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基于解剖学的适配改善了单侧耳聋人工耳蜗植入者在噪声环境中的言语感知。

Anatomy-based fitting improves speech perception in noise for cochlear implant recipients with single-sided deafness.

作者信息

Kurz Anja, Herrmann David, Müller-Graff Franz-Tassilo, Voelker Johannes, Hackenberg Stephan, Rak Kristen

机构信息

Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2025 Jan;282(1):467-479. doi: 10.1007/s00405-024-08984-4. Epub 2024 Sep 19.

Abstract

OBJECTIVE

To evaluate objective and subjective hearing outcomes in experienced cochlear implant users with single sided deafness (SSD CI) who used fitting maps created via anatomy-based fitting (ABF) and clinically-based fitting (CBF).

PARTICIPANTS

Twelve SSD CI users with postlingual hearing loss.

INTERVENTION

OTOPLAN (Version 3. (MED-EL) was used to determine intracochlear electrode contact positions using post-operative high-resolution flat panel volume computed tomography. From these positions, the corresponding center frequencies and bandwidths were derived for each channel. These were implemented in the clinical fitting software MAESTRO to yield an ABF map individualized to each user.

MAIN OUTCOME MEASURES

ABF and CBF maps were compared. Objective speech perception in quiet and in noise, binaural effects, and self-perceived sound quality were evaluated.

RESULTS

Significantly higher speech perception in noise scores were observed with the ABF map compared to the CBF map (mean SRT: -6.49 vs. -4.8 dB SNR for the SN configuration and - 3.85 vs. -2.75 dB SNR for the SN configuration). Summation and squelch effects were significantly increased with the ABF map (0.86 vs. 0.21 dB SNR for summation and 0.85 vs. -0.09 dB SNR for squelch). No improvement in speech perception in quiet or spatial release from masking were observed with the ABF map. A similar level of self-perceived sound quality was reported for each map. Upon the end of the study, all users opted to keep the ABF map. This preference was independent of the angular insertion depth of the electrode array.

CONCLUSIONS

Experienced SSD CI users preferred using the ABF map, which gave them significant improvements in binaural hearing and some aspects of speech perception.

摘要

目的

评估使用基于解剖结构的拟合(ABF)和基于临床的拟合(CBF)创建的拟合图的经验丰富的单侧耳聋人工耳蜗使用者(SSD CI)的客观和主观听力结果。

参与者

12名语后听力损失的SSD CI使用者。

干预措施

使用OTOPLAN(版本3.(MED-EL))通过术后高分辨率平板容积计算机断层扫描确定耳蜗内电极接触位置。从这些位置,为每个通道导出相应的中心频率和带宽。这些被应用于临床拟合软件MAESTRO中,以生成针对每个用户的个性化ABF图。

主要观察指标

比较ABF和CBF图。评估安静和噪声环境下的客观言语感知、双耳效应和自我感知的声音质量。

结果

与CBF图相比,ABF图的噪声环境下言语感知得分显著更高(SN配置的平均言语接收阈:-6.49 vs. -4.8 dB SNR,SN配置的平均言语接收阈:-3.85 vs. -2.75 dB SNR)。ABF图的总和效应和静噪效应显著增加(总和效应为0.86 vs. 0.21 dB SNR,静噪效应为0.85 vs. -0.09 dB SNR)。ABF图在安静环境下的言语感知或掩蔽空间释放方面没有改善。两种图的自我感知声音质量水平相似。在研究结束时所有用户都选择保留ABF图。这种偏好与电极阵列的角度插入深度无关。

结论

经验丰富的SSD CI使用者更喜欢使用ABF图,这使他们在双耳听力和言语感知的某些方面有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80ad/11735480/b2ad5ed17e35/405_2024_8984_Fig1_HTML.jpg

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