Otolaryngology Department, APHP, Hôpital Beaujon, Clichy, France.
Otol Neurotol. 2012 Jan;33(1):30-7. doi: 10.1097/MAO.0b013e31823c9461.
This study aimed to evaluate the interaction of electric and acoustic cues in diotic condition in cochlear implantees.
Five adult cochlear implantees with residual contralateral hearing were prospectively evaluated in hearing aid only (HA), cochlear implant only (CI), and HA + CI modes by audiometry (pure tone, dissyllabic words, and sentences), and sound quality questionnaires. CI electrodes corresponding to preserved frequencies in the contralateral ear (free-field aided thresholds, <50 dB) were then deactivated, and patients were retested after 20 to 30 days.
Sentences in silence showed a benefit of CI and the additive effect of HA + CI. As expected, performances with CI alone decreased after apical electrode deactivation. In contrast, speech performances (Marginal Benefit from Acoustic Amplification sentences) in HA + CI mode were not altered by electrode deactivation in silence (90 ± 5.9% before versus 81 ± 10.1% after deactivation, not significant, 2-way analysis of variance) or in noise (78 ± 4.8% before versus 66 ± 11.9% after deactivation, not significant, 2-way analysis of variance). Performances for dissyllabic words confirmed these results. Questionnaires showed a significant compensation of partial electrode deactivation by the contralateral hearing. Moreover, the human voice was reported to be significantly less metallic.
These results suggested a significant complementarity of acoustic and electric diotic cues but also some redundancy affecting the sound quality.
本研究旨在评估在双侧听力正常的情况下,电声线索在人工耳蜗植入者中的相互作用。
前瞻性评估了 5 名具有残余对侧听力的成年人工耳蜗植入者在助听器(HA)、人工耳蜗(CI)和 HA+CI 模式下的听力(纯音、双音节词和句子)和音质问卷。然后,停用与对侧耳保留频率相对应的 CI 电极(自由场助听听阈,<50dB),并在 20-30 天后重新测试患者。
在安静环境下,句子测试显示出 CI 的优势和 HA+CI 的附加效应。正如预期的那样,单独使用 CI 后,电极激活后性能下降。相比之下,在安静(Marginal Benefit from Acoustic Amplification 句子)或噪声环境下(78±4.8% 测试前 vs. 66±11.9% 测试后,无显著差异,双因素方差分析),HA+CI 模式下的言语表现(90±5.9% 测试前 vs. 81±10.1% 测试后,无显著差异,双因素方差分析)不受电极停用的影响。双音节词测试结果也证实了这一结果。问卷结果表明,对侧听力对部分电极停用有显著的补偿作用。此外,人声音质报告明显不那么金属化。
这些结果表明,电声双线索具有显著的互补性,但也存在一些冗余性,影响声音质量。