Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/Roc Boronat 138, 08018, Barcelona, Spain.
Med-EL, Innsbruck, Austria.
Mol Neurobiol. 2018 Jan;55(1):173-186. doi: 10.1007/s12035-017-0731-z.
Cochlear implantation (CI) surgery is a very successful technique, performed on more than 300,000 people worldwide. However, since the challenge resides in obtaining an accurate surgical planning, computational models are considered to provide such accurate tools. They allow us to plan and simulate beforehand surgical procedures in order to maximally optimize surgery outcomes, and consequently provide valuable information to guide pre-operative decisions. The aim of this work is to develop and validate computational tools to completely assess the patient-specific functional outcome of the CI surgery. A complete automatic framework was developed to create and assess computationally CI models, focusing on the neural response of the auditory nerve fibers (ANF) induced by the electrical stimulation of the implant. The framework was applied to evaluate the effects of ANF degeneration and electrode intra-cochlear position on nerve activation. Results indicate that the intra-cochlear positioning of the electrode has a strong effect on the global performance of the CI. Lateral insertion provides better neural responses in case of peripheral process degeneration, and it is recommended, together with optimized intensity levels, in order to preserve the internal structures. Overall, the developed automatic framework provides an insight into the global performance of the implant in a patient-specific way. This enables to further optimize the functional performance and helps to select the best CI configuration and treatment strategy for a given patient.
人工耳蜗植入 (CI) 手术是一项非常成功的技术，已在全球范围内为超过 30 万人实施。然而，由于挑战在于获得准确的手术规划，因此计算模型被认为提供了这种准确的工具。它们允许我们事先规划和模拟手术程序，以最大限度地优化手术结果，并为术前决策提供有价值的信息。本工作的目的是开发和验证计算工具，以全面评估 CI 手术的患者特定功能结果。开发了一个完整的自动框架来创建和评估计算 CI 模型，重点是植入物电刺激引起的听神经纤维 (ANF) 的神经反应。该框架用于评估 ANF 退化和电极在耳蜗内位置对神经激活的影响。结果表明，电极在耳蜗内的位置对 CI 的整体性能有很大影响。在周边过程退化的情况下，侧向插入可提供更好的神经反应，因此建议与优化的强度水平一起使用，以保护内部结构。总的来说，所开发的自动框架以患者特定的方式提供了对植入物整体性能的深入了解。这使得可以进一步优化功能性能，并有助于为特定患者选择最佳的 CI 配置和治疗策略。
