Place-Based Mapping in Electric-Acoustic Stimulation Listeners

电声刺激听众中的基于位置的映射

• 批准号: 10320457
• 负责人: Margaret T Dillon
• 金额: $ 19.44万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10320457
• 关键词: Acclimatization; Acoustic Stimulation; Acoustics; Apical; Auditory Threshold; Behavioral; Bilateral; Binaural; Clinical; Cochlea; Cochlear Implants; Cochlear implant procedure; Contralateral; Cues; Custom; Data; Devices; Ear; Electric Stimulation; Electrodes; Face; Frequencies; Goals; Growth; Hearing; Hearing Aids; Implant; Implanted Electrodes; Individual; Individual Differences; Location; Maps; Masks; Measures; Methods; Morphology; Operative Surgical Procedures; Patients; Perception; Performance; Peripheral; Population; Positioning Attribute; Postoperative Period; Procedures; Residual state; Source; Speech; Speech Perception; Time; X-Ray Computed Tomography; base; binaural hearing; design; experience; experimental study; hearing preservation; improved; logarithm; normal hearing; novel; precision medicine; simulation

Abstract Cochlear implant (CI) recipients with acoustic hearing in the implanted ear are fit with a hearing aid and CI in the same ear, a configuration described as electric-acoustic stimulation (EAS). While EAS supports better performance than a CI alone, the benefit varies widely across individuals. One possible source of individual differences is variability in the CI frequency-to-place mismatch, which is a discrepancy between the electric filter frequency assigned to a particular electrode and the normal cochlear place frequency at the location of that electrode. While prior studies have shown that tonotopic mismatch impacts speech perception in CI-alone users, the impact of mismatch on EAS performance is poorly understood. Mismatch in EAS occurs because current default mapping procedures use the patient’s unaided hearing thresholds in the implanted ear to determine the lowest frequency filter assigned to electric stimulation and distributes higher-frequency information logarithmically across the remaining electrodes irrespective of their location within the cochlea. Mismatch is prevalent in EAS users due to wide variability in angular insertion depth (AID) across and within electrode arrays, and variability in residual hearing. Mismatch occurs in two scenarios: 1) apical electrodes lie basal to the acoustic cut-off frequency and deliver frequency information that is lower than their associated place frequency, or 2) apical electrodes lie apical to the cut-off frequency and deliver frequency information that is higher than their associated place frequency. In both scenarios, performance with EAS is likely hindered by the mismatch between place of stimulation and natural tonotopicity of the cochlea. Performance in the latter scenario could be further compromised by peripheral electric-on-acoustic masking. However, these problems can be avoided if a patient’s acoustic hearing and electrode array AID are incorporated into EAS mapping using a novel place-based mapping procedure. The proposed experiments evaluate a place-based mapping procedure that uses postoperative computed tomography (CT) to calculate the AID of individual electrodes to determine their cochlear place frequency. The electric filters are assigned to align with the associated cochlear place frequency, resulting in a patient-specific map that eliminates frequency-to-place mismatch and minimizes peripheral masking. We hypothesize that a place-based map will support better monaural hearing (e.g. speech perception) in EAS users by limiting the need to acclimate to spectrally-shifted electric information while the acoustic information is transduced in the natural place. Further, we expect that it will support better binaural hearing (e.g. spatial release from masking) by providing an interaural match of frequency information between ears. Benefits of a place-based map over a default map will likely be most apparent during the initial months of EAS use when acclimatization to mismatch is occurring in the default case, and may persist longer-term for those with the greatest degrees of mismatch. This project is expected to lay the groundwork for a novel and clinically feasible mapping procedure to maximize performance for EAS users.

摘要 在植入耳中具有声学听力的耳蜗植入物（CI）接受者配备助听器，并且CI在植入耳中具有声学听力。 同一只耳朵，一种被描述为电声刺激（EAS）的配置。虽然EAS支持更好的 由于CI的性能优于单独的CI，因此个体之间的益处差异很大。一个可能的个人来源 差异是CI频率与位置不匹配的可变性，这是电参数之间的差异。 分配给特定电极的滤波器频率和在以下位置处的正常耳蜗位置频率 这个电极。虽然先前的研究表明，音调不匹配影响单独CI的言语感知， 用户，不匹配对EAS性能的影响知之甚少。EAS中的不匹配是因为 当前的默认映射过程使用患者在植入耳中的独立听力阈值 确定分配给电刺激的最低频率滤波器并分配较高频率 在耳蜗内的位置无关的情况下，可以在剩余的电极上示意性地传递信息。 EAS用户中普遍存在不匹配，这是由于插入角度深度（AID）的横向和内部变化很大 电极阵列和残余听力的可变性。失配发生在两种情况下：1）心尖电极位于 并传递低于其相关频率的频率信息 放置频率，或2）心尖电极位于截止频率的心尖并传递频率信息 这比他们相关的位置频率要高。在这两种情况下，EAS的性能可能会受到阻碍 刺激的位置和耳蜗的自然音调不匹配。后者的表现 这种情况可能进一步受到外围电声掩蔽的影响。但这些问题 如果将患者的听觉和电极阵列AID结合到EAS标测中， 使用一种新颖的基于地点的映射程序。所提出的实验评估基于位置的映射 使用术后计算机断层扫描（CT）计算单个电极的AID的程序， 确定他们的耳蜗位置频率。电滤波器被分配为与相关的耳蜗对准， 位置频率，产生患者特定标测图，消除频率与位置不匹配， 周边掩蔽我们假设基于位置的地图将支持更好的单耳听力（例如语音 通过限制适应频谱偏移的电信息的需要， 声音信息在自然环境中被转换。此外，我们预计它将支持更好的双耳 通过提供两耳之间的频率信息的耳间匹配， 耳朵基于地点的地图相对于默认地图的优势可能在2010年的最初几个月最为明显。 在默认情况下，当发生对不匹配的适应时使用EAS，并且可能持续更长时间， 那些不匹配程度最高的。该项目预计将为一部小说奠定基础， 临床上可行的标测程序，以最大限度地提高EAS用户的性能。

项目成果

Comparison of Two Place-Based Mapping Procedures on Masked Sentence Recognition as a Function of Electrode Array Angular Insertion Depth and Presence of Acoustic Low-Frequency Information: A Simulation Study.

作为电极阵列角度插入深度和声学低频信息存在的函数的掩蔽句子识别的两种基于位置的映射程序的比较：模拟研究。

• DOI: 10.1159/000531262
• 发表时间: 2023
• 期刊: Audiology & neuro-otology
• 影响因子: 1.6
• 作者: Dillon,MargaretT;Buss,Emily;Johnson,AlecD;Canfarotta,MichaelW;O'Connell,BrendanP
• 通讯作者: O'Connell,BrendanP