Gantz Bruce J, Turner Christopher, Gfeller Kate E
Department of Otolaryngology-Head and Neck Surgery, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa 52242-1078, USA.
Audiol Neurootol. 2006;11 Suppl 1:63-8. doi: 10.1159/000095616. Epub 2006 Oct 6.
This communication details the latest preliminary results from an ongoing multicenter single-subject design clinical trial of the Iowa/Nucleus Hybrid 10-mm cochlear implant. Selection criteria, surgical strategies used for hearing preservation, and the benefits of preserved residual low-frequency hearing, improved word understanding in noise, and music appreciation are described.
The device has been implanted in 48 individuals with residual low-frequency hearing.
Hearing preservation has been accomplished in 46/48 subjects. Acoustic speech perception has also been preserved. Combined acoustic plus electric speech processing has enabled most of this group of volunteers to gain improved word understanding as compared to their preoperative hearing with bilateral hearing aids. A subset of subjects with 12 months or more experience demonstrates CNC word understanding continues to improve more than 24 months after implantation. Improved word understanding in noise is also a benefit of acoustic plus electric speech processing.
The improvement of speech in noise and melody recognition is linked to the ability to distinguish fine pitch differences as the result of preserved residual low-frequency acoustic hearing. Both of these measures are very important in real life to the hearing impaired. Preservation of residual low-frequency hearing should be considered when expanding candidate selection criteria for standard cochlear implants.
本通讯详细介绍了一项正在进行的关于爱荷华/核子混合10毫米人工耳蜗的多中心单受试者设计临床试验的最新初步结果。描述了选择标准、用于听力保留的手术策略,以及保留残余低频听力、改善噪声中的言语理解和音乐欣赏的益处。
该装置已植入48名有残余低频听力的个体。
46/48名受试者实现了听力保留。声学言语感知也得以保留。与术前使用双侧助听器时的听力相比,声学加电刺激言语处理使该组大多数志愿者的言语理解能力得到了改善。一部分有12个月或更长时间使用经验的受试者表明,植入后24个月以上,CNC言语理解能力仍在持续提高。噪声中言语理解能力的改善也是声学加电刺激言语处理的一个益处。
噪声中言语和旋律识别能力的提高与保留残余低频声学听力从而能够区分细微音高差异的能力有关。这两项指标对听力受损者的现实生活都非常重要。在扩大标准人工耳蜗植入候选者选择标准时,应考虑保留残余低频听力。