Cochlear Implant Electrode Effect on Sound Energy Transfer Within the Cochlea During Acoustic Stimulation.
Cochlear Implant Electrode Effect on Sound Energy Transfer Within the Cochlea During Acoustic Stimulation.
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DOI：
10.1097/mao.0000000000000838
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Cass SP
中科院分区：
文献类型：
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作者：
Greene NT;Mattingly JK;Jenkins HA;Tollin DJ;Easter JR;Cass SP
设计用于听力保护的耳蜗植入物（CI）不会改变中耳和内耳的机械性能，如通过耳蜗内压（PIC）和镫骨速度（Vstap）测量的。现在可以使用设计用于提供组合电和声刺激（EAS）的CI。为了保持功能性听觉，重要的是要知道CI电极是否可以改变中耳或内耳力学，因为任何改变都可能导致EAS患者的低频阈值升高。本研究制备了7具人颞骨标本，在120 Hz-10 kHz的纯音刺激下，以高达110 dB SPL的强度呈现。采用激光多普勒测振仪测量前庭阶（PSV）和鼓室（PST）的PIC，同时使用光纤压力传感器和VStap。来自两个不同制造商的具有不同尺寸的五个CI电极经由圆窗方法以六个不同深度（16-25 mm）插入。在基线和电极插入条件下，将PIC和VStap对声刺激的反应评估为刺激频率的函数，标准化为外耳道（EAC）中的SPL。插入电极测量的反应通常在基线的约5 dB内，表明耳蜗植入电极插入对PIC和VStap的影响很小。总体而言，对于所有响应，不同条件下的平均差异较小，并且不同电极类型之间没有一致可见的实质性差异。结果表明，CI电极对中耳和内耳力学的影响是最小的，尽管电极长度和配置的变化。
Cochlear implants (CI) designed for hearing preservation will not alter mechanical properties of the middle and inner ear as measured by intracochlear pressure (PIC) and stapes velocity (Vstap). CIs designed to provide combined electrical and acoustic stimulation (EAS) are now available. To maintain functional acoustic hearing, it is important to know if a CI electrode can alter middle or inner ear mechanics, as any alteration could contribute to elevated low-frequency thresholds in EAS patients. Seven human cadaveric temporal bones were prepared, and pure-tone stimuli from 120Hz–10kHz were presented at a range of intensities up to 110 dB SPL. PIC in the scala vestibuli (PSV) and tympani (PST) were measured with fiber-optic pressure sensors concurrently with VStap using laser Doppler vibrometry. Five CI electrodes from two different manufacturers, with varying dimensions were inserted via a round window approach at six different depths (16–25 mm). The responses of PIC and VStap to acoustic stimulation were assessed as a function of stimulus frequency, normalized to SPL in the external auditory canal (EAC), in baseline and electrode inserted conditions. Responses measured with electrodes inserted were generally within ~5 dB of baseline, indicating little effect of cochlear implant electrode insertion on PIC and VStap. Overall, mean differences across conditions were small for all responses, and no substantial differences were consistently visible across electrode types. Results suggest that the influence of a CI electrode on middle and inner ear mechanics is minimal, despite variation in electrode lengths and configurations.