Irving S, Gillespie L, Richardson R, Rowe D, Fallon J B, Wise A K
Bionics Institute, Melbourne, VIC 3002, Australia ; Department of Psychology, University of Melbourne, Melbourne, VIC 3010, Australia.
Bionics Institute, Melbourne, VIC 3002, Australia ; Department of Otolaryngology, University of Melbourne, Melbourne, VIC 3010, Australia.
Biomed Res Int. 2014;2014:350504. doi: 10.1155/2014/350504. Epub 2014 Sep 4.
Cochlear implants have provided hearing to hundreds of thousands of profoundly deaf people around the world. Recently, the eligibility criteria for cochlear implantation have been relaxed to include individuals who have some useful residual hearing. These recipients receive inputs from both electric and acoustic stimulation (EAS). Implant recipients who can combine these hearing modalities demonstrate pronounced benefit in speech perception, listening in background noise, and music appreciation over implant recipients that rely on electrical stimulation alone. The mechanisms bestowing this benefit are unknown, but it is likely that interaction of the electric and acoustic signals in the auditory pathway plays a role. Protection of residual hearing both during and following cochlear implantation is critical for EAS. A number of surgical refinements have been implemented to protect residual hearing, and the development of hearing-protective drug and gene therapies is promising for EAS recipients. This review outlines the current field of EAS, with a focus on interactions that are observed between these modalities in animal models. It also outlines current trends in EAS surgery and gives an overview of the drug and gene therapies that are clinically translatable and may one day provide protection of residual hearing for cochlear implant recipients.
人工耳蜗已让全球数十万重度聋人恢复听力。最近，人工耳蜗植入的入选标准有所放宽，将有一定残余听力的个体纳入其中。这些接受者能同时获得电刺激和声刺激（EAS）。相较于仅依赖电刺激的人工耳蜗接受者，能够结合这两种听力模式的植入接受者在言语感知、背景噪声下聆听及音乐欣赏方面展现出显著优势。赋予这种优势的机制尚不清楚，但听觉通路中电信号与声信号的相互作用可能起到了一定作用。对于电刺激和声刺激联合使用的人工耳蜗植入而言，在植入期间及之后保护残余听力至关重要。已实施了多项手术改进措施来保护残余听力，且听力保护药物和基因疗法的研发对接受电刺激和声刺激联合使用的人工耳蜗植入者很有前景。本综述概述了当前电刺激和声刺激联合使用的人工耳蜗植入领域，重点关注在动物模型中观察到的这些模式之间的相互作用。它还概述了电刺激和声刺激联合使用的人工耳蜗植入手术的当前趋势，并对可临床转化且未来可能为人工耳蜗接受者提供残余听力保护的药物和基因疗法进行了概述。
