Environmental Sound Recognition Before and After Cochlear Implantation in Adults

项目摘要 耳蜗植入体（CI）是成人感音神经性听力损失的标准治疗， 助听器的选配关于当前CI设备如何影响环境声音识别， 认知（ESR），一个对安全性、独立性和生活质量（QOL）至关重要的非言语结果领域 所有CI用户。缺乏CI如何影响ESR以及影响ESR的患者因素的有力证据， 听力保健专业人员提供ESR康复和循证咨询的能力有限。 这项研究的调查人员通过初步研究发现，语后聋成年人的ESR是 与正常听力的同龄人相比，听力显著降低且高度可变。初步横截面和 孤立呈现的环境声音的纵向ESR评估-与背景丰富的 日常生活的呈现-已经证明，有经验的成年CI用户并不均匀优于CI 在最佳辅助条件下使用助听器进行测试。 目前的研究有两个具体的目的：（1）纵向量化ESR的变化，为成年人的舌后使用 一种新颖的上下文丰富的ESR评估，以更好地近似真实世界的日常听力;（2）确定 ESR对CI用户报告的CI特异性QOL的相对贡献。假设（1）上下文- 丰富的ESR将改善植入后的成人，（2）ESR将有助于显着自我报告 CI特异性QOL。为了检验这些假设，对ESR和CI特异性QOL进行了前瞻性纵向评估， 将在CI前至人工耳蜗植入第一年在语后成人样本中进行。 这项研究的预期好处是，听力健康专业人员将能够（1）为患者提供 基于证据的ESR预测，（2）更全面地了解CI的贡献， 具体的生活质量超越言语感知，（3）奠定基础，为未来的ESR康复策略， CI用户在这个重要的、被忽视的CI结果领域中挣扎。

PROJECT SUMMARY Cochlear implants (CI) are the standard of care for adults with sensorineural hearing loss that is beyond the therapeutic reach of hearing aids. Little is known about how current CI devices affect environmental sound recog- nition (ESR), a nonspeech outcome domain that is crucial for the safety, independence, and quality of life (QOL) for all CI users. Lacking robust evidence for how CIs affect ESR and the patient factors that influence ESR, hearing health professionals are limited in their ability to offer ESR rehabilitation and evidence-based counseling. This research study's investigators have found through pilot studies that ESR in postlingually deaf adults is significantly reduced and highly variable compared to normal hearing peers. Preliminary cross-sectional and longitudinal ESR assessments of environmental sounds presented in isolation – in contrast to context-rich presentation of daily life – have demonstrated that experienced adult CI users do not uniformly outperform CI candidates tested under best-aided conditions with hearing aids. The current study has two Specific Aims: (1) to longitudinally quantify change in ESR for postlingual adults using a novel context-rich ESR assessment to better approximate real-world everyday listening; and (2) to determine the relative contribution of ESR to CI-specific QOL as reported by CI users. It is hypothesized that (1) context- rich ESR will improve in adults following implantation, and (2) that ESR will contribute significantly to self-reported CI-specific QOL. To test these hypotheses, a prospective, longitudinal assessment of ESR and CI-specific QOL will be performed pre-CI through the first year of cochlear implantation in a sample of postlingual adults. The expected benefits of this study are that hearing health professionals will be able to (1) provide patients with evidence-based ESR predictions, (2) develop a more comprehensive understanding of the contributions of CI- specific QOL beyond speech perception, and (3) lay the groundwork for future ESR rehabilitation strategies for CI users who struggle in this important, overlooked CI outcome domain.