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基于平面的拟合:一种新的基于策略的人工耳蜗拟合方法的评估和实用性。

Flat-based fitting: the evaluation and usefulness of a new strategy-based fitting approach for cochlear implants.

机构信息

Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Josef-Schneider-Straße 11, 97080, Würzburg, Germany.

Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.

出版信息

Eur Arch Otorhinolaryngol. 2019 Nov;276(11):3239-3245. doi: 10.1007/s00405-019-05603-5. Epub 2019 Sep 5.

DOI:10.1007/s00405-019-05603-5
PMID:31489495
Abstract

PURPOSE

The traditional fitting method for cochlear implants (CI), the single-channel fitting (SCF), is effective but time-consuming. A fitting method that is significantly faster to perform, but provides at least equivalent speech understanding and subjective benefit would be of clinical usefulness. The study explored the ability of flat strategy-based fitting (FSBF) maps to fill this need.

METHODS

Participants were 16 experienced CI users. They were fit with: SCF maps; the maps that the participants used in their everyday lives, called fine-tuned clinical (FTC) maps; and FSBF maps. The fittings were assessed objectively via speech understanding in noise, time needed to create the map, deviation from FTC map, and correlation between auditory response telemetry thresholds and normalized charge levels; and subjectively via spectral balance and hearing quality.

RESULTS

FSBF maps were significantly faster to generate. FTC maps provided the best subjective hearing quality. In all other assessments, no significant differences were found.

DISCUSSION

FSBF maps can save time and provide CI users with the same level of speech understanding in noise. Participants may have preferred the FTC maps that they were already acclimated to them. These results suggest that the FSBF method could be used in first-fittings or in challenging fitting situations, but subsequent fine-tuning is required in follow-up appointments to improve sound quality.

CONCLUSION

The FSBF method can be a useful and time-saving alternative fitting method in first-fittings or in challenging fitting situations.

摘要

目的

传统的人工耳蜗(CI)适配方法,即单通道适配(SCF),虽然有效,但耗时。如果有一种适配方法能够显著加快速度,同时提供至少相当的言语理解和主观获益,那么它将具有临床应用价值。本研究旨在探讨基于平坦策略的适配(FSBF)图谱是否能够满足这一需求。

方法

参与者为 16 名经验丰富的 CI 用户。他们接受了以下三种适配方法的测试:SCF 图谱、他们日常生活中使用的精细调整临床(FTC)图谱和 FSBF 图谱。通过言语理解测试、创建图谱所需的时间、与 FTC 图谱的偏差以及听觉反应遥测阈值和归一化电荷量之间的相关性来评估客观适配效果,并通过频谱平衡和听力质量来评估主观适配效果。

结果

FSBF 图谱的生成速度明显更快。FTC 图谱提供了最佳的主观听力质量。在所有其他评估中,没有发现显著差异。

讨论

FSBF 图谱可以节省时间,并为 CI 用户提供相同水平的噪声下言语理解能力。参与者可能更喜欢他们已经适应的 FTC 图谱。这些结果表明,FSBF 方法可以用于初次适配或具有挑战性的适配情况,但在随访预约中需要进行后续微调,以改善音质。

结论

FSBF 方法是一种在初次适配或具有挑战性的适配情况下节省时间且有效的替代适配方法。

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本文引用的文献

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2
Long-term Benefit of Unilateral Cochlear Implantation on Quality of Life and Speech Perception in Bilaterally Deafened Patients.双侧聋患者单侧人工耳蜗植入的长期生活质量和言语感知获益。
Otol Neurotol. 2019 Apr;40(4):e430-e440. doi: 10.1097/MAO.0000000000002008.
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Examination of Prosody and Timbre Perception in Adults With Cochlear Implants Comparing Different Fine Structure Coding Strategies.
比较不同精细结构编码策略的成人人工耳蜗使用者的韵律和音色感知检查
Am J Audiol. 2018 Jun 8;27(2):197-207. doi: 10.1044/2017_AJA-17-0046.
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Patient management for cochlear implant recipients in audiology departments: A practice review.
Cochlear Implants Int. 2016 May;17(3):123-8. doi: 10.1080/14670100.2015.1115188. Epub 2016 Mar 29.
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FS4, FS4-p, and FSP: a 4-month crossover study of 3 fine structure sound-coding strategies.FS4、FS4-p和FSP:三种精细结构声音编码策略的4个月交叉研究。
Ear Hear. 2014 Nov-Dec;35(6):e272-81. doi: 10.1097/AUD.0000000000000063.
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Evaluation of the 'Fitting to Outcomes eXpert' (FOX®) with established cochlear implant users.对“适配结果专家系统”(FOX®)与成熟的人工耳蜗使用者进行评估。
Cochlear Implants Int. 2015 Jan;16(1):39-46. doi: 10.1179/1754762814Y.0000000085. Epub 2014 Jun 20.
7
Cochlear implant programming: a global survey on the state of the art.人工耳蜗编程:关于最新技术水平的全球调查。
ScientificWorldJournal. 2014 Feb 4;2014:501738. doi: 10.1155/2014/501738. eCollection 2014.
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Pediatric cochlear implantation: expanding applications and outcomes.儿童人工耳蜗植入:拓展应用与成果。
Pediatr Clin North Am. 2013 Aug;60(4):841-63. doi: 10.1016/j.pcl.2013.04.008.
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Development of a software tool using deterministic logic for the optimization of cochlear implant processor programming.使用确定性逻辑开发软件工具,以优化人工耳蜗处理器编程。
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10
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Int J Audiol. 2010 Jul;49(7):527-34. doi: 10.3109/14992021003663103.