Binaural Hearing with Bilateral Cochlear Implants: Binaural-Unmasking Advantages

描述（由申请人提供）：耳蜗植入物在恢复聋人听力方面非常成功。虽然它们在安静的环境中工作得很好，但几乎所有的用户在噪音存在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侧耳蜗植入，因为已知正常听力者的双耳听力大大增强了将语音与背景噪声分离的能力。然而，与听力正常的人相比，迄今为止报道的双侧人工耳蜗植入者的益处是适度的。一个明显的问题是，目前的耳蜗植入物处理方案不提供允许两个设备最佳地一起工作所需的信息。拟议的工作将测试的假设，即增强语音识别的一个关键机制，由双边人工耳蜗植入用户是双耳解蔽通过耳间相关灵敏度。虽然双耳暴露线索在听觉中已经得到了很好的研究，但对人工耳蜗植入的了解仍然很少。拟议的研究建立在我们的新的初步发现，双侧人工耳蜗植入用户可以利用耳间的差异，以提高在噪声中的信号检测。建议的研究将调查双耳信号检测和语音歧视使用两个互补的范例。我们将测试（1）双侧人工耳蜗植入者和（2）听力正常的受试者，他们听的刺激选择与植入实验中使用的刺激类似。拟议中的工作将扩大我们的知识，双耳系统使用新的刺激与人工耳蜗植入，并将允许开发的声音处理器，以产生更好的语音理解噪声中的人工耳蜗植入用户。我们的研究还将有助于告知临床世界中的一个重要问题：人工耳蜗用户是否应该获得一个或两个设备。了解双侧人工耳蜗植入优势的大小以及如何最大限度地发挥这些优势将为这一临床辩论提供信息。为越来越多的患者提供双侧耳蜗植入物，以努力在存在噪声的情况下改善语音理解，因为已知正常听力收听者的双耳听力提供这种改善。然而，与听力正常的人相比，迄今为止报道的双侧人工耳蜗植入者的益处是适度的。通过研究双侧人工耳蜗植入用户如何感知基本双耳线索，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植入用户可以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.