Iowa Cochlear Implant Clinical Research Center Project VI

这项申请要求继续爱荷华州人工耳蜗术临床研究中心。听力保护和声学加电子语音处理的结合已成为非常重要的概念，本中心在确定残留声学听力的意义方面发挥了重要作用。我们相信，保留听力的电极将改善结果，因为它们允许用户将电听觉刺激与任何剩余的自然声听力结合起来。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。我们还将研究这些侵入性较小的电极在深度耳聋婴儿中的使用，在这些婴儿中，它们可能有助于保留Corti器官的结构元素，并使这一群体能够利用正在进行的未来研究来再生外围听觉系统。我们的第一个目标是比较电极长度如何影响患者适应声音和电刺激组合时产生的严重失真的频率-位置图的能力。这项评估将考察听力、言语和语言，以及音乐感知和享受的结果，并将根据潜在的处理机制来描述CI使用者的特征。因此，我们建议研究可塑性、学习和适应机制，这些机制可能是预测良好结果的核心。我们的第二个目标是确定重听儿童群体中助听器的适宜性和人工耳蜗植入物之间的界限。第三，我们将研究深度失聪的婴儿在植入标准长度的人工耳蜗和侵入性较小的电极后，是否同样能很好地发展言语感知和语言能力。我们将在105名成人和80名儿童以及20名深度失聪的婴儿中研究听力保护电极顺式。对照受试者将从研究登记中获得，该登记现已登记了335名先前植入的成人和儿童。五个研究项目、行政核心A、患者护理、语音处理和技术核心B将解决上述目标。这五个研究项目高度整合，并依赖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.