Graeme Clark Collection

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1984 - 1989 7
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Subject: cochlear implants × Subject: otolaryngology × Author: Dowell, Richard × Start date: 1984 × End date: 1989 ×

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Now showing 1 - 7 of 7
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    The University of Melbourne/Nucleus cochlear prosthesis
    Clark, Graeme M. ; Blamey, P. J. ; Brown, A. M. ; Busby, P. A. ; Dowell, R. C. ; Franz, B. K-H. ; Millar, J. B. ; Pyman, B. C. ; Shepherd, R. K. ; Tong, Y. C. ; Webb, R. L. ; Brimacombe, J. A. ; Hirshorn, M. S. ; Kuzma, J. ; Mecklenburg, D. J. ; Money, D. K. ; Patrick, J. F. ; Seligman, P. M. ( 1988)
    This is a review of research to develop the University of Melbourne/Nucleus cochlear prosthesis for patients with a profound-total hearing loss. A more complete review can be obtained in Clark et al. A prototype receiver-stimulator and multiple-electrode array developed at the University of Melbourne was first implanted in a postlingually deaf adult patient with a profound-total hearing loss on 1 August 1978. A speech processing strategy which could help this patient understand running speech, especially when combined with lipreading was developed in 1978 following initial psychophysical studies. A prototype wearable speech processor was fabricated in 1979, that could provide significant help for the first two patients in understanding running speech when used in combination with lipreading compared with lipreading alone, and it also enabled them to understand some running speech when using electrical stimulation alone. An implantable receiver-stimulator and wearable speech processor embodying the principles of the prototype devices were then produced for clinical trial by the Australian biomedical firm, Nucleus Ltd, and its subsidiaries, Cochlear Pty Ltd and Cochlear Corporation. This cochlear implant was initially clinically trialled on six patients at The Royal Victorian Eye & Ear Hospital in 1982, and shown to give similar results to those obtained with the prototype device. In view of these findings a clinical trial was carried out for a Premarket Approval Application to the US Food and Drug Administration (FDA), and extended to a number of centres in the US, Canada, and West Germany. This clinical trial confirmed that patients could understand running speech when electrical stimulation was combined with lipreading, and that some patients could also understand running speech when using electrical stimulation alone. Today, more than 600 patients world-wide are using cochlear implants developed from the research described in this paper.
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    Speech perception with cochlear implants and tactile aids [Abstract]
    Blamey, P. J. ; Clark, Graeme M. ; Dowell, R. C. ( 1988)
    Abstract not available due to copyright.
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    Telephone use by a multi-channel cochlear implant patient: an evaluation using open-set CID sentences
    Brown, A. M. ; Clark, Graeme M. ; Dowell, R. C. ; Martin, L. F. ; Seligman, P. M. (Cambridge University Press, 1985)
    A totally deaf person with a multiple-channel cochlear prosthesis obtained open-set speech discrimination using the telephone. CID Everyday Sentences were presented by telephone to the patient, who repeated an average of 21 per cent of key words correctly on the first presentation, and 47 per cent when a repeat of the sentences was permitted. This result is consistent with the patient's reports of telephone usage.
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    An acoustic model of a multiple-channel cochlear implant
    Blamey, P. J. ; Dowell, R. C. ; Tong, Y. C. ; Clark, Graeme M. ( 1984)
    Abstract not available due to copyright.
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    Speech processing studies using an acoustic model of a multiple-channel cochlear implant
    Blamey, P. J. ; Dowell, R. C. ; Tong, Y. C. ; Brown, A. M. ; Luscombe, S. M. ; Clark, Graeme M. ( 1984)
    Abstract not available due to copyright.
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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.