Wangchuk Pelden, Umat Cila, Chong Foong Yen, Zaki Faizah Mohd, Abdullah Asma
Center for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Audiology Unit, Department of Otorhinolaryngology, JDWNR Hospital, MoH, Thimphu, Bhutan.
Audiol Neurootol. 2025;30(3):222-236. doi: 10.1159/000540965. Epub 2024 Nov 8.
Anatomy-based fitting (ABF), a relatively new technique for cochlear implant (CI) programming, attempts to lessen the impact of the electrode insertion location-related frequency-to-place mismatch (FPM). This study aimed to compare vowels and consonant perception in quiet and in noise among experienced adult CI users using the ABF and the regular, conventional-based fitting (CBF) map (pre-ABF) over 6 months.
Nine ears from eight experienced adult CI users were included in the experimental and longitudinal research. Using surgical planning software called Otoplan, postoperative computed computed tomography scans were used to determine the locations of intracochlear electrodes and their angle of insertion. The anatomy-based frequency bands were produced by Maestro 9.0 CI fitting software using the Otoplan data. Nonsense syllables with consonant-vowel-consonant (CVC) recognition scores in quiet and noise (+5 dB SNR) were compared at baseline, 3, and 6 months after ABF. The vowels involved were /a, i, u/, while the consonants were voiced /b, d, g/ and voiceless /p, t, k/ plosives. Speech pieces were presented at 30 dB SL in a sound-treated room through a loudspeaker positioned at 0° azimuth.
On average, the ABF maps shifted center frequency ranging from 0.46 semitones (0.04 octave) at (E12) to 23.94 semitones (1.99 octave) at (E1) as compared to the CBF maps. The mean vowel and consonant identification scores in quiet and in noise were significantly higher in ABF than in CBF (p < 0.05) with a large effect size and the trend of improvement was seen with time. Voiced consonants had better scores than the voiceless consonants.
The results demonstrated improved perception of vowels and consonants, particularly for sounds containing voicing cues after using the ABF maps. The results also suggested that ABF could be more effective for voice detection in noise. Overall, the findings indicate that correcting place mismatch with an ABF map may improve speech perception, at least among experienced adult CI users.
基于解剖结构的调试（ABF）是一种相对较新的人工耳蜗（CI）编程技术，旨在减轻电极插入位置相关的频率与位置不匹配（FPM）的影响。本研究旨在比较有经验的成年CI使用者在6个月内使用ABF和常规的基于传统方法的调试（CBF）图谱（ABF前）时，在安静环境和噪声环境下对元音和辅音的感知。
本实验性纵向研究纳入了8名有经验的成年CI使用者的9只耳朵。使用名为Otoplan的手术规划软件，利用术后计算机断层扫描来确定耳蜗内电极的位置及其插入角度。基于解剖结构的频段由Maestro 9.0 CI调试软件利用Otoplan数据生成。在ABF后的基线、3个月和6个月时，比较在安静环境和噪声环境（信噪比+5 dB）下具有辅音-元音-辅音（CVC）识别分数的无意义音节。所涉及的元音为/a、i、u/，辅音为浊音/b、d、g/和清音/p、t、k/爆破音。语音片段在经过声学处理的房间中通过位于0°方位角的扬声器以30 dB SL的强度呈现。
与CBF图谱相比，ABF图谱的中心频率平均偏移范围从（E12）处的0.46半音（0.04倍频程）到（E1）处的23.94半音（1.99倍频程）。在安静环境和噪声环境下，ABF中的元音和辅音识别平均分数显著高于CBF（p < 0.05），效应量较大，且随着时间推移有改善趋势。浊辅音的分数高于清辅音。
结果表明，使用ABF图谱后，元音和辅音的感知得到改善，特别是对于包含浊音线索的声音。结果还表明，ABF在噪声环境中进行语音检测可能更有效。总体而言，研究结果表明，至少在有经验的成年CI使用者中，使用ABF图谱纠正位置不匹配可能会改善言语感知。
