Improving Binaural Hearing in Children with Cochlear Implants

改善植入人工耳蜗儿童的双耳听力

• 批准号: 8827879
• 负责人: Ruth Y Litovsky
• 金额: $ 1.35万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2016-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8827879
• 关键词: 10 year old; Accounting; Achievement; Acoustics; Acquired Deafness; Action Potentials; Age; Apical; Auditory; Benchmarking; Bilateral; Child; Childhood; Clinical; Clinical Treatment; Cochlear Implants; Complex; Complication; Counseling; Cues; Decision Making; Development; Ear; Electrodes; Environment; Excision; Exposure to; Face; Future; Hearing; Hearing Impaired Persons; Implant; Individual; Knowledge; Language; Lead; Learning; Left; Location; Masks; Measures; Metric; Nerve Degeneration; Noise; Normal Range; Outcome; Parents; Performance; Peripheral; Population; Procedures; Process; Process Measure; Psychophysics; Rehabilitation therapy; Relative (related person); Research; Risk; Role; Schools; Science; Signal Transduction; Simulate; Sound Localization; Speech; Speech Development; Stimulus; Structure; Technology; Testing; Time; Work; alternative treatment; binaural hearing; congenital deafness; deafness; design; early childhood; experience; implantation; improved; infancy; interest; novel strategies; peer; public health relevance; relating to nervous system; research study; response; segregation; simulation; skills; sound; standard of care; success; teacher; tool

Abstract When using a cochlear implant (CI) in one ear, children experience difficulties hearing speech in noise and localizing sounds in rooms. This is not surprising, as studies in normal hearing listeners have demonstrated that speech understanding in noise and sound localization can be very poor when binaural hearing is artificially disrupted. Inability to segregate speech from noise and to localize sounds can have a profound impact on the ability of a child to learn in environments such as classrooms, where it is typical to have multiple sounds arrive from various directions, and each child faces the challenge of segregating stimuli of interest from background noise. There has been a sweeping shift in clinical treatment, whereby bilateral CIs have become the standard of care, and 70% of bilateral CI users are children under 10 years of age. The vast majority of children perform significantly worse than their normal hearing, age-matched peers on sound localization and understanding of speech in noise. Using research processors that synchronize the CIs in the two ears, specific aims will investigate mechanisms of sound localization (Aim 1) and speech-in-noise segregation (Aim 2). In addition, we will evaluate whether peripheral measures of neural spread of excitation can serve as a useful tool for predicting binaural processing, in order to ultimately develop objective clinical tools for bilateral fitting of CIs (Aim 3). Studies will be done in implanted children who were congenitally deaf and implanted bilaterally during infancy and children born with hearing and acquired deafness during early childhood. In addition, children with normal hearing will be studied using binaural CI simulations, in order to understand the extent to which differences between CI user and normal hearing children are accounted for by signal degradation that is known to occur with CIs. Limits imposed by the CI simulations relative to standard acoustic cues will provide a benchmark for best performance levels to be expected from the CI populations. Ultimately, the work will lead to development of better speech processors for children who are deaf, and ideally better outcomes in their ability to hear speech in noise, localize sounds, and learn in complex noisy environments.

抽象的 在一只耳朵中使用人工耳蜗（CI）时，孩子在噪音和 将声音定位在房间中。这并不奇怪，正常听众的研究表明 当双耳听力人为地听时，噪音和声音定位中的语音理解可能非常差 破坏了。无法将语音从噪音隔离到本地化的声音会对这种影响产生深远的影响 孩子在教室等环境中学习的能力，在教室等环境中，有多种声音是典型的 从各个方向上，每个孩子都面临着将感兴趣的刺激与背景隔离的挑战 噪音。临床治疗发生了巨大的变化，双边CI已成为标准 护理和70％的双边CI使用者是10岁以下的儿童。绝大多数孩子表演 比他们正常的听力，年龄匹配的同龄人在声音本地化和理解的情况下要差得多 噪音的讲话。使用将两只耳朵同步CI同步的研究处理器，具体目标将 研究声音定位的机理（AIM 1）和噪声隔离（AIM 2）。另外，我们 将评估激发神经传播的外围度量是否可以作为有用的工具 预测双耳加工，以最终开发客观的临床工具以进行双边拟合 （目标3）。研究将在先天聋的植入儿童中进行研究，并在双侧植入 婴儿期和儿童在童年时期患有听力和耳聋。此外，还有 将使用双耳CI模拟研究正常的听力，以了解 CI用户和正常听力儿童之间的差异是由已知的信号降解所解释的 与顺式发生。 CI模拟相对于标准声音提示施加的限制将提供 CI人群可以预期获得最佳性能水平的基准。最终，这项工作将导致 为聋哑儿童开发更好的语音处理器，理想情况下的能力更好 在噪音中听到语音，本地化的声音并在复杂的嘈杂环境中学习。