Cochlear Implants: Combined Electric and Binaural Acoustic Stimulation

人工耳蜗：电刺激和双耳声学刺激相结合

• 批准号: 8220849
• 负责人: Rene H Gifford
• 金额: $ 30.2万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-01 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8220849
• 关键词: Acoustic Stimulation; Acoustics; Apical; Bilateral; Biological Preservation; Cell Nucleus; Clinical; Clinical Trials; Cochlea; Cochlear Implants; Complex; Contralateral; Counseling; Cues; Data; Ear; Electric Stimulation; Electrodes; Environment; Frequencies; Goals; Head; Hearing; Hearing Aids; Hearing Impaired Persons; Hearing Tests; Hybrids; Implant; Implanted Electrodes; Individual; Informed Consent; Ipsilateral; Literature; Measures; Noise; Operative Surgical Procedures; Outcome; Paper; Patients; Performance; Population; Publishing; Qualifying; Relative (related person); Reporting; Research; Residual state; Scala Tympani; Shadowing (Histology); Signal Transduction; Speech; Speech Perception; Stimulus; Testing; Time; Uncertainty; binaural hearing; clinical application; comparison group; design; improved; public health relevance; research study; speech recognition; tool

DESCRIPTION (provided by applicant): In one of the newest applications of cochlear implants, individuals with bilateral low-frequency hearing receive a short electrode array in one cochlea with the aim of preserving hearing in that ear. A successful surgical outcome allows patients to combine electrical (E) stimulation from the implanted ear and acoustic stimulation (S) from both ears or EAS. The long-term goal of this research is to quantify the benefit of acoustic hearing from two partially hearing ears vs. one partially hearing ear - as in the case of bimodal hearing. Previous research has failed to demonstrate significant benefit to speech perception for EAS with two partially hearing ears vs. one partially hearing ear. The standard clinical measures that have been used to assess benefit, however, have not been designed to assess binaural listening. Thus the proposed research will test two groups of patients including (1) EAS recipients, and (2) patients with a conventional electrode array in one ear and low-frequency hearing in the other ear (i.e., bimodal). Experimentation will include complex listening environments which are thought to be sensitive to the use of binaural cues including the spatial separation of speech and noise, reverberation, and localization. The clinical application of this proposal is substantial. Neither audiologists nor otologists are certain how to counsel EAS-qualifying patients about treatment options. This project will provide the necessary information to allow for data-driven counseling. PUBLIC HEALTH RELEVANCE: Combined electric and acoustic stimulation (EAS) with a short electrode array offers a viable treatment option for individuals who do not receive benefit from hearing aids and may not qualify for a cochlear implant due to residual low-frequency hearing. It is critical, however, that both patients and professionals understand the benefits of preserving hearing in the implanted ear as well as the relative benefits of EAS (cochlear implant + binaural acoustic hearing) vs. bimodal hearing (cochlear implant + contralateral acoustic hearing). The current proposal aims to develop this information and, as a consequence, will enable appropriate informed consent for a treatment option that could become a standard surgical tool in the effort to restore hearing to the partially deaf.

描述（由申请人提供）：在人工耳蜗的最新应用之一中，双侧低频听证会的个体在一个耳蜗中收到一个短的电极阵列，目的是保留该耳朵的听证会。成功的手术结局使患者可以将植入的耳朵的电（E）刺激结合在一起，并从耳朵或EAS中进行声学刺激（S）。这项研究的长期目标是量化两个部分听力的耳朵与一个部分听力耳朵的听力的好处 - 如双峰听证的情况。先前的研究未能证明对EA的语音感知有重大的好处，其中有两个部分听力的耳朵与一个部分听力的耳朵。但是，尚未设计用于评估利益的标准临床指标来评估双耳听力。因此，拟议的研究将测试包括（1）个EA的接受者在内的两组患者，以及（2）另一只耳朵中有传统电极阵列的患者（即另一只耳朵）（即双峰）。实验将包括复杂的聆听环境，这些听力环境被认为对使用双耳线索敏感，包括语音和噪声的空间分离，混响和本地化。该提案的临床应用是很大的。听力学家和耳科医生都没有确定如何就治疗选择来咨询资格的患者。该项目将提供必要的信息以允许数据驱动的咨询。 公共卫生相关性：将电气和声学刺激（EAS）与短电极阵列组合在一起，为那些因剩余的低频听力而无法获得助听器且可能没有资格获得耳蜗植入物的个人提供了可行的治疗选择。然而，至关重要的是，患者和专业人员都了解保留植入耳朵的听力的好处，以及EAS（耳蜗植入物 +双耳声听力）的相对好处与双峰听证（手工耳蜗 +对侧声学听力）。当前的提案旨在开发此信息，因此，将对治疗方案征得适当的知情同意书，该方案可能会成为努力恢复部分聋哑人听力的标准外科手术工具。