Binaural Hearing with Bilateral Cochlear Implants: Binaural-Unmasking Advantages

描述（由申请人提供）：人工耳蜗在聋人恢复听力方面非常成功。虽然它们在安静的环境中工作得很好，但几乎所有用户在有噪音的情况下都很难理解语音。为了缓解这一问题，越来越多的患者接受了双耳人工耳蜗植入手术，因为正常听力者的双耳听力可以大大提高从背景噪音中分离语音的能力。然而，与听力正常的人相比，迄今为止报道的双侧人工耳蜗使用者的益处是有限的。一个明显的问题是，目前的人工耳蜗处理方案不提供所需的信息，使两个设备协同工作的最佳。本研究将验证双侧人工耳蜗使用者增强语音识别的关键机制是通过耳间相关敏感性来揭示双耳掩蔽的假设。虽然双耳揭露线索已经在声学听力中得到了很好的研究，但它们在人工耳蜗植入中仍然知之甚少。我们提出的研究建立在我们新的初步发现的基础上，即双侧人工耳蜗使用者可以利用耳际差异来提高噪声中的信号检测。本研究将利用两种互补的范式来研究双耳信号检测和语音识别。我们将测试(1)双侧人工耳蜗使用者和(2)听力正常的受试者听与人工耳蜗实验中类似的刺激。这项工作将扩大我们对双耳系统的认识，利用人工耳蜗提供的新刺激，并将允许声音处理器的发展，使人工耳蜗用户在噪音中更好地理解语音。我们的研究也将有助于告知临床世界的一个重要问题：人工耳蜗使用者是否应该得到一个或两个设备。了解双侧人工耳蜗优势的大小以及如何最大化这些优势将为临床辩论提供信息。越来越多的患者接受双侧人工耳蜗植入，以提高他们在噪音环境下的言语理解能力，因为众所周知，正常听力者的双耳听力可以提供这种改善。然而，与听力正常的人相比，迄今为止报道的双侧人工耳蜗使用者的益处是有限的。通过研究双侧人工耳蜗使用者如何感知基本的双耳信号，我们的目标是开发处理器，以最大限度地提高双侧人工耳蜗使用者从他们的设备中获得的好处。

DESCRIPTION (provided by applicant): Cochlear implants have become extremely successful at restoring hearing in deaf individuals. Although they work well in quiet environments, almost all users have great difficulty understanding speech in the presence of noise. Bilateral cochlear implants are provided to a growing number of patients in an effort to alleviate this problem because binaural hearing in normal-hearing listeners is known to greatly enhance the ability to segregate speech from background noise. However, the benefits in bilateral cochlear implants users reported to date are modest compared with what is seen in normal-hearing persons. An obvious problem is that present cochlear implants processing schemes do not provide the information required to allow two devices to work together optimally. The proposed work will test the hypothesis that a key mechanism for enhancing speech discrimination by bilateral cochlear implant users is binaural unmasking via interaural correlation sensitivity. Although binaural unmasking cues have been well-studied in acoustic hearing, they remain poorly understood with cochlear implants. The proposed research builds on our novel preliminary finding that bilateral cochlear implant users can exploit interaural differences to improve signal detection in noise. The proposed research will investigate binaural signal detection and speech discrimination using two complementary paradigms. We will test (1) bilateral cochlear implant users and (2) normal-hearing subjects listening to stimuli chosen to be analogous to those used in the implant experiments. The proposed work will expand our knowledge of the binaural system using the novel stimuli available with cochlear implants and will allow the development of sound processors to produce better speech understanding in noise by cochlear implant users. Our research will also help inform an important question in the clinical world: whether cochlear implant users should get one or two devices. Knowing the magnitude of the bilateral cochlear implant advantages and how to maximize those advantages will inform this clinical debate. Bilateral cochlear implants are provided to a growing number of patients in an effort to improve speech understanding in the presence of noise because binaural hearing in normal-hearing listeners is known to provide such improvements. However, the benefits in bilateral cochlear implant users reported to date are modest compared with what is seen in normal-hearing persons. By studying how fundamental binaural cues are perceived by bilateral cochlear implant users we aim to develop processors to maximize the benefits bilateral cochlear implant users can obtain from their devices.