Graeme Clark Collection
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ItemChronic middle ear disease and cochlear implantation( 1995)Profound or total hearing loss can occur in the setting of chronic suppurative otitis media (CSOM), either coincidentally or secondary to the disease process. Obviously, inserting a foreign body through a potentially infected field into a space that communicates intracranially presents a challenging management problem. This paper presents the experience from the Melbourne Cochlear Implant Clinic (CIC) in implanting patients with bilateral CSOM. This is certainly not a common problem, as there have been only 3 cases from 121 implanted adults. However, we feel that it is an important issue with potentially devastating consequences. In addition, there are many countries in which bilateral CSOM is a more common problem and cause of profound or total hearing loss.
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ItemVowel imitation task: results over time for 28 cochlear implant children under the age of eight years( 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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ItemA new portable sound processor for the University of Melbourne/ Nucleus Limited multielectrode cochlear implant( 1992)Abstract not available due to copyright.
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ItemPlace pitch perception with multiple electrode cochlear implants: the use of concurrent activation of nearby electrodes to produce additional ptich percepts [Abstract]( 1992)In multiple electrode cochlear implants, each electrode produces a pitch percept which is usually related monotonically to its distance from the round window. The number of these pitch percepts is limited by the number of usable electrodes and their discriminability, varying up to a maximum of 22 for the mini-system 22 implant but sometimes significantly less. A study on two implanted subjects in which the pitch of pulse trains on two concurrently activated nearby electrodes was compared with the pitch produced when each of the electrodes was activated on its own, showed that the pitch of the concurrently activated electrodes was different from each component electrode and was placed in an intermediate position. Furthermore the pitch of the concurrent stimulation could be altered by adjusting the relative current levels on the two component electrodes. This may partly explain the improvements, particularly in vowel discrimination, obtained with the SMSP strategy described in the accompanying paper.
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ItemInitial results for six patients with a multiple-channel cochlear prosthesis(Monash University Press, 1983)A total of eight patients have been assessed with the multi-channel cochlear prosthesis at the University of Melbourne. The first two patients were implanted with a prototype device in 1978 and 1979, and their results with various speech evaluation procedures have been reported and summarized in detail elsewhere (Clark & Tong, 1982). Briefly, these results indicated that some very significant benefit could be obtained for these patients when using the cochlear prosthesis with external speech processing, particularly when using the device in conjunction with lipreading. It was also shown that some significant understanding of speech was possible without lipreading (open-set) for both patients, although this was fairly limited.
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ItemBrainstem encoding of short voice onset times in natural speech( 2001)An auditory nerve study has shown that short voice onset times (VOTs) in synthetic consonant-vowel syllables are not accurately encoded by the fibres' discharge rate. We have re-examined this issue within the ventral Cochlear nucleus (VCN), using natural speech and a fine-grain analysis of single unit responses. We recorded extracellularly from 93 VCN neurons in rats anaesthetised with urethane (2.5 g/kg ip). After identifying a cell's response type and best frequency (BF), 3 syllables spoken by a male were presented at double rate and 3 intensities (/bεt/, /dεt/, and /gεt/, at 45, 65, and 75 dB SPL). These three syllables differ in their VOTs (the interval between consonant release and the onset of glottal pulses associated with voicing) due to the different points of articulation of the three initial stop consonants. In many neurons (particularly onset cells), these syllables evoked a clear response to consonant release, followed by an interval of inactivity or reduced activity before the periodic response to the vowel's voicing frequency commenced. This interval of reduced or no activity corresponded to a given syllable's VOT. The responses of all cells (BFs: 0.9-19 kHz) to the 9 different syllable-SPL combinations were plotted as Grand Average post-stimulus time histograms. In 8/9 combinations, syllable onset was associated with a statistically significant peak in activity and the next significant peak in discharge rate occurred at the time of voice onset (± I ms). These results indicate that the prominent responses to consonant release and voice onset, produced by the synchronous firing of neurons with a wide range of BFs, accurately encode short VOTs.
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ItemImplantation of the new nucleus C1-3 receiver stimulator and electrode array [Abstract]( 1997)There is an important need to fix the cochlear implant electrode array 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 sites have been in the region of the posterior root of the zygoma and the floor of the antrum. Fixation has been by Dacron mesh ties platinum wire ties, or clips inserted with-special instruments. Biological cements have previously been tried but found to be toxic. The most ideal site is in the region of the cochleostomy.
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ItemPsychophysics and speech perception with a premodiolar electrode array( 1997)A perimodiolar electrode array, designed to lie closer to the modiolus than the standard Coclear Limited array and developed by the Cooperative Research Centre for Cochlear Implant, Speech and Hearing Research in conjunction with Cochlear Limited, has recently been implanted in an adult patient. While excellent speech results have been obtained using the standard array, it is hypothesised that the improved place coding expected from an array lying closer to the modiolus would result in improved speech perception. Analysis of a modified Stenvers view X-ray revealed that the most apical electrode was inserted to an angle of 311 0 and that the apical half of the array was considerably closer to the modiolus than would have been the case for a standard array. Thresholds and comfortable levels were correlated with the lateral position of the stimulated electrode in the scala tympani, being much reduced for the apical electrodes. Forward masking and electrode discrimination are being measured in order to study the spread of neural excitation and the distinctness of percepts for different electrodes.
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ItemResponses from single units in the dorsal cochlear nucleus to electrical stimulation of the cochlea( 1992)To help improve our understanding of how the brain responds to electrical stimulation of the auditory nerve we have examined the responses of dorsal cochlear nucleus (DCN) units to both acoustic stimulation and electrical stimulation of the cochlea. This work extended our previous studies which have compared the responses to electrical and acoustic stimulation In the auditory nerve (Javel et al 1987, Ann. Otol. Rhinol. laryngeal. Suppl. 128, 96:2630) and the ventral cochlear nucleus (Shepherd et al 1988, NIH Contract NO1-NS-72342, 5th Quarterly Progress Report).
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ItemCochlear implantation in young children: long-term effects of implantation on normal hair cells and spiral ganglion cells in the monkey model [Abstract]( 1992)Recent independent results obtained by profoundly deaf children implanted with the Melbourne 22-channel cochlear implant (1) have provided further impetus. for examining thefeasibility of implanting children under two and children with profound deafness. Safety st1,ldies, in appropriate animal models, must first establish the safety of this procedure.