Sato Mika, Baumhoff Peter, Tillein Jochen, Kral Andrej
*Institute of AudioNeuroTechnology †Department of Experimental Otology, ENT Clinics, Medical University Hannover, Hannover ‡MED-EL Germany GmbH, Starnberg, Germany §School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas.
Otol Neurotol. 2017 Sep;38(8):e215-e223. doi: 10.1097/MAO.0000000000001428.
Electrical stimulation is normally performed on ears that have no hearing function, i.e., lack functional hair cells. The properties of electrically-evoked responses in these cochleae were investigated in several previous studies. Recent clinical developments have introduced cochlear implantation (CI) in residually-hearing ears to improve speech understanding in noise. The present study documents the known physiological differences between electrical stimulation of hair cells and of spiral ganglion cells, respectively, and reviews the mechanisms of combined electric and acoustic stimulation in the hearing ears.
Literature review from 1971 to 2016.
Compared with pure electrical stimulation the combined electroacoustic stimulation provides additional low-frequency information and expands the dynamic range of the input. Physiological studies document a weaker synchronization of the evoked activity in electrically stimulated hearing ears compared with deaf ears that reduces the hypersynchronization of electrically-evoked activity. The findings suggest the possibility of balancing the information provided by acoustic and electric input using stimulus intensity. Absence of distorting acoustic-electric interactions allows exploiting these clinical benefits of electroacoustic stimulation.
电刺激通常在没有听力功能的耳朵上进行，即缺乏功能性毛细胞的耳朵。此前已有多项研究对这些耳蜗中电诱发反应的特性进行了研究。最近的临床进展已将人工耳蜗植入（CI）应用于仍有残余听力的耳朵，以改善噪声环境下的言语理解。本研究分别记录了毛细胞电刺激和螺旋神经节细胞电刺激之间已知的生理差异，并综述了听力正常的耳朵中电声联合刺激的机制。
1971年至2016年的文献综述。
与纯电刺激相比，电声联合刺激可提供额外的低频信息并扩大输入的动态范围。生理学研究表明，与失聪耳朵相比，电刺激听力正常的耳朵时诱发活动的同步性较弱，这减少了电诱发活动的过度同步。研究结果表明，利用刺激强度平衡声刺激和电刺激所提供信息具有可能性。不存在失真的声电相互作用使得能够利用电声刺激的这些临床益处。
