Iowa Cochlear Implant Clinical Research Center Project VI

本申请要求继续爱荷华人工耳蜗临床研究中心。听力保护和声电结合语音处理已成为非常重要的概念，本中心在识别残音听力的意义方面发挥了重要作用。我们相信保存听力的电极将改善结果，因为它们允许使用者将电听觉刺激与任何残余的自然听觉结合起来。我们的首要目标是研究这种语音处理的混合方法如何使新的成人和儿童群体受益。我们还将研究这些微创电极在深度失聪婴儿中的应用，在那里它们可能有助于保存Corti器官的结构元素，并使这些人能够利用正在进行的未来研究来再生周围听觉系统。我们的第一个目标是比较电极长度如何影响患者适应听觉的能力，当声学和电刺激相结合时产生严重扭曲的频率位置图。这项评估将检查听力、言语和语言、音乐感知和享受的结果，并将从潜在的处理机制方面描述Cl使用者的特征。因此，我们建议研究可塑性、学习和适应机制，这可能是预测良好结果的核心。我们的第二个目标是定义听力障碍儿童群体中助听器与人工耳蜗植入的适当性之间的界限。第三，我们将研究深度失聪婴儿在使用标准长度的人工耳蜗和使用微创电极时，语言感知和语言能力的发展是否同样良好。我们将对105名成人、80名残听儿童和20名重度耳聋婴儿进行听力保存电极CIs的研究。对照受试者将从一个研究注册中心获得，该注册中心目前已经招募了335名先前植入的成人和儿童。五个研究项目，一个行政核心A，病人护理，语音处理和技术核心B将解决上述目标。这五个研究项目是高度整合的，并且依赖于彼此的数据来回答实验问题。

This application requests continuation of the Iowa Cochlear Implant Clinical Research Center. Hearing preservation and combining acoustic plus electric speech processing have become very important concepts and our Center has played an important role in identifying the significance of residual acoustic hearing. We believe that hearing-preservation electrodes will improve outcomes because they allow users to combine electric auditory stimulation with any residual natural acoustic hearing. Our overarching goal is to examine how this hybrid approach to speech processing might benefit new populations of adults and children. We will also investigate the use of these less invasive electrodes in profoundly deaf infants, where they might help preserve the structural elements of the organ of Corti and enable this population to take advantage of ongoing future research to regenerate the peripheral auditory system. Our first objective aims to compare how electrode length affects the patient's ability to adapt to hearing the severely distorted frequency-place maps produced when acoustic plus electric stimulation are combined. This assessment will examine outcomes for hearing, speech and language, and music perception and enjoyment, and will also characterize Cl users in terms of underlying processing mechanisms. Thus, we propose to study the plasticity, learning, and adaptation mechanisms that might be central to predicting good outcomes. Our second objective is to define the boundaries between the appropriateness of hearing aids versus cochlear implants in populations of hard of hearing children. Third, we will examine whether profoundly deaf infants develop speech perception and language equally well with standard-length cochlear implants versus less invasive electrodes. We will study hearing-preservation electrode CIs in 105 adults and 80 children with residual acoustic hearing and 20 profoundly deaf infants. Control subjects will be obtained from a research registry that now has enrolled 335 previously implanted adults and children. Five research projects, an administrative Core A, and Patient Care, Speech Processing, and Technical Core B will address the above goals. The five research projects are highly integrated and depend on data from each other to answer the experimental questions.