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  • 1.

    【2hr】Cortical Processing of Frequency Changes Reflected By the Acoustic Change Complex in Adult Cochlear Implant Users

    包量

    机译 成年人工耳蜗使用者的声音变化复合体反映的频率变化的皮层处理
    摘要：The purpose of this study was to examine neural substrates of frequency change detection in cochlear implant (CI) recipients using the acoustic change complex (ACC), a type of cortical auditory evoked potential elicited by acoustic changes in an ongoing stimulus. A psychoacoustic test and electroencephalographic (EEG) recording were administered in 12 post-lingually deafened adult CI users. The stimuli were pure tones containing different magnitudes of upward frequency changes. Results showed that the frequency change detection threshold (FCDT) was 3.79% in the CI users, with a large variability. The ACC N1’ latency was significantly correlated to the FCDT and the clinically collected speech perception score. The results suggested that the ACC evoked by frequency changes can serve as a useful objective tool in assessing frequency change detection capability and predicting speech perception performance in CI users.
  • 2.

    【2hr】Toward Optimizing VEMP: Normalization Reduces the Need for Strong Neck Muscle Contraction

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    机译 致力于优化VEMP：归一化减少了强壮颈肌收缩的需要
    摘要：BackgroundThe cervical vestibular evoked myogenic potential (cVEMP) represents an inhibitory reflex of the saccule measured in the ipsilateral sternocleidomastoid muscle (SCM) in response to acoustic or vibrational stimulation. Since cVEMP is a modulation of SCM electromyographic (EMG) activity, cVEMP amplitude is proportional to muscle EMG amplitude. We sought to evaluate muscle contraction influences on cVEMP peak-to-peak amplitudes (VEMPpp), normalized cVEMP amplitudes (VEMPn) and inhibition depth (VEMPid).
  • 3.

    【2hr】Histopathology of the human inner ear in Cogan’s syndrome with cochlear implantation

    包量

    机译 人工耳蜗植入后科干综合症中人内耳的组织病理学
    摘要：Cogan’s syndrome is a rare disorder characterized by nonsyphilitic interstitial keratitis and audiovestibular symptoms. Profound sensorineural hearing loss has been reported in approximately half of patients with Cogan’s syndrome resulting in candidacy for cochlear implantation in some patients. The current study is the first report of the histopathology of the temporal bones from a patient with Cogan’s syndrome who during life underwent bilateral cochlear implantation. Preoperative MRI revealed tissue with high density in the basal turns of both cochleae and both vestibular systems consistent with fibrous tissue due to labyrinthitis. Histopathology demonstrated fibrous tissue and new bone formation within the cochlea and vestibular apparatus, worse on the right. Severe degeneration of the vestibular end organs and new bone formation in the labyrinth were seen more on the right than the left. Although severe bilateral degeneration of the spiral ganglion neurons was seen, especially on the right, the postoperative word discrimination score was between 50 and 60 % bilaterally. Impedance measures were generally higher in the right ear, possibly related to more fibrous tissue and new bone found in the scala tympani on the right side.
  • 4.

    【2hr】Histopathology of the Human Inner Ear in the p.L114P COCH Mutation (DFNA9)

    包量

    机译 p114L COCH突变（DFNA9）中人内耳的组织病理学
    摘要：The histopathology of the inner ear in a patient with hearing loss caused by the p.L114P COCH mutation and correlation with the clinical phenotype are presented. To date, 23 COCH mutations causative of DFNA9 autosomal dominant sensorineural hearing loss and vestibular disorder have been reported, and the histopathology of the human inner ear has been described in four of these. The p.L114P COCH mutation was first described by in a Korean family. We have identified the same mutation in a family of non-Asian ancestry in the United States, and the temporal bone histopathology and clinical findings are presented herein. The histopathology found in the inner ear was similar to that shown in the four other COCH mutations and included degeneration of the spiral ligament with deposition of an eosinophilic acellular material, which was also found in the distal osseous spiral lamina, at the base of the spiral limbus and in mesenchymal tissue at the base of the vestibular neuroepithelium. This is the first description of human otopathology of the COCH p.L114P mutation. In addition, it is the only case with otopathology characterization in an individual with any COCH mutation and with residual hearing, therefore allowing assessment of primary histopathological events in DFNA9, before progression to more profound hearing loss. A quantitative cytologic analysis of atrophy in this specimen and immunostaining using anti-neurofilament and anti-myelin protein zero antibodies confirmed that the principal histopathologic correlate of hearing loss was degeneration of the dendritic fibers of spiral ganglion cells in the osseous spiral lamina. The implications for cochlear implantation in this disorder are discussed.
  • 5.

