Graeme Clark Collection

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http://hdl.handle.net/11343/375

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1992 - 1993 2
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Subject: cochlear implant × Subject: otology × Subject: otolarngology × Author: Clark, Graeme × Author: PYMAN, BRIAN ×

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    The development of auditory comprehension in children after receiving a cochlear multiple-channel implant
    Rance, G. ; Sarant, J.Z. ; Pyman, B. C. ; Barker, Elizabeth J. ; Clark, Graeme M. ; Dawson, P. W. ; Dettman, S. J. ; Hollow, R. ( 1992)
    Since late 1989, half the cochlear implant patients at the Royal Victorian Eye and Ear Hospital have been young children. There is a gradual improvement of auditory comprehension in most cases using the criteria of environmental sound detection, as well as, prosody, high frequency phoneme and word discrimination. The rate of improvement and final result depend on the duration of deafness, presence of residual hearing, and quality of auditory-oral habilitation. Younger children usually progress more quickly than older children. Some adolescents who use Total Communication and who have no residual hearing, achieve assistance with lipreading. Children with Usher's Syndrome should be actively encouraged to participate in auditory-oral habilitation should they become totally deaf or blind.
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    Cochlear implant skin flap design: the vascular pattern of the postauricular region
    Dahm, Markus C. ; Pyman, Brian C. ; Crock, John G. ; Aoyagi, M. ; Clark, Graeme M. ( 1993)
    Cochlear implantation proved to be a safe surgical procedure. Complications are rare, but the most significant of them are skin flap related problems, occasionally resulting in removal of the device. To evaluate the vascular pattern of the scalp and its implications for cochlear implant skin flap design we performed a dye injection study on cadavers. Our results on ten specimens indicate, that the blood supply for the skin in the postauricular region is provided inferiorly by indirect musculocutaneous perforators, posteriorly by the occipital artery, superiorly by the superficial temporal artery and anteriorly by the network around the base of the auricle and by cutaneous branches of the postauricular artery. A flap for cochlear implantation raised in this region cannot be based on one single axial source artery and has to rely on a variable number of different arterial contributors, resulting in a combination of random, axial and/or musculocutaneous flap. Inferiorly-based flaps as the inverted U shaped or the extended enaural (Hannover) are considered to be superior to the C-shaped anteriorly-based flap.