Selecting electrode configurations for image-guided cochlear implant programming using template matching

摘要

Cochlear implants (CIs) are used to treat patients with severe-to-profound hearing loss. In surgery, an electrode array is implanted in the cochlea. After implantation, the CI processor is programmed by an audiologist. One factor that negatively impacts outcomes and can be addressed by programming is cross-electrode neural stimulation overlap (NSO). In the recent past, we have proposed a system to assist the audiologist in programming the CI that we call Image-Guided CI Programming (IGCIP). IGCIP permits using CT images to detect NSO and recommend which subset of electrodes should be active to avoid NSO. In an ongoing clinical study, we have shown that IGCIP leads to significant improvement in hearing outcomes. Most of the IGCIP steps are robustly automated but electrode configuration selection still sometimes requires expert intervention. With expertise, Distance-Vs-Frequency (DVF) curves, which are a way to visualize the spatial relationship learned from CT between the electrodes and the nerves they stimulate, can be used to select the electrode configuration. In this work, we propose an automated technique for electrode configuration selection. It relies on matching new patients' DVF curves to a library of DVF curves for which electrode configurations are known. We compare this approach to one we have previously proposed. We show that, generally, our new method produces results that are as good as those obtained with our previous one while being generic and requiring fewer parameters.