Improving cochlear implant performance by optimizing bilateral speech processors

描述（由申请人提供）：双侧人工耳蜗植入已取得相当大的改善。然而，双侧ci在临床上通常被编程为两个独立的装置。因此，双侧植入物的全部潜力尚未开发。多个电极可以激活重叠的神经群，从而产生相似的感知（“感知重叠”）。双耳间的知觉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CIs可以优化，以最大限度地提高跨耳匹配电极的感知重叠（“匹配”），这目前尚未在临床上实现。每只耳朵内的知觉重叠会极大地限制CI的性能。双侧ci可以优化，通过在耳朵上划分信号，将相邻的频率区域发送到相反的耳朵（“交错”），以减少电极之间的感知重叠。通过匹配，将相同的频率区域发送到两只耳朵，双侧匹配的电极需要产生最大的感知重叠。在交叉传输中，来自不同频率区域的信号被发送到相反的耳朵，这样的配对需要避免。匹配与交错的益处可能因患者而异，一些患者可能通过在电极阵列的不同部分结合两种方法获得最佳益处。我们的长期目标是优化双边关系

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.