Place-Based Mapping in Electric-Acoustic Stimulation Listeners

电声刺激听众中的基于位置的映射

• 批准号: 10320457
• 负责人: Margaret T Dillon
• 金额: $ 19.44万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10320457
• 关键词: Acclimatization; Acoustic Stimulation; Acoustics; Apical; Auditory Threshold; Behavioral; Bilateral; Binaural; Clinical; Cochlea; Cochlear Implants; Cochlear implant procedure; Contralateral; Cues; Custom; Data; Devices; Ear; Electric Stimulation; Electrodes; Face; Frequencies; Goals; Growth; Hearing; Hearing Aids; Implant; Implanted Electrodes; Individual; Individual Differences; Location; Maps; Masks; Measures; Methods; Morphology; Operative Surgical Procedures; Patients; Perception; Performance; Peripheral; Population; Positioning Attribute; Postoperative Period; Procedures; Residual state; Source; Speech; Speech Perception; Time; X-Ray Computed Tomography; base; binaural hearing; design; experience; experimental study; hearing preservation; improved; logarithm; normal hearing; novel; precision medicine; simulation

Abstract Cochlear implant (CI) recipients with acoustic hearing in the implanted ear are fit with a hearing aid and CI in the same ear, a configuration described as electric-acoustic stimulation (EAS). While EAS supports better performance than a CI alone, the benefit varies widely across individuals. One possible source of individual differences is variability in the CI frequency-to-place mismatch, which is a discrepancy between the electric filter frequency assigned to a particular electrode and the normal cochlear place frequency at the location of that electrode. While prior studies have shown that tonotopic mismatch impacts speech perception in CI-alone users, the impact of mismatch on EAS performance is poorly understood. Mismatch in EAS occurs because current default mapping procedures use the patient’s unaided hearing thresholds in the implanted ear to determine the lowest frequency filter assigned to electric stimulation and distributes higher-frequency information logarithmically across the remaining electrodes irrespective of their location within the cochlea. Mismatch is prevalent in EAS users due to wide variability in angular insertion depth (AID) across and within electrode arrays, and variability in residual hearing. Mismatch occurs in two scenarios: 1) apical electrodes lie basal to the acoustic cut-off frequency and deliver frequency information that is lower than their associated place frequency, or 2) apical electrodes lie apical to the cut-off frequency and deliver frequency information that is higher than their associated place frequency. In both scenarios, performance with EAS is likely hindered by the mismatch between place of stimulation and natural tonotopicity of the cochlea. Performance in the latter scenario could be further compromised by peripheral electric-on-acoustic masking. However, these problems can be avoided if a patient’s acoustic hearing and electrode array AID are incorporated into EAS mapping using a novel place-based mapping procedure. The proposed experiments evaluate a place-based mapping procedure that uses postoperative computed tomography (CT) to calculate the AID of individual electrodes to determine their cochlear place frequency. The electric filters are assigned to align with the associated cochlear place frequency, resulting in a patient-specific map that eliminates frequency-to-place mismatch and minimizes peripheral masking. We hypothesize that a place-based map will support better monaural hearing (e.g. speech perception) in EAS users by limiting the need to acclimate to spectrally-shifted electric information while the acoustic information is transduced in the natural place. Further, we expect that it will support better binaural hearing (e.g. spatial release from masking) by providing an interaural match of frequency information between ears. Benefits of a place-based map over a default map will likely be most apparent during the initial months of EAS use when acclimatization to mismatch is occurring in the default case, and may persist longer-term for those with the greatest degrees of mismatch. This project is expected to lay the groundwork for a novel and clinically feasible mapping procedure to maximize performance for EAS users.

抽象的 在植入的耳朵中具有声音听力的人工耳蜗（CI）接受者与助听器和CI相吻合 相同的耳朵，一种被描述为电声刺激的构型（EAS）。虽然EAS支持更好 比单独的CI表现，这些好处在个人之间的范围广泛。个人的一种来源 差异是CI频到位的不匹配的可变性，这是电气之间的差异 滤波频率分配给特定电极和正常的耳蜗位置频率 那个电极。虽然先前的研究表明，TONOTOPIC不匹配会影响CI-NONE的语音感知 用户，不匹配对EAS性能的影响知之甚少。 EAS中的不匹配是因为 当前的默认映射程序使用患者在植入耳朵中的未辅助听力阈值 确定分配给电动仿真的最低频率过滤器并分布高频 无论其在耳蜗中的位置如何，在其余电极上以对数的信息进行对数。 由于跨越角度插入深度（AID）的差异很大，因此EAS用户不匹配不匹配 电极阵列和剩余听力的可变性。不匹配发生在两种情况下：1）顶部电极躺在 声音截止频率和交付频率信息的基础，该信息低于其相关的 放置频率，或2）顶端电子躺在截止频率和输送频率信息上 这高于其相关的位置频率。在这两种情况下，EAS的性能都可能受到阻碍 通过刺激的位置与耳蜗的自然顿量之间的不匹配。稍后的表现 外围电气掩盖可能会进一步损害场景。但是，这些问题 如果将患者的声学听力和电极阵列辅助纳入EAS映射，则可以避免 使用新颖的基于地方的映射程序。提出的实验评估了基于地方的映射 使用术后计算机断层扫描（CT）来计算单个电子对的程序 确定他们的人工耳蜗频率。将电滤波器分配为与相关的耳蜗保持一致 放置频率，导致特定于患者的地图，以消除频率与位置的不匹配并最小化 外围掩蔽。我们假设基于地点的地图将支持更好的单声听力（例如语音 在EAS用户中，感知）通过限制需要适应光谱的电气信息的需求 声学信息在自然的地方翻译。此外，我们希望它将支持更好的双耳 通过提供频率信息之间的互动匹配，听证会听证 耳朵。在最初的几个月中，基于位置地图比默认地图的好处可能是最明显的 在默认情况下发生适应不匹配的不匹配时的EAS使用，并且可能会长期存在 那些不匹配的程度最大的人。预计该项目将为小说奠定基础 在临床上可行的映射程序，以最大程度地提高EAS用户的性能。

项目成果

Comparison of Two Place-Based Mapping Procedures on Masked Sentence Recognition as a Function of Electrode Array Angular Insertion Depth and Presence of Acoustic Low-Frequency Information: A Simulation Study.

作为电极阵列角度插入深度和声学低频信息存在的函数的掩蔽句子识别的两种基于位置的映射程序的比较：模拟研究。

• DOI: 10.1159/000531262
• 发表时间: 2023
• 期刊: Audiology & neuro-otology
• 影响因子: 1.6
• 作者: Dillon,MargaretT;Buss,Emily;Johnson,AlecD;Canfarotta,MichaelW;O'Connell,BrendanP
• 通讯作者: O'Connell,BrendanP