Optimizing the Combination of Electric and Acoustic Hearing

优化电听和声听的结合

• 批准号: 7829954
• 负责人: Carolyn J Brown
• 金额: $ 40.68万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-17 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7829954
• 关键词: Acoustics; Address; American; Behavioral; Cell Nucleus; Childhood; Cochlear Implants; Communities; Devices; Ear; Effectiveness; Electric Stimulation; Electrodes; Environment; Evoked Potentials; Frequencies; Goals; Grant; Hearing; Hearing Aids; Hybrids; Individual; Investigation; Lead; Length; Life; Measures; Medical; Methods; Music; Noise; Outcome; Patients; Perception; Performance; Population; Process; Relative (related person); Research; Residual state; Series; Signal Transduction; Speech; Speech Acoustics; Speech Perception; Stimulus; System; Techniques; Technology; Testing; Time; Underserved Population; behavior measurement; computerized data processing; design; hearing impairment; implantation; improved; new technology; patient population; programs; public health relevance; sound; speech recognition; success; treatment strategy

DESCRIPTION (provided by applicant): Previous research suggests that an approach that includes a combination of acoustic and electrical stimulation within the same ear can be particularly effective for this group of hearing impaired listeners (von Ilberg et al., 1999; Gantz and Turner, 2003; Turner et al., 2008). This approach has been termed "Combined Electric and Acoustic (A+E) Hearing" and requires implantation of a Hybrid cochlear implant (CI). Preliminary results with the Hybrid CI have been very encouraging. Hybrid CI users can outperform traditional CI users on many tasks, including perception of music and speech in noise. While such results are promising, many important questions remain relative to the most appropriate signal processing techniques to use to combine the acoustic and electric stimuli. This study addresses a very specific goal: to determine how best to divide the acoustic speech spectrum between the acoustic and electric stimulation modes. We hypothesize that manipulation of this variable will have a significant effect on performance, and that understanding more about how to combine the acoustic and electrical signals within the same ear will lead to significantly improved levels of performance with the CI. We propose to systematically vary the way the hearing aid and/or cochlear implant are programmed and to assess the impact of those changes on performance. The specific changes in programming will include varying the range of frequencies allotted for acoustic and electric stimulation modes as well as the degree of overlap between the two frequency ranges. We propose to evaluate the effectiveness of these different approaches to programming the two devices using a range of both speech perception tests as well as a series of electrophysiologic measures that may be more applicable for difficult-to-test or pediatric populations. Hybrid CIs are a new technology that addresses a very significant need for a relatively large population. The proposed research will determine how best to approach fitting the two devices for individual hearing impaired listeners in order to maximize the effectiveness of this A+E technology in a relatively short time. PUBLIC HEALTH RELEVANCE: Well over 28 million Americans suffer from some degree of hearing loss. Many, because of the specific configuration of their hearing loss, have too much hearing to be considered for a cochlear implant but because of the configuration of their hearing loss, are not able to benefit from conventional hearing aids. These hearing impaired individuals struggle tremendously - particularly in noisy listening environments - and the impact on their lives and the public as a whole is significant. Preliminary research suggests that a new type of cochlear implant (CI), the Nucleus Hybrid CI, that is designed to preserve acoustic low frequency hearing while allowing high frequency components in speech or other environmental sounds to be processed electrically, can result in substantially improved hearing. Importantly, the ability of these listeners to continue to use their residual low frequency hearing to process acoustic signals and to combine that with electrical hearing in the same ear has resulted in significantly improved performance on tests that measure understanding of speech in background noise and enhanced perception of music. Currently, however, the number of individuals who use this technology is small. There is still a great deal that is not known about how these individuals will perform relative to patients who use a traditional CI and importantly, the best way to program the hearing aid and/or speech processor of the cochlear implant to optimize hearing abilities in this subject group has not been determined. That is the specific challenge this proposal seeks to address. The goal is to determine how best to divide the acoustic signal between the cochlear implant and the hearing aid. Outcome will be assessed using both behavioral as well as electrophysiologic methods that will be needed when the candidacy criteria for the Hybrid device is expanded to include pediatric or otherwise difficult-to-test populations. Such information can reasonably be collected within the two year time period of this grant and has the potential to dramatically accelerate the acceptance of this strategy by the medical community for this relatively large but previously underserved population.

描述（由申请人提供）：先前的研究表明，在同一只耳朵内结合声学和电刺激的方法对于这组听力受损的听众特别有效（von Ilberg 等，1999；Gantz 和 Turner， 2003；特纳等人，2008）。这种方法被称为“电声组合 (A+E) 听力”，需要植入混合人工耳蜗 (CI)。混合 CI 的初步结果非常令人鼓舞。混合 CI 用户在许多任务上都可以优于传统 CI 用户，包括在噪声中感知音乐和语音。虽然这些结果很有希望，但与用于组合声刺激和电刺激的最合适的信号处理技术相关的许多重要问题仍然存在。这项研究解决了一个非常具体的目标：确定如何最好地在声刺激模式和电刺激模式之间划分声学语音频谱。我们假设操纵这个变量将对性能产生显着影响，并且更多地了解如何在同一只耳朵内结合声学和电信号将导致 CI​​ 的性能水平显着提高。我们建议系统地改变助听器和/或人工耳蜗的编程方式，并评估这些变化对性能的影响。编程的具体变化将包括改变分配给声学和电刺激模式的频率范围以及两个频率范围之间的重叠程度。我们建议使用一系列语音感知测试以及一系列可能更适用于难以测试或儿科人群的电生理测量来评估这两种设备编程的不同方法的有效性。混合 CI 是一项新技术，可以满足相对较大人群的非常重要的需求。拟议的研究将确定如何最好地为个别听力受损的听众安装这两种设备，以便在相对较短的时间内最大限度地发挥 A+E 技术的有效性。 公共卫生相关性：超过 2800 万美国人患有某种程度的听力损失。许多人，由于其听力损失的特定配置，有太多的听力需要考虑植入人工耳蜗，但由于其听力损失的配置，无法从传统助听器中受益。这些听力障碍人士面临着巨大的困难，尤其是在嘈杂的聆听环境中，这对他们的生活和整个公众的影响是巨大的。初步研究表明，一种新型人工耳蜗 (CI) Nucleus Hybrid CI 旨在保留声学低频听力，同时允许对语音或其他环境声音中的高频分量进行电处理，可以显着改善听力。重要的是，这些听众能够继续使用残余的低频听力来处理声学信号，并将其与同一只耳朵的电听力相结合，从而在测量背景噪声中的语音理解和增强感知的测试中显着提高性能。的音乐。然而，目前使用这项技术的人数很少。与使用传统 CI 的患者相比，这些人的表现仍然有很多未知之处，重要的是，对人工耳蜗植入物的助听器和/或语音处理器进行编程以优化听力能力的最佳方法主题组尚未确定。这就是该提案寻求解决的具体挑战。目标是确定如何最好地在人工耳蜗和助听器之间分配声音信号。当混合设备的候选标准扩大到包括儿科或其他难以测试的人群时，将需要使用行为和电生理学方法来评估结果。这些信息可以在这笔拨款的两年时间内合理收集，并且有可能大大加快医学界对这一相对较大但以前服务不足的人群接受这一策略的速度。