suggest a complex relationship whereby hearing impairment reduces speech perception, which slows language development, which has a further adverse effect on speech perception.
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ItemCochlear implants in the second and third millennia( 1998)Much has been achieved in the Second Millennium in the development of cochlear implants for profoundly deaf people, but further advances in the Third Millennium should result in most severely to profoundly deaf people being able to communicate effectively in a hearing community.
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ItemNew method for anlayzing the synchronization of synaptic input and spike output in neural systems( 1998)We present a new technique for analyzing the probability distribution of output spikes for the integrate and fire model. Using this method we investigate models with arbitrary synaptic response functions and the results, which are compared with numerical simulations, are exact in the limit of a large number of small amplitude inputs. We apply this method to the synchronization problem, in which the relationship between the spread in arrival times of the inputs (the temporal jitter of the synaptic input) and the resultant spread in the times at which the output spikes are generated (output jitter) is analyzed. The results indicate that the ratio of the output jitter to the input jitter is consistently less than one and that it decreases for increasing numbers of inputs, in agreement with earlier studies. We identify the variation in the spike generating thresholds of the neurons and the variation in the number of active inputs as being important factors that determine the timing jitter in layered networks, in addition to those identified previously.
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ItemDirect current measurements in cochlear implants: an in vivo and in vitro study( 1998)Direct current (DC) was measured both in vivo and in vitro in cochlear implant electrodes with stimulation at moderate to high pulse rates in monopolar and bipolar modes. In vivo DC was approximately 2-3 times higher than that measured in vitro. In vivo DC levels were <100 nA even at very high rates, although DC levels increased as a function of stimulus rate and charge intensity. DC levels were lower: in the monopolar than in the bipolar stimulation condition. Stimulation with a monopolar capacitively coupled extracochlear electrode showed even lower DC levels in the intracochlear .electrodes. Our results indicated that the Nucleus electrode shorting system is able to maintain a low level of DC during very high rate stimulation for both monopolar and bipolar modes.
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ItemThe development of a tympanic membrane sensor for a totally implantable cochlear implant or hearing aid(Monduzzi Editore, 1997)We present the design and development of a tympanic membrane sensor for a totally implantable cochlear implant or hearing aid system. The sensor employs a fiber-optic lever which is hermetically sealed in a biocompatible cartridge and implanted in the middle ear cavity. The sensor prototype has been designed, constructed and tested in cats. In addition, the implantation procedure of the device has also been studied using human temporal bones.
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ItemPeri-modiolar electrode arrays: a comparison of electrode position n the human temporal bone(Monduzzi Editore, 1997)This paper describes a radiologic evaluation of three types of peri-modiolar arrays, comparing their trajectory within the scala tympani with a standard Mini-22 electrode. All peri-modiolar arrays were found to lie closer to the modiolus for much of their insertion length compared with the standard array. While one design showed evidence for the potential of increased insertion trauma, two designs produced satisfactory results. Although further electrode development, temporal bone and histopathologic studies arE required, it would appear that the benefits of peri-modiolar electrode arrays will be realised clinically.
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ItemEvoked potential assessment of children with severe/profound hearing loss: a comparison of steady-state evoked potential (SSEP) and behavioural hearing threshold levels in subjects with absent click evoked auditory brainstem responses (ABR)(Monduzzi Editore, 1997)Steady-state evoked potential testing offers a means of obtaining accurate, frequency specific estimates of hearing threshold in subjects with even severe to total hearing losses. As such, the technique can play an important role in the preoperative evaluation of young cochlear implant candidates.
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ItemSiting the receiver-stimulator of the CI-24M model of the Cochlear Limited multiple-channel cochlear implant and fixation of its electrode array(Monduzzi Editore, 1997)The correct siting of the cochlear implant receiver-stimulator package is important. The package should not obtrude significantly above the surface of bone, and should be so that blows to the head do not in damage to the package, skull or brain. The cochlear implant electrode array must be fixed at a site close to the cochlea, so that the electrode will not slide out, or be subject to differential movement with growth changes. Fixation, with Dacron® mesh, platinum-iridium ties, or clips, has been in the region of the posterior root of the zygoma and the floor of the antrum. Our research studies demonstrate that a specially-designed collar around the array can be placed through the cochleostomy and provide the necessary locking to prevent retraction of the array. It has a ceramic surround to encourage union with neighbouring bone, and stress relief to reduce wire fracture at the point where the array leaves the cochlea.
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