Improving cochlear implant performance by optimizing bilateral speech processors

描述（由申请人提供）：双侧植入已显著改善人工耳蜗（CI）的性能。然而，双侧CI通常在临床上被程控为两个独立的器械。因此，双侧种植体的全部潜力仍未开发。多个电极可以激活重叠的神经群体，从而导致类似的感知（“感知重叠”）。双耳之间的感知重叠对于感知双耳线索，特别是双耳间的时间差至关重要。双侧CI可以被优化以最大化跨耳朵匹配的电极的感知重叠（“匹配”），这目前在临床上还没有完成。每只耳朵内的感知重叠会大大限制CI性能。可以优化双侧CI，以减少电极之间的感知重叠，方法是将信号在耳朵上划分，将相邻的频率区域发送到相对的耳朵（“交织”）。在匹配的情况下，相同的频率区域被发送到双耳，双侧匹配的电极需要产生最大的感知重叠。在交织的情况下，来自不同频率区域的信号被发送到相对的耳朵，需要避免这种配对。匹配与交错的益处可能因患者而异，并且一些患者可能从在电极阵列的不同部分上组合两种方法中获得最佳益处。我们的长期目标是优化双边 在困难的听力情况下进行刺激。我们假设，最佳配对电极在耳朵将提高空间线索的感知。我们还假设，最大限度地减少耳朵内和耳朵之间的感知重叠将提供额外的频谱线索。最后，我们假设，结合双侧匹配和交错不同的耳蜗区域将最大限度地提高双边植入的好处。

DESCRIPTION (provided by applicant): Bilateral implantation has yielded considerable improvements in cochlear implant (CI) performance. However, bilateral CIs are generally programmed clinically as two independent devices. As a result, the full potential of bilateral implants remains untapped. Multiple electrodes can activate overlapping neural populations and thus cause similar percepts ("perceptual overlap"). Perceptual overlap between ears is critical for perceiving binaural cues, particularly interaural time difference. Bilateral CIs can be optimized to maximize the perceptual overlap of electrodes that are matched-up across ears ("matching"), which is not currently done clinically. Perceptual overlap within each ear can considerably limits CI performance. Bilateral CIs can be optimized to reduce the perceptual overlap between electrodes by dividing the signal across the ears, sending adjacent frequency regions to opposite ears ("interleaving"). With matching, where the same frequency regions are sent to both ears, electrodes that are bilaterally matched need to yield the maximum perceptual overlap. With interleaving, where signals from different frequency regions are sent to opposite ears, such pairings need to be avoided. The benefits of matching versus interleaving may vary across patients, and some patients may receive optimal benefit from combining the two methods over different portions of the electrode array. Our long-term goal is to optimize bilateral stimulation for difficult listening situations. We hypothesize that optimally pairing electrodes across ears will improve the perception of spatial cues. We also hypothesize that minimizing the perceptual overlap within and across ears will provide additional spectral cues. Finally, we hypothesize that combining bilateral matching and interleaving for different cochlear regions will maximize the benefit of bilateral implantation.