Vanderbilt University, Department of Electrical and Computer Engineering, Nashville, TN, United States of America.
Vanderbilt University Medical Center, Department of Hearing and Speech Sciences, Nashville, TN, United States of America.
Biomed Phys Eng Express. 2022 Nov 23;9(1). doi: 10.1088/2057-1976/ac9aba.
. The cochlear implant is a neural prosthesis designed to directly stimulate auditory nerve fibers to induce the sensation of hearing in those experiencing severe-to-profound hearing loss. After surgical implantation, audiologists program the implant's external processor with settings intended to produce optimal hearing outcomes. The likelihood of achieving optimal outcomes increases when audiologists have access to tools that objectively present information related to the patient's own anatomy and surgical outcomes. This includes visualizations like the one presented here, termed the activation region overlap image, which is designed to decrease subjectivity when determining amounts of overlapping stimulation between implant electrodes.. This visualization uses estimates of electric field strength to indicate spread of neural excitation due to each electrode. Unlike prior visualizations, this method explicitly defines regions of nerves receiving substantial stimulation from each electrode to help clinicians assess the presence of significant overlapping stimulation. A multi-reviewer study compared this and an existing technique on the consistency, efficiency, and optimality of plans generated from each method. Statistical significance was evaluated using the two-sided Wilcoxon rank sum test.. The study showed statistically significant improvements in consistency ( < 10), efficiency ( < 10), and optimality ( < 10) when generating plans using the proposed method versus the existing method.. This visualization addresses subjectivity in assessing overlapping stimulation between implant electrodes, which currently relies on reviewer estimates. The results of the evaluation indicate the provision of such objective information during programming sessions would likely benefit clinicians in making programming decisions.
. 人工耳蜗是一种神经假体，旨在通过直接刺激听神经纤维，为重度至极重度听力损失患者带来听觉感知。在手术植入后，听力学家会使用旨在产生最佳听力效果的设置对植入体外部处理器进行编程。当听力学家能够使用客观呈现与患者自身解剖结构和手术结果相关信息的工具时，就能更有可能获得最佳效果。这包括这里展示的一种可视化效果，称为激活区域重叠图像，它旨在减少在确定植入电极之间重叠刺激量时的主观性。这种可视化使用电场强度的估计来指示每个电极引起的神经兴奋的扩散。与之前的可视化方法不同，这种方法明确定义了从每个电极接收大量刺激的神经区域，以帮助临床医生评估是否存在显著的重叠刺激。一项多评论者研究比较了这种方法和现有技术在从每种方法生成的计划的一致性、效率和最优性方面的表现。使用双侧 Wilcoxon 秩和检验评估了统计学意义。该研究表明，与使用现有方法相比，使用所提出的方法生成计划时，在一致性（<10）、效率（<10）和最优性（<10）方面都有统计学上的显著改进。这种可视化方法解决了评估植入电极之间重叠刺激时的主观性问题，目前这种主观性依赖于评估者的估计。评估结果表明，在编程过程中提供这种客观信息可能会使临床医生在做出编程决策时受益。
