Environmental Sound Recognition Before and After Cochlear Implantation in Adults

项目概要 人工耳蜗 (CI) 是成人感音神经性听力损失的标准治疗方法 助听器的治疗范围。目前对于当前的 CI 设备如何影响环境声音识别知之甚少。 概念（ESR），一个对安全、独立和生活质量（QOL）至关重要的非言语结果领域 对于所有 CI 用户。缺乏关于 CI 如何影响 ESR 以及影响 ESR 的患者因素的有力证据， 听力健康专业人员提供 ESR 康复和循证咨询的能力有限。 这项研究的调查人员通过试点研究发现，语后聋成人的 ESR 与正常听力同龄人相比，显着降低且高度可变。初步横截面和 对孤立呈现的环境声音进行纵向 ESR 评估——与丰富的环境声音相比 日常生活的呈现——已经证明，有经验的成年 CI 用户的表现并不完全优于 CI 考生在使用助听器的最佳辅助条件下进行测试。 目前的研究有两个具体目标：(1) 使用 新颖的上下文丰富的 ESR 评估，可以更好地模拟现实世界的日常听力； (2) 确定 CI 用户报告的 ESR 对 CI 特定 QOL 的相对贡献。假设 (1) 上下文 丰富的 ESR 将改善成人植入后的情况，并且 (2) ESR 将显着有助于自我报告 CI 特定的 QOL。为了检验这些假设，对 ESR 和 CI 特定的 QOL 进行了前瞻性纵向评估 将在舌后成人样本中进行 CI 前至人工耳蜗植入第一年的研究。 这项研究的预期好处是听力健康专业人员将能够 (1) 为患者提供 基于证据的 ESR 预测，(2) 对 CI 的贡献有更全面的了解 言语感知之外的具体生活质量，(3) 为未来的 ESR 康复策略奠定基础 CI 用户在这个重要的、被忽视的 CI 结果领域中苦苦挣扎。

PROJECT SUMMARY Cochlear implants (CI) are the standard of care for adults with sensorineural hearing loss that is beyond the therapeutic reach of hearing aids. Little is known about how current CI devices affect environmental sound recog- nition (ESR), a nonspeech outcome domain that is crucial for the safety, independence, and quality of life (QOL) for all CI users. Lacking robust evidence for how CIs affect ESR and the patient factors that influence ESR, hearing health professionals are limited in their ability to offer ESR rehabilitation and evidence-based counseling. This research study's investigators have found through pilot studies that ESR in postlingually deaf adults is significantly reduced and highly variable compared to normal hearing peers. Preliminary cross-sectional and longitudinal ESR assessments of environmental sounds presented in isolation – in contrast to context-rich presentation of daily life – have demonstrated that experienced adult CI users do not uniformly outperform CI candidates tested under best-aided conditions with hearing aids. The current study has two Specific Aims: (1) to longitudinally quantify change in ESR for postlingual adults using a novel context-rich ESR assessment to better approximate real-world everyday listening; and (2) to determine the relative contribution of ESR to CI-specific QOL as reported by CI users. It is hypothesized that (1) context- rich ESR will improve in adults following implantation, and (2) that ESR will contribute significantly to self-reported CI-specific QOL. To test these hypotheses, a prospective, longitudinal assessment of ESR and CI-specific QOL will be performed pre-CI through the first year of cochlear implantation in a sample of postlingual adults. The expected benefits of this study are that hearing health professionals will be able to (1) provide patients with evidence-based ESR predictions, (2) develop a more comprehensive understanding of the contributions of CI- specific QOL beyond speech perception, and (3) lay the groundwork for future ESR rehabilitation strategies for CI users who struggle in this important, overlooked CI outcome domain.