Graeme Clark Collection

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    Hearing restoration with the multichannel auditory brainstem implant
    Briggs, R. J. S. ; Kaye, A. H. ; Dowell, R. C. ; Hollow, R. D. ; Clark, Graeme M. ( 1997)
    Restoration of useful hearing is now possible in patients with bilateral acoustic neuromas by direct electrical stimulation of the cochlear nucleus. Our first experience with the Multichannel Auditory Brainstem Implant is reported. A forty four year old female with bilateral acoustic neuromas and a strong family history of Neurofibromatosis Type II presented with profound bilateral hearing impairment. Translabyrinthine removal of the right tumour was performed with placement of the Nucleus eight electrode Auditory Brainstem Implant. Intraoperative electrically evoked auditory brainstem response monitoring successfully confirmed placement over the cochlear nucleus. Postoperatively, auditory responses were obtained on stimulation of all electrodes with minimal non-auditory sensations. The patient now receives useful auditory sensations using the "SPEAK" speech processing strategy. Auditory brainstem Implantation should be considered for patients with Neurofibromatosis Type II in whom hearing preservation tumour removal is not possible.
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    The progress of children using the multichannel cochlear implant in Melbourne
    Cowan, R. S. C. ; Dowell, R. C. ; Hollow, R. ; Dettman, S. J. ; Rance, G. ; Barker, E. J. ; Sarant, J. Z. ; Galvin, K. L. ; Webb, R. C. ; Pyman, B. C. ; Cousins, V. C. ; Clark, Graeme M. ( 1995)
    Multi-channel cochlear implantation in children began in Australia in 1985 and there are now close to 4000 profoundly deaf children and adolescents using the Australian implant system around the world. The aim of the implant procedure is to provide adequate hearing for speech and language development through auditory input. This contrasts with the situation for adults with acquired deafness where the cochlear implant aims to restore hearing for someone with well-developed auditory processing and language skills. As with adults, results vary over a wide range for children using the Multi-channel implant. Many factors have been suggested that may contribute to differences in speech perception for implanted children. In an attempt to better understand these factors, the speech perception results for children implanted in Melbourne were reviewed and subjected to statistical analysis. This has indicated that the amount of experience with the implant and the length of sensory deprivation are strongly correlated with perceptual results. This means that younger children are likely to perform better with an implant and that a number of years of experience are required for children to reach their full potential. The results have also indicated that educational placement and management play a crucial role in children reaching their potential. Overall, 60% of the children and adolescents in the study have reached a level of open-set speech understanding using the cochlear implant without lipreading.
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    Vowel imitation task: results over time for 28 cochlear implant children under the age of eight years
    Dettman, S. J. ; Barker, E. J. ; Dowell, R. C. ; Dawson, P. W. ; Blamey, P. J. ; Clark, Graeme M. ( 1995)
    With increasing numbers of implanted children under the age of 4 years, numerous researchers have reminded us of the need for valid, sensitive, and reliable tests of developing speech perception.1,2 In addition to studies of the efficacy of implanted prostheses, there is a need to investigate the many variables that influence children's communicative performance, such as changes in speech-coding strategy, updated speech-processing systems, the effects of various training regimens, and the selection of educational and communication modes.
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    The development of the Melbourne/Cochlear multiple-channel cochlear implant for profoundly deaf children
    Clark, Graeme M. ; Busby, Peter A. ; Dowell, Richard C. ; Dawson, Pamella W. ; Pyman, Brian C. ; Webb, Robert L. ; Staller, Steven J. ; Beiter, Anne L. ; Brimacombe, Judith A. ( 1992)
    In 1978-79, a speech processing strategy which extracted the voicing (FO) and second formant (F2) frequencies and presented these as rate and place of stimulation respectively to residual auditory nerve fibres was developed for the University of Melbourne's prototype multiple-channel receiver-stimulator (Clark et aI1977, Clark et a11978, Tong et aI1980). This speech processing strategy was shown to provide post linguistically deaf adults with some open-set speech comprehension using electrical stimulation alone, and considerable help when used in combination with lipreading (Clark et al 1981).
