Stimulating the Cochlear Apex Without Longer Electrodes: Preliminary Results With a New Approach.
Stimulating the Cochlear Apex Without Longer Electrodes: Preliminary Results With a New Approach.
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DOI：
10.1097/mao.0000000000003529
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发表时间：
2022-06-01
影响因子：
2.1
通讯作者：
Roland, J. Thomas, Jr.
中科院分区：
文献类型：
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作者：
Landsberger, David M.;Stupak, Natalia;Spitzer, Emily R.;Entwisle, Lavin;Mahoney, Laurel;Waltzman, Susan B.;McMenomey, Sean;Friedmann, David R.;Svirsky, Mario A.;Shapiro, William;Roland, J. Thomas, Jr.
研究一种新的手术和信号处理技术，在不延长电极阵列长度的情况下，使用人工耳蜗体提供耳蜗尖刺激。三名使用这项新技术的成年患者接受了人工耳蜗术。患者接受了人工耳蜗植入术。该手术与标准方法的不同之处在于，通过耳蜗尖造口将接地电极放置在耳蜗螺旋毛孔内，而不是放置在颞肌下的典型位置。对临床拟合进行了改进，从而使用顶端放置的电极作为接地来表示低频。音调调整和语音识别所有手术都很成功，没有并发症。节距调整表明，使用顶部放置的电极作为地面，相对于单极刺激，降低了电刺激的感知节距。与手术前的分数相比，语音理解能力得到了改善。新的手术入路和临床适配是可行的。当使用顶部放置的电极作为接地时，相对于使用耳廓外接地(即单极模式)的刺激，可以感觉到较小的节距，这表明可以在不使用更长的电极阵列的情况下更顶部地提供刺激。还需要进一步的工作，以确定新方法在结果和最佳信号处理方面的潜在改进。
To investigate a new surgical and signal processing technique that provides apical stimulation of the cochlea using a cochlear implant without extending the length of the electrode array. Three adult patients who underwent cochlear implantation using this new technique. The patients received a cochlear implant. The surgery differed from the standard approach in that a ground electrode was placed in the cochlear helicotrema via an apical cochleostomy rather than in its typical location underneath the temporalis muscle. Clinical fitting was modified such that low frequencies were represented using the apically-placed electrode as a ground. Pitch scaling and speech recognition All surgeries were successful with no complications. Pitch scaling demonstrated that use of the apically-placed electrode as a ground lowered the perceived pitch of electric stimulation relative to monopolar stimulation. Speech understanding was improved compared to preoperative scores. The new surgical approach and clinical fitting are feasible. A lower pitch is perceived when using the apically-placed electrode as a ground relative to stimulation using an extracochlear ground (i.e. monopolar mode), suggesting that stimulation can be provided more apically without the use of a longer electrode array. Further work is required to determine potential improvements in outcomes and optimal signal processing for the new approach.