Mechanisms and Effects of Hearing Loss After Cochlear Implantation

项目摘要 大约有2200万美国人患有听力障碍。人工耳蜗植入物，一种神经 假体被开发用于治疗严重的听力损失，显著改善了在安静状态下的语言理解能力 对于许多听力受损的人来说。然而，收益在患者群体中仍然存在很大的变数， 而噪声中的语音理解仍然是一个问题。 最新的进展是电声刺激(EAS)CI，它允许将电和 同一只耳朵中的声学刺激。EAS显著改善了在噪音、语音中的语音感知 识别和音乐旋律识别。这些益处与剩余听力成正比。 人工耳蜗术后保存。然而，30%-55%的EAS CI接受者的损失超过30分贝 植入后的残留听力，这可能会抵消这些好处。此外，年龄的增加也与 听力损失更大。为了改善听力保护和EAS结果，我们需要了解 植入后听力损失的机制。 听力保护也可能改善普通CI人群的预后。传统配置项用户具有 即使只使用CI，听力保护也有更好的结果，这表明 听力保护和电刺激的有效性。为了改善所有人的传播和信息成果 对于患者来说，了解CI表现如何以及为什么与残余听力保护有关是至关重要的。 在这项计划中，我们将研究1)植入后听力损失的潜在机制，以及 与年龄的交互作用；以及2)这种听力损失对CI电刺激的影响。调查结果 将指导选择更有针对性的药物或治疗方法，以改善听力保护和一般情况 独联体的结果。

Project Summary Approximately 22 million Americans have a hearing impairment. Cochlear implants (CIs), a neural prosthesis developed to treat severe hearing loss, have significantly improved speech understanding in quiet for many individuals with hearing loss. However, benefit remains highly variable across the patient population, and speech understanding in noise remains a problem. A recent advance is the Electro-Acoustic Stimulation (EAS) CI, which allows combined electric and acoustic stimulation in the same ear. EAS dramatically improves speech perception in noise, voice recognition, and musical melody recognition. These benefits are proportional to the amount of residual hearing preserved after cochlear implantation. However, 30-55% of EAS CI recipients lose more than 30 dB of residual hearing after implantation, which can negate these benefits. In addition, increased age is associated with greater hearing loss. In order to improve hearing preservation and EAS outcomes, we need to understand the mechanisms of post-implantation hearing loss. Hearing preservation may also improve outcomes for the general CI population. Traditional CI users with hearing preservation have better outcomes even with just the CI alone, suggesting a relationship between hearing preservation and effectiveness of electrical stimulation. In order to improve CI outcomes for all patients, it is critical to understand how and why CI performance is related to residual hearing preservation. In this proposal, we will investigate 1) the potential mechanisms of hearing loss after implantation, and the interaction with age; and 2) the impact of this hearing loss on electrical stimulation with the CI. The findings will guide the selection of more targeted drugs or treatments that improve hearing preservation and general outcomes with CIs.