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）：在人工耳蜗植入的最新应用之一中，双侧低频听力的个体在一侧耳蜗中接收短电极阵列，目的是保持该只耳朵的听力。成功的手术结果允许患者将植入耳朵的电 (E) 刺激和双耳或 EAS 的声刺激 (S) 结合起来。这项研究的长期目标是量化两只部分听力的耳朵与一只部分听力的耳朵的声学听力的好处 - 就像双模态听力的情况一样。之前的研究未能证明两耳部分听力的 EAS 与一只部分听力耳朵相比，EAS 的语音感知有显着优势。然而，用于评估益处的标准临床措施并未设计用于评估双耳听力。因此，拟议的研究将测试两组患者，包括（1）EAS 接受者和（2）一只耳朵具有传统电极阵列而另一只耳朵具有低频听力（即双峰）的患者。实验将包括复杂的聆听环境，这些环境被认为对双耳线索的使用敏感，包括语音和噪声的空间分离、混响和定位。该提案的临床应用意义重大。听力学家和耳科医生都不确定如何向符合 EAS 资格的患者提供有关治疗选择的建议。该项目将提供必要的信息，以便进行数据驱动的咨询。 公共健康相关性：将电刺激和声刺激 (EAS) 与短电极阵列相结合，为那些无法从助听器中受益并且由于残余低频听力而可能不符合人工耳蜗植入资格的个人提供了可行的治疗选择。然而，至关重要的是，患者和专业人员都必须了解保留植入耳听力的好处，以及 EAS（人工耳蜗 + 双耳听觉）与双模听力（人工耳蜗 + 对侧听觉）的相对益处。目前的提案旨在开发这些信息，从而为治疗方案提供适当的知情同意，该治疗方案可能成为恢复部分聋哑人听力的标准手术工具。