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 人工耳蜗 (CI) 接受者在植入耳朵中具有听觉听力，需要佩戴助听器并在人工耳蜗中佩戴 CI 同一只耳朵，这种配置被称为电声刺激 (EAS)，而 EAS 支持更好。 与单独的 CI 相比，收益因人而异，其中一个可能的来源是个体差异很大。 差异是 CI 频率与位置不匹配的可变性，这是电气之间的差异 分配给特定电极的滤波器频率和该位置的正常耳蜗位置频率 虽然之前的研究表明音调不匹配会影响单独 CI 的语音感知。 用户对 EAS 不匹配的影响了解甚少，因为 EAS 发生不匹配。 当前的默认映射程序使用患者植入耳朵的无辅助听力阈值来 确定分配给电刺激的最低频率滤波器并分配较高频率 剩余电极上的信息以对数方式传递，无论它们在耳蜗内的位置如何。 由于跨度和内部的角度插入深度 (AID) 存在较大差异，因此 EAS 用户中普遍存在不匹配现象 电极阵列和残余听力的变化发生在两种情况下：1）心尖电极位于。 到声学截止频率并提供比其相关的基础频率信息更低的频率信息 放置频率，或 2) 顶端电极位于截止频率的顶端并提供频率信息 在这两种情况下，EAS 的性能都可能会受到阻碍。 由于刺激位置与耳蜗自然音调性能之间的不匹配。 然而，这些问题可能会受到外围电声掩蔽的影响。 如果将患者的声学听力和电极阵列 AID 纳入 EAS 映射中，则可以避免 使用新颖的基于地点的映射程序所提出的实验评估基于地点的映射。 使用术后计算机断层扫描 (CT) 计算各个电极的 AID 的过程 确定它们的耳蜗位置频率 电滤波器被分配以与相关的耳蜗对齐。 地点频率，产生针对特定患者的地图，消除频率与地点的不匹配并最大限度地减少 我们勇敢地说，基于地点的地图将支持更好的单耳听力（例如语音）。 通过限制 EAS 用户适应谱移电信息的需要，同时 此外，我们预计它将支持更好的双耳声音。 通过提供频率信息的耳间匹配来实现听觉（例如从掩蔽中释放空间） 基于地点的地图相对于默认地图的优势可能会在最初的几个月中最为明显。 当在默认情况下发生适应不匹配的情况时使用 EAS，并且可能会持续更长时间 那些具有最大程度不匹配的人预计该项目将为小说和小说奠定基础。 临床上可行的映射程序，可最大限度地提高 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