The importance of human cochlear anatomy for the results of modiolus-hugging multichannel cochlear implants
The importance of human cochlear anatomy for the results of modiolus-hugging multichannel cochlear implants
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DOI：
10.1097/00129492-200105000-00012
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发表时间：
2001-05-01
影响因子：
2.1
通讯作者：
Grote, JJ
中科院分区：
文献类型：
--
作者：
Frijns, JHM;Briaire, JJ;Grote, JJ
假设：特别是人类耳蜗基底部的解剖结构与其他物种有本质的不同，这可能会影响人工耳蜗植入的结果。背景：多通道人工耳蜗比单通道人工耳蜗具有更好的语音理解能力。它们的目的是通过选择性地刺激听神经亚群来利用耳蜗的张力组织。在较高的刺激水平和单极刺激下，来自其他回合的神经纤维的兴奋可能会干扰这一概念，特别是在模量拥抱电极时。方法：以组织学资料为基础，建立人耳蜗三维螺旋形计算机模型，对有无定位器的Clarion HiFocus植入物进行交叉刺激前的空间选择性和动态范围进行测试。结果与相似的豚鼠耳蜗模型进行了比较。结果：在人类中（与豚鼠相反），设计良好的模量拥抱电极产生降低的电流阈值和高空间选择性，而不会降低有用的动态范围。然而，在这方面，人类耳蜗的耳尖转动在很大程度上与豚鼠耳蜗相似，后者的交叉转动刺激大大减少了动态范围。结论：人类人工耳蜗植入术的临床成功与否，以及人工耳蜗包绕装置的良好效果取决于人类耳蜗的解剖结构。
Hypothesis: The fact that the anatomy of the basal turn of the human cochlea, especially, is essentially different from that of other species is likely to influence the outcome of cochlear implantation.Background: Multichannel cochlear implants give better speech understanding than single-channel devices. They are intended to make use of the tonotopic organization of the cochlea by selectively stimulating subpopulations of the auditory nerve. At higher stimulus levels and with monopolar stimulation, excitation of nerve fibers from other turns may interfere with this concept, especially with modiolus-hugging electrodes.Methods: A three-dimensional spiraling computer model of the human cochlea, based on histologic data, was used to test the spatial selectivity and the dynamic range before cross-turn stimulation takes place for the Clarion HiFocus implant with and without a positioner. The results were compared with a similar model of the guinea pig cochlea.Results: In humans (in contrast to the guinea pig), a well-designed modiolus-hugging electrode yielded reduced current thresholds and high spatial selectivity without reduction of the useful dynamic range. The apical turn of the human cochlea, however, is largely comparable in this respect with the guinea pig cochlea, where cross-turn stimulation reduces the dynamic range substantially.Conclusion: The clinical success of cochlear implantation in humans and the favorable results with modiolus-hugging devices depend on the anatomy of the human cochlea.