Graeme Clark Collection

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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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    Electrical stimulation of the auditory nerve: stimulus induced reductions in neural excitability [Abstract]
    Shepherd, R. K. ; Clark, Graeme M. ( 1987)
    Electrical stimulation of the auditory nerve elicits highly synchronised neural activity (Javel et al., in press). As the stimulus current is increased the neural response becomes highly deterministic with every current pulse eliciting a spike even at stimulus rates of 600-800 pulses per second (pps). Our previous acute experimental studies have shown that high stimulus rates (> 200 pps) and high stimulus currents (> 1.0 mA) can result in temporary and sometimes permanent reductions in the excitability of the auditory nerve (Shepherd and Clark, 1986). The present study was designed to examine the mechanisms underlying these stimulus induced reductions in excitability. These results will have implications for the maximum safe and effective stimulus rates that can be employed in cochlear implants.
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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.