Mechanisms and Effects of Hearing Loss After Cochlear Implantation

人工耳蜗植入后听力损失的机制和影响

• 批准号: 10225708
• 负责人: Lina A. Reiss
• 金额: $ 75.13万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10225708
• 关键词: Acoustic Nerve; Acoustic Stimulation; Acoustics; Affect; Age; Aging; American; Area; Auditory Brainstem Responses; Auditory Prosthesis; Basilar Membrane; Blood Vessels; Blood flow; Bone Growth; Cavia; Clinical; Cochlea; Cochlear Implants; Cochlear implant procedure; Code; Data; Detection; Development; Drug Targeting; Ear; Effectiveness; Electric Stimulation; Electrocochleographies; Electrodes; Etiology; Fibrosis; Frequencies; Future; Gender; Goals; Growth; Hair Cells; Health; Hearing; Hearing Tests; Histologic; Human; Impairment; Implant; Individual; Knowledge; Lateral; Link; Measures; Modeling; Modiolus; Motion; Music; Nerve Fibers; Neural Pathways; Neurites; Noise; Noise-Induced Hearing Loss; Operative Surgical Procedures; Outcome; Outer Hair Cells; Pathologic; Pathology; Patients; Performance; Pharmaceutical Preparations; Physiologic Ossification; Population; Research; Residual state; Risk Factors; Speech; Speech Perception; Stria Vascularis; Structure; Structure of radial nerve; Synaptic Transmission; Techniques; Time; Trauma; age group; clinically significant; cohort; comparative; density; design; excitotoxicity; ganglion cell; hearing impairment; hearing preservation; implantation; improved; improved outcome; male; myelination; neural prosthesis; optogenetics; otoacoustic emission; patient population; preservation; relating to nervous system; response; ribbon synapse; sound; speech in noise; spiral ganglion; time use; voice recognition

Project Summary Approximately 22 million Americans have a hearing impairment. Cochlear implants (CIs), a neural prosthesis developed to treat severe hearing loss, have significantly improved speech understanding in quiet for many individuals with hearing loss. However, benefit remains highly variable across the patient population, and speech understanding in noise remains a problem. A recent advance is the Electro-Acoustic Stimulation (EAS) CI, which allows combined electric and acoustic stimulation in the same ear. EAS dramatically improves speech perception in noise, voice recognition, and musical melody recognition. These benefits are proportional to the amount of residual hearing preserved after cochlear implantation. However, 30-55% of EAS CI recipients lose more than 30 dB of residual hearing after implantation, which can negate these benefits. In addition, increased age is associated with greater hearing loss. In order to improve hearing preservation and EAS outcomes, we need to understand the mechanisms of post-implantation hearing loss. Hearing preservation may also improve outcomes for the general CI population. Traditional CI users with hearing preservation have better outcomes even with just the CI alone, suggesting a relationship between hearing preservation and effectiveness of electrical stimulation. In order to improve CI outcomes for all patients, it is critical to understand how and why CI performance is related to residual hearing preservation. In this proposal, we will investigate 1) the potential mechanisms of hearing loss after implantation, and the interaction with age; and 2) the impact of this hearing loss on electrical stimulation with the CI. The findings will guide the selection of more targeted drugs or treatments that improve hearing preservation and general outcomes with CIs.

项目概要 大约 2200 万美国人有听力障碍。人工耳蜗 (CI) 是一种神经 为治疗严重听力损失而开发的假体，显着提高了安静时的言语理解能力 对于许多有听力损失的人来说。然而，不同患者群体的获益仍然存在很大差异， 噪声中的语音理解仍然是一个问题。 最近的一项进展是电声刺激 (EAS) CI，它允许将电和 在同一只耳朵中进行声刺激。 EAS 显着改善噪音、语音中的语音感知 识别、音乐旋律识别。这些益处与残余听力量成正比 人工耳蜗植入后保留。然而，30-55% 的 EAS CI 接收者损失了超过 30 dB 植入后残留听力，这可能会抵消这些好处。此外，年龄的增长也与 具有更大的听力损失。为了改善听力保护和 EAS 结果，我们需要了解 植入后听力损失的机制。 听力保护还可以改善普通 CI 人群的预后。传统 CI 用户 即使仅使用 CI，听力保留也能获得更好的结果，这表明听力之间存在关系 听力保护和电刺激的有效性。为了改善所有人的 CI 结果 对于患者来说，了解 CI 表现如何以及为何与残余听力保留相关至关重要。 在本提案中，我们将研究 1）植入后听力损失的潜在机制，以及 与年龄的相互作用； 2) 这种听力损失对 CI 电刺激的影响。研究结果 将指导选择更有针对性的药物或治疗方法，以改善听力保护和一般情况 CI 的结果。