The auditory midbrain implant: A new auditory prosthesis for neural deafness - Concept and device description
The auditory midbrain implant: A new auditory prosthesis for neural deafness - Concept and device description
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DOI：
10.1097/01.mao.0000232010.01116.e9
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发表时间：
2006-09-01
影响因子：
2.1
通讯作者：
Lenarz, Minoo
中科院分区：
文献类型：
--
作者：
Lenarz, Thomas;Lim, Hubert H.;Lenarz, Minoo
听觉中脑植入体（AMI）是一种用于穿透刺激下丘的新型中枢听觉假体。急性心肌梗死的主要候选人群包括2型神经纤维瘤病（NF 2）患者，这些患者由于双侧听神经瘤的生长和/或手术切除而发生神经性耳聋。由于缺乏可行的听觉神经，这些患者无法从人工耳蜗植入中受益。另一种解决方案是听觉脑干植入物（ABT），它刺激耳蜗核。然而，NF 2 ABI患者的言语感知性能有限。ABI能够在非肿瘤患者中产生高水平的言语感知（耳蜗不可及或耳蜗神经创伤后损伤）的事实表明，NF 2患者的ABI性能限制可能与肿瘤或肿瘤切除过程引起的耳蜗核损伤有关。因此，刺激邻近受损耳蜗核的听觉中脑可能是NF 2患者听力恢复的更好选择。我们建议下丘中央核（ICC）作为潜在的网站。沿着ICC的明确定义的音调分布梯度排列的穿透电极阵列应该选择性地激活不同的频率区域，这是支持良好语音理解的重要因素。本文的目的是提出ICC作为NF 2患者听觉植入的替代部位，并描述第一个人类原型AMI的设计。此外，还将讨论实施AMI的实际考虑因素。
The auditory midbrain implant (AMI) is a new central auditory prosthesis designed for penetrating stimulation of the human inferior colliculus. The major group of candidates for the AMI consists of neurofibromatosis type 2 (NF2) patients who develop neural deafness because of growth and/or surgical removal of bilateral acoustic neuromas. Because of the absence of a viable auditory nerve, these patients cannot benefit from cochlear implants. An alternative solution has been the auditory brainstem implant (ABT), which stimulates the cochlear nucleus. However, speech perception performance in NF2 ABI patients has been limited. The fact that the ABI is able to produce high levels of speech perception in nontumor patients (with inaccessible cochleae or posttraumatic damage to the cochlear nerve) suggests that limitations in ABI performance in NF2 patients may be associated with cochlear nucleus damage caused by the tumors or the tumor removal process. Thus, stimulation of the auditory midbrain proximal to the damaged cochlear nucleus may be a better alternative for hearing restoration in NF2 patients. We propose the central nucleus of the inferior colliculus (ICC) as the potential site. A penetrating electrode array aligned along the well-defined tonotopic gradient of the ICC should selectively activate different frequency regions, which is an important element for supporting good speech understanding. The goal of this article is to present the ICC as an alternative site for an auditory implant for NF2 patients and to describe the design of the first human prototype AMI. Practical considerations for implementation of the AMI will also be discussed.