Localization and Speech Intelligibility in EAS and Bilateral CI Users

EAS 和双边 CI 用户的本地化和语音清晰度

• 批准号: 8201824
• 负责人: Louise H. Loiselle
• 金额: $ 3.15万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-15 至 2013-04-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8201824
• 关键词: Acoustic Stimulation; Acoustics; Algorithms; Bilateral; Cochlear Implants; Consensus; Contralateral; Cueing for speech; Cues; Dyes; Ear; Electric Stimulation; Environment; Frequencies; Goals; Health Personnel; Hearing; Hearing Aids; Implant; Individual; Insurance; Masks; Measures; Noise; Outcome; Paper; Patients; Performance; Process; Publications; Reporting; Research; Research Design; Research Personnel; Residual state; Restaurants; Shapes; Speech; Speech Intelligibility; Speech Perception; Stimulus; Surgeon; Taxes; Time; hearing impairment; improved; simulation

DESCRIPTION (provided by applicant): Until relatively recently, most cochlear implants were unilateral. Now, however, there are two groups of implant patients who can use the same kind of input from two ears. One group uses bilateral cochlear implants (CI). These individuals have two CIs with no residual hearing (Bilateral CI). Another group has preserved low- frequency acoustic hearing in the implanted ear and also has acoustic low-frequency hearing in the contralateral ear. These patients combine electric and acoustic stimulation (EAS) in the implanted ear and have residual low frequency hearing contralaterally. They have access to bilateral low frequency acoustic cues and are referred to as EAS. (EAS are different than bimodal CI users who have electric stimulation in one ear via a CI and acoustic hearing contralateral to the CI. In other words bimodal CI users have different hearing in each ear.) We can use these two groups of patients, Bilateral CI and EAS, with different types of bilateral hearing to assess the value of interaural level difference (ILD) cues and interaural time difference (ITD) cues in localization and in speech understanding in real world environments. Interaural time and intensity differences are known to provide normal hearing listeners with the ability to localize and are thought to underlie spatial release from masking (SRM). To date, there is a single paper (Dunn et al., 2010) on localization in EAS users. Dunn reported that EAS users are able to localize although not as well as normal hearing listeners. The study, however, lacked controls for the frequency information used in localization. There is a consensus that bilateral users have ILD sensitivity but do not have access to ITD cues (Grantham et al., 2007). Loizou et al. (2009) report bilateral CI users do not benefit from spatial release from masking, presumably due to the absence of ITD cues. If ITD cues are necessary for SRM in real world noise environments, EAS patients may benefit more in these environments than bilateral CI patients. The specific aims of this research are to determine (i) which underlying mechanism, ITD, ILD or both, underlie localization by the two groups, (ii) whether ITD or ILD cues provide a greater advantage when CI listeners are placed in difficult real world listening situations, and (iii) if there is a relationship between the availability of interaural ITD and ILD cues and SRM. The answers to these questions will shape our understanding of cochlear implant benefit and provide information to patients about real world benefits of CIs. The research design is a 2(groups=bilateral CI and EAS) X 3 (low-pass, high-pass, wideband noise) repeated measures ANOVA for localization ability from the three noise conditions and a 2 (groups = bilateral CI and EAS) X 2 (mode of listening and noise condition) repeated measures ANOVA for speech perception in noise. An analysis will be calculated to determine if performance on localization correlates with spatial release from masking. PUBLIC HEALTH RELEVANCE: The implications for a potential cochlear implant patient who is trying to decide between bilateral versus EAS could justifiably impact the decision of the patient, the surgeon, the audiologist, the tax payers, and even the insurance companies. This information will provide potential CI users and hearing health care providers with the necessary information to make an informed decision regarding expected outcomes.

描述（由申请人提供）：直到最近，大多数人工耳蜗都是单侧的。然而，现在有两组植入患者可以使用来自两只耳朵的相同类型的输入。一组使用双侧人工耳蜗 (CI)。这些人有两个 CI，没有残余听力（双边 CI）。另一组在植入的耳朵中保留了低频声学听力，并且在对侧耳朵中也保留了低频声学听力。这些患者在植入的耳朵中结合了电刺激和声刺激 (EAS)，并且对侧有残留的低频听力。他们可以获取双边低频声学线索，被称为 EAS。 （EAS 与双模态 CI 用户不同，双模态 CI 用户通过 CI 对一只耳朵进行电刺激，对 CI 对侧进行声学听力。换句话说，双模态 CI 用户每只耳朵的听力不同。）我们可以使用这两组具有不同类型双侧听力的患者（双侧 CI 和 EAS）来评估耳间电平差 (ILD) 线索和耳间时间差 (ITD) 线索在定位和言语理解中的价值 在现实世界环境中。众所周知，耳间时间和强度差异可以为听力正常的听众提供定位能力，并且被认为是掩蔽空间释放 (SRM) 的基础。迄今为止，有一篇关于 EAS 用户本地化的论文（Dunn 等人，2010）。 Dunn 报告称，EAS 用户能够进行定位，尽管不如正常听力听众。然而，该研究缺乏对定位中使用的频率信息的控制。人们一致认为，双边用户具有 ILD 敏感性，但无法获得 ITD 线索（Grantham 等，2007）。洛伊祖等人。 (2009) 报告双边 CI 用户没有从掩蔽的空间释放中受益，大概是由于缺乏 ITD 线索。如果 ITD 提示对于现实世界噪声环境中的 SRM 是必要的，则 EAS 患者在这些环境中可能比双侧 CI 患者受益更多。这项研究的具体目的是确定 (i) ITD、ILD 或两者是哪一种潜在机制，是两组定位的基础；(ii) 当 CI 听众处于困难的现实世界听力环境中时，ITD 或 ILD 线索是否提供更大的优势；(iii) 耳间 ITD 和 ILD 线索的可用性与 SRM 之间是否存在关系。这些问题的答案将影响我们对人工耳蜗植入益处的理解，并为患者提供有关人工耳蜗在现实世界中益处的信息。研究设计是对三种噪声条件下的定位能力进行 2（组=双边 CI 和 EAS）X 3（低通、高通、宽带噪声）重复测量方差分析，以及对噪声中的语音感知进行 2（组=双边 CI 和 EAS）X 2（聆听模式和噪声条件）重复测量方差分析。将进行分析以确定定位性能是否与遮蔽的空间释放相关。 公共健康相关性：对于试图在双侧人工耳蜗植入还是 EAS 之间做出选择的潜在人工耳蜗患者来说，这可能会合理地影响患者、外科医生、听力学家、纳税人甚至保险公司的决定。这些信息将为潜在的 CI 用户和听力保健提供者提供必要的信息，以便就预期结果做出明智的决定。