影响耳植入成人的表现的因素:对认知和残留耳功能的作用
Amit Walia1, Matthew A Shew, Shannon M Lefler
1Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
概括
电耳道学-总响应 (ECochG-TR) 有效地测量耳健康,以确定耳植入物 (CI) 的适用性. 虽然ECochG-TR是语音感知的关键,但在噪音中的表现也取决于认知功能.
科学领域:
- 听力学 听力学是指听力学.
- 神经外科 神经外科
- 生物医学工程 生物医学工程
背景情况:
- 耳植入器 (CI) 手术为患有严重至严重的感觉神经听力损失的成年人提供了显著的听力恢复.
- 预测术后CI表现仍然具有挑战性,对耳健康,认知功能和手术因素之间的相互作用的理解有限.
- 确定可靠的CI结果的生物标志物对于患者选择和手术规划至关重要.
研究的目的:
- 评估术前和术后因素对语言后成人耳植入物 (CI) 性能的影响.
- 为CI结果开发一个多变量预测模型.
- 为了验证电脑耳道学总响应 (ECochG-TR) 作为与CI刺激相关的耳道健康的衡量标准.
主要方法:
- 一项前性队列研究,涉及239名在第三级推中心的后语言成人CI接受者.
- 在手术后的3,6个月和12个月进行语音感知测试 (CNC文字识别,噪音中的AzBio).
- 在插入电极之前,在圆形窗口上测量电心电图-总响应 (ECochG-TR).
主要成果:
- 6个月后ECochG-TR与辅音-核心-辅音 (CNC) 词得分有很强的相关性 (r = 0.71,p < 0.0001).
- 包括年龄,听力损失持续时间,插入深度和ECochG-TR在内的多变量模型并没有显著改善CNC预测,而不是单独使用ECochG-TR.
- 在噪音分数中,AzBio与蒙特利尔认知评估 (MoCA; r = 0.38) 和ECochG-TR (r = 0.42) 显示了中度的相关性,ECochG-TR和MoCA解释了45.1%的变化.
结论:
- ECochG-TR被验证为对耳健康和适合CI刺激的测量.
- 耳神经基质,如ECochG-TR所示,是CI后语音感知表现的主要驱动因素.
- 在噪音中的听觉表现是复杂的,受到耳功能 (ECochG-TR) 和认知能力 (MoCA) 的影响.
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