Wilson Blake S, Lawson Dewey T, Muller Joachim M, Tyler Richard S, Kiefer Jan
Center for Auditory Prosthesis Research, Research Triangle Institute, Research Triangle Park, North Carolina 27709, USA.
Annu Rev Biomed Eng. 2003;5:207-49. doi: 10.1146/annurev.bioeng.5.040202.121645. Epub 2003 Apr 16.
The history of cochlear implants is marked by large improvements in performance, especially over the past two decades and especially due to the development of ever-better processing strategies. Although the progress to date has been substantial, present devices still do not restore normal speech reception, even for top performers and particularly for listening to speech in competition with noise or other talkers. In addition, a wide range of outcomes persists, with some patients receiving little benefit using the same devices that support high levels of speech reception for others. The purpose of this review is to describe some likely possibilities for further improvement, including (a) combined electric and acoustic stimulation of the auditory system for patients with significant residual hearing, (b) use of bilateral implants, (c) a closer replication with implants of the processing steps in the normal cochlea, and (d) applications of knowledge about factors that are correlated with outcomes to help patients presently at the low end of the performance scale.
人工耳蜗的历史以性能的大幅提升为标志，特别是在过去二十年中，尤其得益于不断改进的处理策略的发展。尽管迄今为止取得了重大进展，但目前的设备仍无法恢复正常的语音接收能力，即使对于表现最佳的使用者也是如此，尤其是在与噪音或其他说话者竞争的情况下听语音时。此外，结果差异很大，一些患者使用对其他患者有高语音接收水平支持的相同设备却获益甚微。本综述的目的是描述一些进一步改进的可能途径，包括：(a) 对有显著残余听力的患者进行听觉系统的电声联合刺激；(b) 使用双侧植入物；(c) 更紧密地模拟正常耳蜗中的处理步骤进行植入；(d) 应用与结果相关因素的知识来帮助目前处于性能量表低端的患者。
