Improving Binaural Hearing in Children with Cochlear Implants

改善植入人工耳蜗儿童的双耳听力

基本信息

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
项目类别：
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

项目摘要

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.

抽象的当在一只耳朵中使用人工耳蜗 (CI) 时，儿童会在噪音和噪音中听不到讲话。定位房间内的声音。这并不奇怪，因为对正常听力听众的研究表明当双耳听力被人工控制时，噪声和声音定位中的语音理解可能会很差扰乱了。无法将语音与噪音分开并定位声音可能会对孩子在教室等环境中学习的能力，在这种环境中通常会听到多种声音来自各个方向，每个孩子都面临着将兴趣刺激与背景分开的挑战噪音。临床治疗发生了彻底的转变，双侧 CI 已成为标准 70% 的双边 CI 用户是 10 岁以下的儿童。绝大多数孩子表现在声音定位和理解方面明显比正常听力、年龄匹配的同龄人差噪音中的讲话。使用同步两耳 CI 的研究处理器，特定目标将研究声音定位（目标 1）和噪声中语音分离（目标 2）的机制。此外，我们将评估兴奋神经传播的外周测量是否可以作为有用的工具预测双耳处理，以便最终开发用于 CI 双边拟合的客观临床工具（目标 3）。研究将在先天性耳聋并在植入期间进行双侧植入的植入儿童中进行。婴儿期和出生时有听力并在幼儿期获得后天性耳聋的儿童。此外，患有以下疾病的儿童将使用双耳 CI 模拟来研究正常听力，以了解正常听力的程度 CI 用户和正常听力儿童之间的差异是由已知的信号衰减造成的与 CI 一起发生。 CI 模拟相对于标准声学线索所施加的限制将提供 CI 群体预期最佳绩效水平的基准。最终，这项工作将导致为聋哑儿童开发更好的语音处理器，理想情况下他们的能力会得到更好的结果在噪音中听到语音、定位声音并在复杂的噪音环境中学习。