Mechanisms and Effects of Hearing Loss After Cochlear Implantation

人工耳蜗植入后听力损失的机制和影响

• 批准号: 10225708
• 负责人: Lina A. Reiss
• 金额: $ 75.13万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10225708
• 关键词: Acoustic Nerve; Acoustic Stimulation; Acoustics; Affect; Age; Aging; American; Area; Auditory Brainstem Responses; Auditory Prosthesis; Basilar Membrane; Blood Vessels; Blood flow; Bone Growth; Cavia; Clinical; Cochlea; Cochlear Implants; Cochlear implant procedure; Code; Data; Detection; Development; Drug Targeting; Ear; Effectiveness; Electric Stimulation; Electrocochleographies; Electrodes; Etiology; Fibrosis; Frequencies; Future; Gender; Goals; Growth; Hair Cells; Health; Hearing; Hearing Tests; Histologic; Human; Impairment; Implant; Individual; Knowledge; Lateral; Link; Measures; Modeling; Modiolus; Motion; Music; Nerve Fibers; Neural Pathways; Neurites; Noise; Noise-Induced Hearing Loss; Operative Surgical Procedures; Outcome; Outer Hair Cells; Pathologic; Pathology; Patients; Performance; Pharmaceutical Preparations; Physiologic Ossification; Population; Research; Residual state; Risk Factors; Speech; Speech Perception; Stria Vascularis; Structure; Structure of radial nerve; Synaptic Transmission; Techniques; Time; Trauma; age group; clinically significant; cohort; comparative; density; design; excitotoxicity; ganglion cell; hearing impairment; hearing preservation; implantation; improved; improved outcome; male; myelination; neural prosthesis; optogenetics; otoacoustic emission; patient population; preservation; relating to nervous system; response; ribbon synapse; sound; speech in noise; spiral ganglion; time use; voice recognition

Project Summary Approximately 22 million Americans have a hearing impairment. Cochlear implants (CIs), a neural prosthesis developed to treat severe hearing loss, have significantly improved speech understanding in quiet for many individuals with hearing loss. However, benefit remains highly variable across the patient population, and speech understanding in noise remains a problem. A recent advance is the Electro-Acoustic Stimulation (EAS) CI, which allows combined electric and acoustic stimulation in the same ear. EAS dramatically improves speech perception in noise, voice recognition, and musical melody recognition. These benefits are proportional to the amount of residual hearing preserved after cochlear implantation. However, 30-55% of EAS CI recipients lose more than 30 dB of residual hearing after implantation, which can negate these benefits. In addition, increased age is associated with greater hearing loss. In order to improve hearing preservation and EAS outcomes, we need to understand the mechanisms of post-implantation hearing loss. Hearing preservation may also improve outcomes for the general CI population. Traditional CI users with hearing preservation have better outcomes even with just the CI alone, suggesting a relationship between hearing preservation and effectiveness of electrical stimulation. In order to improve CI outcomes for all patients, it is critical to understand how and why CI performance is related to residual hearing preservation. In this proposal, we will investigate 1) the potential mechanisms of hearing loss after implantation, and the interaction with age; and 2) the impact of this hearing loss on electrical stimulation with the CI. The findings will guide the selection of more targeted drugs or treatments that improve hearing preservation and general outcomes with CIs.

项目摘要 大约有2200万美国人的听力障碍。人工耳蜗植入物（CIS），一种神经 为治疗严重的听力损失而开发的假体，在安静中显着改善了语音理解 对于许多有听力损失的人。但是，福利在整个患者人群中仍然很大变化， 噪音中的语音理解仍然是一个问题。 最近的进步是电声刺激（EAS）CI，它允许电气组合和 同一耳朵中的声刺激。 EAS极大地改善了噪音的语音感知，声音 认可和音乐旋律认可。这些好处与剩余听证的数量成正比 人工耳蜗后保存。但是，30-55％的EAS CI接收者损失了30 dB 植入后的剩余听力，这可以否定这些好处。另外，年龄增加与 听力损失更大。为了改善听力保存和EAS的结果，我们需要了解 植入后听力损失的机制。 听力保存也可能改善CI总体人群的预后。传统的CI用户与 听力保存即使仅凭CI也有更好的结果，这表明 听力保存和电刺激的有效性。为了改善所有人的CI结果 患者，了解CI表现如何以及为什么与剩余听力保存相关，这一点至关重要。 在此提案中，我们将研究1）植入后听力损失的潜在机制，以及 与年龄相互作用； 2）听力损失对CI的电刺激的影响。发现 将指导选择更有针对性的药物或治疗方法，以改善听力保存和一般性 独联体的结果。