House Research Institute, Los Angeles, California 90057, USA.
Curr Opin Neurol. 2012 Feb;25(1):61-6. doi: 10.1097/WCO.0b013e32834ef878.
Auditory prostheses use electric currents on multiple electrodes to stimulate auditory neurons and recreate auditory sensations in deaf people. Cochlear implants have restored hearing in more than 200 000 deaf adults and children to a level that allows most to understand speech. Here we review the reasons underlying these results and describe new directions in restoring hearing to additional patient populations and the design of new devices.
From their early development about 50 years ago, cochlear implants have been well received and beneficial to people who had lost their hearing. Although those first implants did not allow high levels of speech understanding, they provided auditory information that worked synergistically with lip reading to improve communication. Present day cochlear implants provide excellent speech understanding in children and in postlingually deafened adults. Research is focused on improved signal processing and new electrode designs. Electric stimulation of the auditory brainstem can also produce excellent hearing in some children and adults.
Auditory prostheses, both at the level of the sensory nerve and at the brainstem, can restore patterns of neural activation that are sufficient for high levels of speech understanding. These prostheses are not only clinically successful but also important tools for understanding sensory processing in the brain.
目的综述：听觉假体通过多个电极上的电流刺激听觉神经元，为聋人重建听觉感知。人工耳蜗已为超过 20 万成年和儿童聋人恢复听力，使其达到能理解言语的程度。本文旨在探讨这些成果的背后原因，并介绍为更多患者群体恢复听力和设计新型设备的新方向。
最新发现：自 50 年前问世以来，人工耳蜗已被广泛接受，并使失聪人群受益。虽然最初的植入物无法实现高水平的言语理解，但它们提供的听觉信息与唇读协同作用，改善了交流。如今的人工耳蜗可使儿童和后天失聪的成年人实现极佳的言语理解。研究集中在改进信号处理和新型电极设计上。电刺激听觉脑干也可使一些儿童和成人获得极佳的听力。
总结：感觉神经和脑干水平的听觉假体都可以恢复足以实现高水平言语理解的神经激活模式。这些假体不仅在临床上取得了成功，而且还是研究大脑感觉处理的重要工具。
