Preservation of hearing in cochlear implant surgery: Advantages of combined electrical and acoustical speech processing
Preservation of hearing in cochlear implant surgery: Advantages of combined electrical and acoustical speech processing
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DOI：
10.1097/01.mlg.0000157695.07536.d2
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发表时间：
2005-05-01
期刊：
影响因子：
2.6
通讯作者：
Lowder, MW
中科院分区：
文献类型：
--
作者：
Gantz, BJ;Turner, C;Lowder, MW
目标/假设。本研究记录了保留残余低频听觉的重要性，因为选择了具有更多残余听力的人进行人工耳蜗植入。手术策略用于听力保存与短混合人工耳蜗植入概述。保留残余的低频听力，提高噪音中的单词理解和音乐欣赏的好处。研究设计：多中心、前瞻性、单受试者设计。方法.审查了21名参与美国食品药品监督管理局（FDA）可行性临床试验的个体的记录，这些个体接受了爱荷华州/Nucleus 10 mm电极。还对在爱荷华州大学接受植入物的第二组受试者进行了审查，这些受试者使用了10 mm器械2年至6个月。结果的措施包括单音节词的理解标准化测试，在噪音中的spondees，和共同的旋律识别。结果所有患者术后即刻均保持低频听力。1例受试者在病毒感染后术后2.5个月丧失听力。该小组在125至1，000 Hz之间的低频听觉平均损失-9 dB。在FDA的一项临床试验中，使用植入物加助听器的一组人在6个月时的单音节单词理解得分为69%正确。对于在爱荷华州接受植入物的长期组，使用该设备6个月至2年的患者的单音节单词理解率为79%。其他重要的发现包括与标准人工耳蜗植入者相比，噪音中的语音识别得到改善（改善9 dB），这些人工耳蜗植入者在安静和接近正常的普通旋律识别中进行语音识别。结论所概述的手术策略在96%的个体中成功地保留了低频听力。与双侧助听器的术前听力和一组接受标准人工耳蜗植入并具有类似设备经验的个体相比，组合电和声学语音处理使这组志愿者获得了更好的单词理解。语音在噪声和旋律识别中的改善归因于作为保留的残余低频声学听觉的结果的区分细微音高差异的能力。低频听觉的保存对于改善听力受损者在噪声中的言语和音乐欣赏是重要的，这两者在现实生活中都是重要的。
Objectives/Hypothesis. This study documents the importance of preserving residual low-frequency acoustic hearing as those with more residual hearing are selected for cochlear implantation. Surgical strategies used for hearing preservation with a short hybrid cochlear implant are outlined. The benefits of preserved residual low-frequency hearing, improved word understanding in noise, and music appreciation are described. Study Design: Multicenter, prospective, single-subject design. Methods. Records were reviewed of 21 individuals participating in an Food and Drug Administration (FDA) feasibility clinical trial who have received an Iowa/Nucleus 10 mm electrode. A second group of subjects receiving implants at the University of Iowa that have used the 10 mm device between 2 years and 6 months were also reviewed. Outcome measures included standardized tests of monosyllabic word understanding, spondees in noise, and common melody recognition. Results. Low-frequency hearing was maintained in all individuals immediately postoperative. One subject lost hearing at 2.5 months postoperative after a viral infection. The group has averaged a loss of -9 dB low-frequency acoustic hearing between 125 and 1,000 Hz. Monosyllabic word understanding scores at 6 months for a group being followed for an FDA clinical trial using the implant plus hearing aids was 69% correct. For the long-term group receiving implants at Iowa, monosyllabic word understanding in those who have used the device between 6 months and 2 years is 79%. Other important findings include improved recognition of speech in noise (9 dB improvement) as compared with standard cochlear implant recipients who were matched for speech recognition in quiet and near normal recognition of common melodies. Conclusion. The surgical strategies outlined have been successful in preservation of low-frequency hearing in 96% of individuals. Combined electrical and acoustical speech processing has enabled this group of volunteers to gain improved word understanding as compared with their preoperative hearing with bilateral hearing aids and a group of individuals receiving a standard cochlear implant with similar experience with their device. The improvement of speech in noise and melody recognition is attributed to the ability to distinguish fine pitch differences as the result of preserved residual low-frequency acoustic hearing. Preservation of low-frequency acoustic hearing is important for improving speech in noise and music appreciation for the hearing impaired, both of which are important in real-life situations.