    【2hr】Intracochlear drug injections through the round window membrane: Measures to improve drug retention

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    机译 通过圆窗膜进行耳蜗内药物注射：改善药物滞留的措施
    摘要：The goal of this study was to develop appropriate methodology to apply drugs quantitatively to perilymph of the ear. Intratympanic applications of drugs to the inner ear often result in variable drug levels in perilymph and can only be used for molecules that readily permeate the round window (RW) membrane. Direct intracochlear and intralabyrinthine application procedures for drugs, genes or cell-based therapies by-pass the tight boundaries at the round window, oval window, otic capsule and the blood-labyrinth barrier. However, perforations can release inner ear pressure, allowing cerebrospinal fluid to enter through the cochlear aqueduct, displacing the injected drug solution into the middle ear. Two markers, fluorescein or fluorescein isothiocyanate (FITC)-labeled dextran, were used to quantify how much of an injected substance was retained in cochlear perilymph following an intracochlear injection. We evaluated whether procedures to mitigate fluid leaks improved marker retention in perilymph. Almost all procedures to reduce volume efflux, including the use of gel for internal sealing and glue for external sealing of the injection site, resulted in improved retention of the marker in perilymph. Adhesive on the RW membrane effectively prevented leaks but also influenced fluid exchange between CSF and perilymph. We conclude that drugs can be delivered to the ear in a consistent, quantitative manner using intracochlear injections if care is taken to control the fluid leaks that result from cochlear perforation.
  • 6.

    【2hr】Hearing Loss after Round Window Surgery in Mice is due to Middle Ear Effusion

    包量

    机译 小鼠圆窗手术后的听力损失是由于中耳积液引起的
    摘要：Background:Delivery of therapeutic agents directly through the round window (RW) offers promise for treating sensorineural hearing loss. However, hearing loss can result from the surgical approach itself, and the reasons for this are poorly understood. We examined the hearing loss following the three major steps involved with the RW approach to access the mouse cochlea: bullostomy, RW puncture, and RW injection.
  • 7.

    【2hr】Force Perception Thresholds in Cochlear Implantation Surgery

    包量

    机译 人工耳蜗植入术中的力感知阈值
    摘要：Tissue trauma is a frequent complication of cochlear implantation (CI) surgery, but the relationship between intracochlear trauma, electrode insertion forces, and surgeons’ ability to perceive these forces is poorly understood. In this study, we simulated CI surgery using a benchtop apparatus to repeatably apply small forces to subject’s hands while reducing variability in their hand movements. We used a psychophysical testing procedure to estimate the force perception thresholds of ten otologic surgeons, and found a median threshold of 20.4 mN. The results suggest that surgeons have the capability to sense at least some insertion forces and are likely to perceive severe trauma such as occurs when the electrode crosses from one scala to the other.
  • 8.

    【2hr】Exploring the source of neural responses of different latency obtained from different recording electrodes in cochlear implant users

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    机译 探索从人工耳蜗植入用户的不同记录电极获得的不同潜伏期的神经反应的来源
    摘要：In this study we measured the electrically evoked compound action potential (ECAP) from different recording electrodes in cochlea. Under the assumption that different response latency may be the result of differences in the neural population contributing to the response, we assessed the relationship between neural response latency and spread of excitation. First, we evaluated changes in N1 latency when the recording electrode site was varied. Second, we recorded channel interaction functions using a forward masking technique but with recording electrodes at different intra-cochlear locations. For most individuals, N1 latency was similar across recording electrodes. However, reduced N1 latencies were observed in 21% of CI users when ECAPs were recorded using a remote recording electrode. We hypothesized that if recordings from different electrodes represented contributions from different populations of neurons, then one might expect that channel interaction functions would be different. However, we did not observe consistent differences in channel interaction functions (neither peak location nor breadth of the functions), and further, any variation in channel interaction functions were not correlated with ECAP latency. These results suggest that ECAPs from different recording electrodes with different latency originate from similar neural populations.
  • 9.

