Optimizing Bilateral and Single-Sided Deafness Cochlear Implants for Functioning in Complex Auditory Environments

摘要：在大约10万名人工耳蜗（CI）使用者中，绝大多数都有严重到严重的听力障碍。 一只耳朵，一只耳朵，一只耳朵。然而，双耳无法听到声音严重阻碍了 听觉系统克服背景噪声的能力，这有许多后果，包括增加 沟通所需的努力。即使双耳都能听到声音，双耳或"双耳" 双侧CI（BI-CI）和单侧耳聋CI（SSD-CI）用户的受益与正常听力相比很小， 听众由于双耳之间可能存在频率失配，目前还不清楚当前的标准是否 编程CI的方法最大化双耳的语音理解，特别是在环境中 有多个声源。我们的长期目标是理解和最大限度地提高语音理解和二进制- CI通过改善耳间频率、水平和定时编码而带来的听觉益处。接下来的步骤 为了实现这一目标，这里的目标是评估耳间频率失配，并开发新的CI 程序（MAP）来纠正不匹配。我们的中心假设是BI-CI和SSD-CI中的双耳功能 由于耳间频率失配，用户是次优的。我们的方法是优化频率- 分配在较差的耳朵，以尽量减少不匹配，并可能提高语音理解和空间 听证会有了强有力的初步数据在手，中心假设将通过追求三个具体的测试。 目的：（1）评估BI-CI和SSD-CI使用者个体电极的耳间频率失配。(2)比较 标准MAP和新型MAP的急性功能益处和局限性， BI-CI和SSD-CI用户的频率不匹配。(3)在一项纵向研究中，评估标准 MAP和新的MAP引起BI中音高处理、双耳处理和语音理解的变化。 CI和SSD-CI用户。预期结果是改善BI-CI和SSD-CI用户的双耳功能， 牺牲了语言理解能力本文的研究对CI的发展具有积极的意义 通过改善安静和嘈杂环境中的沟通来提高用户的生活质量。这一建议具有创新性 因为它使用双耳神经处理的知识来提供一种新颖的、非侵入性的、廉价的 方法来重新编程双侧听力的CI。

ABSTRACT: The vast majority of the roughly 100,000 cochlear-implant (CI) users have severe-to-profound hear- ing loss, but only receive a single CI in one ear. Yet, not having access to sound in two ears severely hampers the auditory systems' ability to overcome background noise, which has many consequences including increasing the amount of effort it takes to communicate. Even with access to sound in both ears, two-ear or “binaural” benefits for bilateral CI (BI-CI) and single-sided deaf CI (SSD-CI) users are small compared to normal-hearing listeners. Because of possible frequency mismatch between the two ears, it is unclear if the current standard approach of programming the CIs maximizes speech understanding for two ears, particularly in environments with multiple sound sources. Our long-term goal is to understand and maximize speech understanding and bin- aural benefits imparted by CIs by improving interaural frequency, level, and timing encoding. The next steps toward this goal and the objectives here are to evaluate interaural frequency mismatch and to develop novel CI programs (MAPs) to correct for mismatch. Our central hypothesis is that binaural function in BI-CI and SSD-CI users is suboptimal because of interaural frequency mismatch. Our approach will be to optimize the frequency- allocation in the poorer ear to minimize the mismatch and potentially improve speech understanding and spatial hearing. With strong preliminary data in hand, the central hypothesis will be tested by pursuing three specific aims: (1) Assess interaural frequency mismatch for individual electrodes in BI-CI and SSD-CI users. (2) Compare the acute functional benefits and limitations for the standard MAP and novel MAPs that minimize interaural fre- quency mismatch in BI-CI and SSD-CI users. (3) In a longitudinal study, evaluate the extent to which standard MAP and novel MAPs cause changes in pitch processing, binaural processing, and speech understanding in BI- CI and SSD-CI users. The expected outcome is improved binaural function for BI-CI and SSD-CI users, without sacrificing speech understanding. This research is significant because it will produce a positive impact in CI users' quality of life by improving communication in quiet and noisy environments. This proposal is innovative because it uses knowledge of binaural neural processing to provide a novel, non-invasive, and inexpensive method to reprogram CIs for bilateral hearing.