病因、阵列类型和耳聋持续时间对人工耳蜗使用者聚焦检测阈值的影响

文献信息

中文摘要

人工耳蜗（CI）被认为能有效恢复重度听力损失患者的部分听力能力。然而，成人CI使用者的表现结果存在相当大的变异性。一个可能的变异来源是电极-神经元接口（ENI）的质量，它描述了植入电极刺激耳蜗内邻近螺旋神经节神经元（SGN）的效果。通过聚焦电刺激测量的绝对阈值已被提出作为ENI的行为学估计。在这项回顾性研究中，比较了来自74名成人人工耳蜗使用者的92只耳的聚焦刺激阈值模式，这些使用者具有不同的病因、耳聋持续时间和电极阵列类型。结果显示，植入预弯阵列的CI使用者往往比直阵列使用者具有更低的总体聚焦阈值，并且其阈值曲线在阵列两端阈值较低（更好），而在阵列中部附近阈值最高。病因与自身免疫功能障碍相关（如梅尼埃病）的CI使用者往往呈现相反的曲线，即阵列中部附近阈值最低。未观察到耳聋持续时间对聚焦阈值的显著影响。进一步研究哪些人口学和设备因素影响聚焦阈值，从而可能影响ENI，有助于阐明CI结果的变异性并指导个体化治疗策略的开发。

英文摘要

Cochlear implants (CIs) are considered effective at restoring some hearing abilities to individuals with severe hearing loss. However, there is considerable variability in performance outcomes among adults with CIs. One likely source of variability is the quality of the electrode-neuron interface (ENI), which describes how well implanted electrodes stimulate nearby spiral-ganglion neurons (SGNs) in the cochlea. Absolute thresholds, measured via focused electrical stimulation, have been proposed as a behavioral estimate of ENI. In this retrospective study, focused-stimulation threshold patterns were compared for 92 ears from 74 adult cochlear implant listeners with various etiologies, durations of deafness, and electrode array types. The results showed that CI listeners implanted with a pre-curved array tended to have lower overall focused thresholds than listeners with straight arrays, as well as a threshold profile with lower (better) thresholds at each end of the array and highest thresholds near the middle of the array. CI listeners with etiologies related to auto-immune dysfunction, such as Meniere's disease, tended to have the opposite profile, with lowest thresholds near the middle of the array. No significant effect of duration of deafness on focused thresholds was observed. Further investigation into which demographic and device factors affect focused thresholds, and therefore potentially ENI, could shed light on the variability of CI outcomes and guide development of individualized treatment strategies.