Graeme Clark Collection

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    Evoked 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)
    Rance, G. ; Dowell, Richard, C. ; Rickards, F. W. ; Clark, Graeme M. (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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    The relationship between aetiology of hearing loss and outcome following cochlear implantation in a paediatric population
    O'Sullivan, P. G. ; Ellul, S. M. ; Dowell, B. C. ; Clark, Graeme M. (Monduzzi Editore, 1997)
    Eighty-eight children who underwent cochlear implantation at the University of Melbourne Cochlear Implant Clinic are reviewed. The aetiology of the hearing loss is classified and is compared to their best level of speech perception performance. The group whose hearing loss was not congenital in origin performed better than those who were congenital in origin. Of those whose hearing loss was congenital in nature those with rubella appeared to perform best.
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    Rehabilitation strategies for adult cochlear implant users
    Dowell, R. C. ; Blamey, P. J. ; Clark, Graeme M. (Monduzzi Editore, 1997)
    This paper summarizes open-set speech perception results using audition alone for a large group of adult Nucleus cochlear implant users in Melbourne. The results show wide variation in performance but significant improvement over the years from 1982 to 1995. Analysis of these results shows that speech processor developments have made the major contribution to this improvement over this time. Recent results for patients using the SPECTRA-SPEAK processor show !hat most subjects obtain good speech perception within six months of implantation and the need for intensive auditory training is minimal for many of these patients. Postoperative care should encourage consistent device use by providing opportunities for success and providing long term technical support for implant users. In some cases, including elderly patients, those with long term profound deafness, and those with special needs, there will still be a need for additional rehabilitation and auditory training support.
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    Factors affecting outcomes in children with cochlear implants
    Dowell, R. C. ; Blamey, P. J. ; Clark, Graeme M. (Monduzzi Editore, 1997)
    Open-set speech perception tests were completed for a group of 52 children and adolescents who were long-term users of the Nucleus multiple channel cochlear prosthesis. Results showed mean scores for the group of 32.4% for open-set BKE sentences and 48.1% for phonemes in open-set monosyllabic words. Over 80% of the group performed significantly on these tas1cs. Age at implantation was identified as a significant factor affecting speech perception performance with improved scores for children implanted early. This factor was evident in the results at least down to the age of three years. Duration.. of profound hearing loss, progressive hearing loss, educational program and preoperative residual hearing were also identified as significant factors that may affect speech perception performance.
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    Speech perception, production and language results in a group of children using the 22-electrode cochlear implant
    Busby, P. A. ; Brown, A. M. ; DOWELL, RICHARD ; Rickards, Field W. ; Dawson, Pam W. ; Blamey, Peter J. ; Rowland, L.C. ; Dettman, Shani J. ; Altidis, P. M. ; Clark, Graeme M. ( 1989)
    Paper presented at the 118th Meeting of the Acoustical Society of America
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    Selection of patients for multiple-channel cochlear implantation
    Brown, A. M. ; Dowell, R. C. ; Clark, Graeme M. ; Martin, L. F. A. ; Pyman, B. C. (Raven Press, 1985)
    Only profoundly, bilaterally deaf adults are considered for evaluation. It is necessary to determine that the patient's communication ability cannot be improved to any significant degree with conventional hearing aids currently available. Initial assessment consists of audiometry, hearing aid evaluation(s), otological and medical examination, and for patients with no recent experience with hearing aids, a hearing aid trial. Polytome x-rays of temporal bones is carried out to ensure that cochlea structures are not grossly abnormal. Electrical stimulation of the promontory is used to confirm the presence of residual auditory nerve fibers. Where there is an audiometric difference between ears, the poorer ear is chosen for implantation provided there are no other contraindications. Intensive counselling is carried out to enable patients to make a fully informed decision about implantation. Patients undergo a battery of speech discrimination and lipreading tests with their hearing aid after their hearing aid trial. This is to provide a baseline for comparison with postoperative results and to assess the benefit obtained from the hearing aid. Any significant improvement in test results when using a hearing aid over lipreading alone would be a contraindication for implantation. Medical assessment is carried out as for any major surgery, including pathology, respiratory function tests and cardiovascular assessment. Particular emphasis is placed on infection prevention immediately preoperatively and during surgery.