Improving cochlear implant performance by optimizing bilateral speech processors

描述(由申请人提供)：双侧植入在人工耳蜗术(CI)中产生了相当大的改善。然而，在临床上，双边CI通常被编程为两个独立的设备。因此，双侧植入物的全部潜力仍然没有得到开发。多个电极可以激活重叠的神经群，从而导致相似的感知(“感知重叠”)。耳朵之间的知觉重叠对于感知双耳提示，特别是耳间时差是至关重要的。可以优化双侧顺应性，以最大限度地提高跨耳匹配的电极的知觉重叠(“匹配”)，这是目前临床上不做的。每只耳朵内的知觉重叠会大大限制CI的表现。通过将信号分成两个耳朵，将相邻的频率区域发送到相反的耳朵(“交错”)，可以优化双边顺式以减少电极之间的知觉重叠。在匹配的情况下，相同的频率区域被发送到两只耳朵，两侧匹配的电极需要产生最大的知觉重叠。对于交织，其中来自不同频率区域的信号被发送到相反的耳朵，需要避免这样的配对。匹配与交错的益处可能因患者而异，一些患者可能会在电极阵列的不同部分上结合这两种方法获得最佳益处。我们的长期目标是优化双边关系 为困难的听力情况提供刺激。我们假设，在耳朵上最佳地配对电极将改善对空间线索的感知。我们还假设，最大限度地减少耳朵内部和耳朵之间的知觉重叠将提供额外的光谱线索。最后，我们假设结合双侧匹配和针对不同耳蜗区的交织将最大化双侧植入的好处。

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.