Koka Kanthaiah, Saoji Aniket A, Attias Joseph, Litvak Leonid M
Research and Technology, Advanced BionicsValencia, CA, USA.
Schneider Children's Medical Center of Israel and Rabin Medical CenterPetach Tikva, Israel.
Front Neurosci. 2017 Apr 18;11:210. doi: 10.3389/fnins.2017.00210. eCollection 2017.
Although, cochlear implants (CI) traditionally have been used to treat individuals with bilateral profound sensorineural hearing loss, a recent trend is to implant individuals with residual low-frequency hearing. Notably, many of these individuals demonstrate an air-bone gap (ABG) in low-frequency, pure-tone thresholds following implantation. An ABG is the difference between audiometric thresholds measured using air conduction (AC) and bone conduction (BC) stimulation. Although, behavioral AC thresholds are straightforward to assess, BC thresholds can be difficult to measure in individuals with severe-to-profound hearing loss because of vibrotactile responses to high-level, low-frequency stimulation and the potential contribution of hearing in the contralateral ear. Because of these technical barriers to measuring behavioral BC thresholds in implanted patients with residual hearing, it would be helpful to have an objective method for determining ABG. This study evaluated an innovative technique for measuring electrocochleographic (ECochG) responses using the cochlear microphonic (CM) response to assess AC and BC thresholds in implanted patients with residual hearing. Results showed high correlations between CM thresholds and behavioral audiograms for AC and BC conditions, thereby demonstrating the feasibility of using ECochG as an objective tool for quantifying ABG in CI recipients.
尽管传统上人工耳蜗（CI）一直用于治疗双侧重度感音神经性听力损失患者，但最近的趋势是为仍有低频残余听力的患者植入人工耳蜗。值得注意的是，这些患者中的许多人在植入后低频纯音阈值方面表现出气骨导差（ABG）。ABG是指使用气导（AC）和骨导（BC）刺激测量的听力阈值之间的差异。虽然行为气导阈值易于评估，但由于对高强度低频刺激的振动触觉反应以及对侧耳听力的潜在影响，骨导阈值在重度至极重度听力损失患者中可能难以测量。由于在有残余听力的植入患者中测量行为骨导阈值存在这些技术障碍，因此拥有一种确定ABG的客观方法将很有帮助。本研究评估了一种创新技术，该技术利用耳蜗微音电位（CM）反应测量电耳蜗图（ECochG）反应，以评估有残余听力的植入患者的气导和骨导阈值。结果显示，在气导和骨导条件下，CM阈值与行为听力图之间具有高度相关性，从而证明了使用ECochG作为量化人工耳蜗植入受者ABG的客观工具的可行性。
