Cochlear Implant performance in Realistic Listening Environments

描述（由申请人提供）：在不久的将来，大多数人工耳蜗患者将使用两只“耳朵”来听力——要么使用两个人工耳蜗（CI），要么在另一只耳朵上使用一个人工耳蜗和助听器（电声联合听力或EAS）。这里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测试的性质和用于评估双耳参与语言理解的益处的环境。标准的临床测试环境只能近似于听者周围有声音的真实世界环境。具有多个空间分隔扬声器的实验室环境可以模拟真实世界的环境，但由于时间、空间和成本的原因，无法在临床中复制。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，目的是创建一个决策矩阵，将临床中容易收集的数据（例如，CNC在安静和残余听力方面的得分）与临床中无法收集的数据（即通过多个空间分离的扬声器收集的数据）联系起来。我们建议在两种真实的测试环境中测试双侧CI患者和EAS患者，使用8扬声器“环绕声系统”，该系统可以以高保真度模拟(i)以语音胡言乱语为噪声的餐厅环境，以及（ii）以竞争性句子材料为噪声的鸡尾酒会环境-一种“信息”掩蔽的情况。

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.