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    Cochlear implants in children, adolescents, and prelinguistically deafened adults: speech perception
    Dawson, Pam W. ; Blamey, Peter J. ; Rowland, Louise C. ; Dettman, Shani J. ; Clark, Graeme M. ; Busby, Peter A. ; Brown, Alison M. ; Dowell, Richard C. ; Rickards, Field W. ( 1992)
    A group of 10 children, adolescents, and prelinguistically deafened adults were implanted with the 22-electrode cochlear implant (Cochlear Ply Ltd) at the University of Melbourne Cochlear Implant Clinic and have used the prosthesis for periods from 12 to 65 months. Postoperative performance on the majority of closed-set speech perception tests was significantly greater than chance, and significantly better than preoperative performance for all of the patients. Five of the children have achieved substantial scores on open-set speech tests using hearing without lipreading. Phoneme scores in monosyllabic words ranged from 30% to 72%; word scores in sentences ranged from 26% to 74%. Four of these 5 children were implanted during preadolescence (aged 5:5 to 10:2 years) and the fifth, who had a progressive loss, was implanted during adolescence (aged 14:8 years). The duration of profound deafness before implantation varied from 2 to 8 years. Improvements were also noted over postoperative data collection times for the younger children. The remaining 5 patients who did not demonstrate open-set recognition were implanted after a longer duration of profound deafness (aged 13:11to 20:1 years). The results are discussed with reference to variables that may affect implant performance, such as age at onset of loss, duration of profound loss, age at implantation, and duration of implantation. They are compared with results for similar groups of children using hearing aids and cochlear implants.
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    Recent developments with the Nucleus 22-electrode cochlear implant: a new two formant speech coding strategy and its performance in background noise
    Franz, Burkhard K-H. G. ; Dowell, Richard C. ; Clark, Graeme M. ; Seligman, Peter M. ; Patrick, James F. ( 1987)
    A clinical evaluation of speech processing strategies for the Nucleus 22-electrode cochlear implant showed improvements in understanding speech using the new F0F1F2 speech coding strategy instead of the F0F2 strategy. Significant improvement in closed-set speech recognition in the presence of background noise was an additional advantage of the new speech processing strategy.
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    Evaluation of a two-formant speech-processing strategy for a multichannel cochlear prosthesis
    Dowell, R. C. ; Seligman, P. M. ; Blamey, P. J. ; Clark, Graeme M. ( 1987)
    Initial results with the two-formant speech-processing strategy (F0FIF2) confirm the advantage of a multichannel cochlear prosthesis capable of stimulating at different sites within the cochlea. The successful presentation of two spectral components by varying the place of stimulation leads to the possibility of presenting further spectral information in this manner. Because virtually all multichannel implant patients demonstrate good "place" (electrode site) discrimination, these more refined coding strategies should lead to benefits for the majority of implantees. Already, with the F0FIF2 strategy, we have a system that appears to provide some effective auditory-alone communication ability for the average patient.
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    A multiple-electrode intracochlear implant for children
    Clark, Graeme M. ; Blamey, Peter J. ; Busby, Peter A. ; Dowell, Richard C. ; Franz, Burkhard K-H. ; Musgrave, Gaye Nicholls ; Nienhuys, Terry G. ; Pyman, Brian C. ; Roberts, Susan A. ; Tong, Yit C. ; Webb, Robert L. ; Kuzma, Januz A. ; Money, David K. ; Patrick, James F. ; Seligman, Peter M. ( 1987)
    A multiple-electrode intracochlear implant that provides 21 stimulus channels has been designed for use in young children. It is smaller than the adult version and has magnets to facilitate the attachment of the headset. It has been implanted in two children aged 5 and 10 years. The two children both lost hearing in their third year, when they were still learning language. Following implantation, it was possible to determine threshold and comfortable listening levels for each electrode pair. This was facilitated in the younger child by prior training in scaling visual and electrotactile stimuli. Both children are regular users of the implant, and a training and assessment program has been commenced.
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    Two-component hearing sensations produced by two-electrode stimulation in the cochlear of a deaf patient
    Tong, Y. C. ; Dowell, R. C. ; Blamey, P. J. ; Clark, Graeme M. ( 1983)
    http://www.sciencemag.org/cgi/content/abstract/219/4587/993?ijkey=v6jEOhdpzPCxw&keytype=ref&siteid=sci
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    Psychophysical studies evaluating the feasibility of a speech processing strategy for a multiple-channel cochlear implant
    Tong, Y. C. ; Blamey, P. J. ; Dowell, R. C. ; Clark, Graeme M. ( 1983)
    Abstract not available due to copyright.