Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Speech-Language Pathology & Audiology, Towson University, MD, USA.
Trends Hear. 2020 Jan-Dec;24:2331216520902001. doi: 10.1177/2331216520902001.
Multiple studies have shown significant speech recognition benefit when acoustic hearing is combined with a cochlear implant (CI) for a bimodal hearing configuration. However, this benefit varies greatly between individuals. There are few clinical measures correlated with bimodal benefit and those correlations are driven by extreme values prohibiting data-driven, clinical counseling. This study evaluated the relationship between neural representation of fundamental frequency (F0) and temporal fine structure via the frequency following response (FFR) in the nonimplanted ear as well as spectral and temporal resolution of the nonimplanted ear and bimodal benefit for speech recognition in quiet and noise. Participants included 14 unilateral CI users who wore a hearing aid (HA) in the nonimplanted ear. Testing included speech recognition in quiet and in noise with the HA-alone, CI-alone, and in the bimodal condition (i.e., CI + HA), measures of spectral and temporal resolution in the nonimplanted ear, and FFR recording for a 170-ms/da/stimulus in the nonimplanted ear. Even after controlling for four-frequency pure-tone average, there was a significant correlation (r = .83) between FFR F0 amplitude in the nonimplanted ear and bimodal benefit. Other measures of auditory function of the nonimplanted ear were not significantly correlated with bimodal benefit. The FFR holds potential as an objective tool that may allow data-driven counseling regarding expected benefit from the nonimplanted ear. It is possible that this information may eventually be used for clinical decision-making, particularly in difficult-to-test populations such as young children, regarding effectiveness of bimodal hearing versus bilateral CI candidacy.
多项研究表明,当声学听力与人工耳蜗(CI)结合用于双模式听力配置时,会显著提高语音识别能力。然而,这种益处因人而异,差异很大。目前很少有与双模式益处相关的临床测量方法,而且这些相关性是由极值驱动的,这使得数据驱动的临床咨询变得困难。本研究评估了未植入耳的基本频率(F0)和时域精细结构的神经表现(通过频率跟随反应 FFR)与未植入耳的频谱和时域分辨率以及安静和噪声环境下言语识别的双模式益处之间的关系。参与者包括 14 名单侧 CI 用户,他们在未植入耳中佩戴助听器(HA)。测试包括在安静环境中和使用 HA 单独、CI 单独以及双模式条件(即 CI+HA)下的言语识别、未植入耳的频谱和时域分辨率测量以及未植入耳的 170-ms/da/刺激的 FFR 记录。即使在控制了四频纯音平均值后,未植入耳的 FFR F0 幅度与双模式益处之间仍存在显著相关性(r=.83)。未植入耳的其他听觉功能测量与双模式益处没有显著相关性。FFR 具有作为一种客观工具的潜力,可能允许对来自未植入耳的预期益处进行数据驱动的咨询。有可能最终会将这些信息用于临床决策,特别是在难以测试的人群(如幼儿)中,涉及双模式听力与双侧 CI 候选资格的有效性。