Cochlear Dead Regions Constrain the Benefit of Combining Acoustic Stimulation With Electric Stimulation
Cochlear Dead Regions Constrain the Benefit of Combining Acoustic Stimulation With Electric Stimulation
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DOI：
10.1097/aud.0000000000000032
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发表时间：
2014-07-01
期刊：
影响因子：
3.7
通讯作者：
Moore, Brian C. J.
中科院分区：
文献类型：
--
作者：
Zhang, Ting;Dorman, Michael F.;Moore, Brian C. J.
目的：本研究的目的是(1)检测双模人工耳蜗使用者耳中残余声学听力的耳蜗死区存在和边缘频率（f(e)），以及(2)确定基于死区存在或不存在的放大是否会提高语音理解和音质。设计：测试了22名听者，其中一只耳朵植入人工耳蜗，另一只耳朵未植入人工耳蜗。11名听者在听觉听觉的耳朵上有耳蜗死区，11名听者没有。采用阈值均衡噪声（TEN）和扫频噪声、心理生理调谐曲线测试对死区进行评估。用单音节单词和+10 dB信噪比的AzBio句子来评估语音理解能力。用音质判断问卷进行语音质量和音乐质量的判断。结果：使用心理生理调谐曲线尖端偏移作为诊断依据，TEN对该人群具有高灵敏度（0.91）和低特异性（0.55）。用扫频噪声、心理生理调谐曲线测试估计的f(e)值比用TEN测试估计的要低。对于耳蜗死区听者，在死区内不进行频率放大时，语音理解、语音质量和音乐质量最好。对于没有死区的听者，全带宽放大时语音理解效果最好，当听力学阈值超过80 dB HL时不进行放大，语音理解效果下降。结论：本研究的数据表明，为了提高电声结合刺激的听者的双峰效应，听力学家应该定期测试耳蜗死区的存在，并相应地确定放大带宽。
Objective: The aims of this study were to (1) detect the presence and edge frequency (f(e)) of a cochlear dead region in the ear with residual acoustic hearing for bimodal cochlear implant users, and (2) determine whether amplification based on the presence or absence of a dead region would improve speech understanding and sound quality.Design: Twenty-two listeners with a cochlear implant in one ear and residual acoustic hearing in the nonimplanted ear were tested. Eleven listeners had a cochlear dead region in the acoustic-hearing ear and 11 did not. Dead regions were assessed with the threshold-equalizing noise (TEN) and the sweeping noise, psychophysical tuning curve tests. Speech understanding was assessed with monosyllabic words and the AzBio sentences at +10 dB signal-to-noise ratio. Speech-and music-quality judgments were obtained with the Judgment of Sound Quality questionnaire.Results: Using shifted tips of the psychophysical tuning curve as a basis for diagnosis, the TEN had high sensitivity (0.91) and poor specificity (0.55) for this population. The value of f(e) was lower when estimated with the sweeping noise, psychophysical tuning curve test than with the TEN test. For the listeners with cochlear dead regions, speech understanding, speech quality and music quality were best when no amplification was applied for frequencies within the dead region. For listeners without dead regions, speech understanding was best with full-bandwidth amplification and was reduced when amplification was not applied when the audiometric threshold exceeded 80 dB HL.Conclusion: The data from this study suggest that, to improve bimodal benefit for listeners who combine electric and acoustic stimulation, audiologists should routinely test for the presence of cochlear dead regions and determine amplification bandwidth accordingly.