Cochlear Implant performance in Realistic Listening Environments

描述（由申请人提供）：在不久的将来，大多数人工耳蜗植入患者将用两只“耳朵”听到声音--要么用两只人工耳蜗植入体（CI），要么用一只人工耳蜗植入体和另一只耳朵中的助听器（组合电和声学听力或EAS）。本文提出的研究目标是开发一种与这两种干预措施相关的临床决策工具。临床决策将主要取决于用于评估双耳参与语音理解的益处的测试和环境的性质。标准的临床测试环境只能近似于使声音围绕收听者的真实的世界环境。具有多个空间分离的扬声器的实验室环境可以模拟真实的世界环境，但是由于时间、空间和成本的原因不能在临床中复制。在这个项目中，我们将在标准和现实的测试环境中测试EAS和双侧CI患者，目标是创建一个决策矩阵，该矩阵将可以在临床中轻松收集的数据联系起来，例如，安静时的CNC评分和残余听力量，以及无法在临床中收集的数据，即，用多个空间分离的扬声器收集的数据。我们建议测试双边CI患者和EAS患者在两个现实的测试环境中，使用8扬声器的“环绕声系统”，它可以模拟，高保真度，（i）餐厅环境与语音牙牙学语的噪音，和（ii）一个鸡尾酒会的环境与竞争的句子材料的噪音-一种情况下的“信息”掩蔽。 公共卫生相关性：该项目将允许临床医生对符合人工耳蜗植入条件的患者的听力恢复选项做出数据驱动的决定。这些数据将使临床医生能够确定两个人工耳蜗植入物，还是一个植入物加助听器，是更好的选择。

DESCRIPTION (provided by applicant): In the near future most cochlear implant patients will hear with two 'ears' -- either with two cochlear implants (CI) or with a CI and a hearing aid in the opposite ear (combined electric and acoustic hearing or EAS). The goal of the research proposed here is to develop a tool for clinical decision making relative to these two interventions. Clinical decision making will depend critically on the nature of the tests and environments used to assess the benefit of having two ears participate in speech understanding. Standard clinical test environments can only approximate the real world environment of having sound surround the listener. Laboratory environments with multiple, spatially separated speakers can simulate real world environments but cannot be duplicated in the clinic for reasons of time, space and cost. In this project we will test EAS and bilateral CI patients in both standard and realistic test environments with the goal of creating a decision matrix that links data that can be easily collected in the clinic, e.g., CNC scores in quiet and the amount of residual hearing, with data that cannot be collected in the clinic, i.e., data collected with multiple, spatially separated loudspeakers. We propose to test bilateral CI patients and EAS patients in two realistic test environments using an 8-speaker 'surround sound system' which can simulate, with high fidelity, (i) a restaurant environment with speech babble as the noise, and (ii) a cocktail party environment with competing sentence material as the noise - a situation of 'informational' masking. PUBLIC HEALTH RELEVANCE: This project will allow clinicians to make data-driven decisions about options for hearing restoration in patients who qualify for a cochlear implant. The data will allow clinicians to determine whether two cochlear implants, or an implant plus hearing aid, is the better option.