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联合电声刺激(EAS)在儿童中的应用:研究双侧与单侧声觉刺激的获益差异。

Combined Electric and Acoustic Stimulation (EAS) in Children: Investigating Benefit Afforded by Bilateral Versus Unilateral Acoustic Hearing.

机构信息

Hearts for Hearing, Tulsa, Oklahoma.

Boys Town National Research Hospital, Omaha, Nebraska.

出版信息

Otol Neurotol. 2021 Aug 1;42(7):e836-e843. doi: 10.1097/MAO.0000000000003139.

Abstract

PURPOSE

Electric and acoustic stimulation (EAS) with preserved hearing in the implanted ear provides benefit for speech understanding, spatial hearing, and quality of life in adults. However, there is limited research on EAS outcomes in children. The aims of this study were to estimate the magnitude of EAS-related benefit on speech understanding in children with preserved acoustic hearing and to determine what role acoustic interaural time difference (ITD) sensitivity may have on said EAS benefit.

METHODS

Six children with acoustic hearing preservation and 20 children with normal hearing (NH) were recruited to participate. Speech recognition was assessed via an eight-loudspeaker array with speech presented from one loudspeaker at 0 degree and restaurant noise from all other loudspeakers (45-315 degrees). ITD thresholds were measured for a 250-Hz signal presented acoustically via insert earphones.

RESULTS

Only one EAS listener demonstrated significant benefit from bilateral acoustic hearing as compared with acoustic hearing from a single ear. ITD thresholds were poor in the range of 302 to 1000+ ms and were considerably poorer than ITD thresholds for the NH group.

CONCLUSION

These data suggest that children with acoustic hearing preservation may not exhibit initial EAS benefit for speech recognition in semi-diffuse noise; however, because none exhibited a decrement in performance with bilateral acoustic stimulation, EAS fittings are recommended to provide binaural acoustic access allowing for EAS adaptation to binaural cues over time. Future research should address the emergence of EAS benefit, binaural cue sensitivity, and the role of EAS experience in children and adults.

摘要

目的

植入耳中保留听力的电声刺激(EAS)可提高成人的言语理解能力、空间听觉能力和生活质量。然而,关于儿童 EAS 结果的研究有限。本研究的目的是评估在具有保留的听觉的儿童中 EAS 对言语理解的相关益处的程度,并确定听觉的强度差(ITD)敏感性对 EAS 益处的作用。

方法

招募了 6 名具有听觉保留的儿童和 20 名具有正常听力(NH)的儿童参加。通过八扬声器阵列评估言语识别,通过插入耳机以 0 度和餐厅噪声从所有其他扬声器(45-315 度)来呈现言语。通过插入耳机以声学方式呈现 250-Hz 信号来测量 ITD 阈值。

结果

只有一名 EAS 听众与单侧声学听力相比表现出双侧声学听力的显著益处。在 302 至 1000+毫秒的范围内,ITD 阈值较差,并且比 NH 组的 ITD 阈值差得多。

结论

这些数据表明,具有听觉保留的儿童在半扩散噪声中可能不会表现出最初的 EAS 言语识别益处;然而,由于双侧声学刺激的性能没有下降,因此推荐 EAS 适配以提供双耳声学访问,从而使 EAS 适应双耳线索随时间的变化。未来的研究应解决 EAS 益处的出现、双耳线索敏感性以及 EAS 经验在儿童和成人中的作用。

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