    【2hr】Sound source localization by normal hearing listeners, hearing-impaired listeners and cochlear implant listeners

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    机译 正常听力，听障者和人工耳蜗的听众对声源的定位
    摘要：ObjectiveOur primary aim was to determine whether listeners in patient groups including (i) hearing impaired with bilateral hearing aids, (ii) bimodal cochlear implant (CI), (iii) bilateral CI, (iv) hearing preservation CI, (v) single-sided deaf CI, and (vi) combined bilateral CI and bilateral hearing preservation, achieve localization accuracy within the 95th percentile of accuracy shown by younger or older NH listeners.
  • 10.

    【2hr】Sound source localization by hearing preservation patients with and without symmetric, low-frequency acoustic hearing

    包量

    机译 带有和不带有对称低频听觉的听力保护患者的声源定位
    摘要：The aim of this paper was to study sound source localization by cochlear implant (CI) listeners with low-frequency (LF) acoustic hearing in both the operated ear and in the contralateral ear. Eight CI listeners had symmetrical LF acoustic hearing (symm) and four had asymmetric LF acoustic hearing (asymm). The effects of two variables were assessed: (i) the symmetry of the LF thresholds in the two ears and (ii) the presence/absence of bilateral acoustic amplification. Stimuli consisted of low-pass, high pass, and wide-band noise bursts presented in the frontal horizontal plane. Localization accuracy was 23 degrees of error for the symm listeners and 76 degrees of error for the asymm listeners. The presence of a unilateral CI used in conjunction with bilateral LF acoustic hearing does not impair sound source localization accuracy, but amplification for acoustic hearing can be detrimental to sound source localization accuracy.
  • 11.

    【2hr】Assessment of the effects of superior canal dehiscence location and size on intracochlear sound pressures

    包量

    机译 评估上管开裂位置和大小对耳蜗内声压的影响
    摘要：Superior canal dehiscence (SCD) is a defect in the bony covering of the superior semicircular canal. Patients with SCD present with a wide range of symptoms, including hearing loss, yet it is unknown whether hearing is affected by parameters such as the location of the SCD. Our previous human cadaveric temporal bone study, utilizing intracochlear pressure measurements, generally showed that an increase in dehiscence size caused a low-frequency monotonic decrease in the cochlear drive across the partition, consistent with increased hearing loss. This previous study was limited to SCD sizes including and smaller than 2 mm long and 0.7 mm wide. However, the effects of larger SCDs (>2 mm long) were not studied, although larger SCDs are seen in many patients. Therefore, to answer the effect of parameters that have not been studied, this present study assessed the effect of SCD location and the effect of large-sized SCD (>2 mm long) on intracochlear pressures. We used simultaneous measurements of sound pressures in scala vestibuli and scala tympani at the base of the cochlea to determine the sound-pressure difference across the cochlear partition – a measure of the cochlear drive in a temporal bone preparation – allowing for assessment of hearing loss. We measured the cochlear drive before and after SCDs were made at different locations (e.g., closer to the ampulla of the superior semicircular canal or closer to the common crus), and for different dehiscence sizes (including larger than 2 mm long and 0.7 mm wide). Our measurements suggest that: 1) Different SCD locations result in similar cochlear drive; 2) Larger SCDs produce larger decreases in cochlear drive at low frequencies. However, the effect of SCD size seems to saturate as the size increases above 2–3 mm long and 0.7 mm wide. Although the monotonic effect was generally consistent across ears, the quantitative amount of change in cochlear drive due to dehiscence size varied across ears. Additionally, the size of the dehiscence above which the effect on hearing saturated, varied across ears. These findings show that the location of the SCD does not generally influence the amount of hearing loss and that SCD size can help explain some of the variability of hearing loss in patients.
  • 12.

    【2hr】Histopathology of the Human Inner Ear in Alström Syndrome

    包量

    机译 Alström综合征的人内耳的组织病理学
    摘要：Alström syndrome is an autosomal recessive syndromic genetic disorder caused by mutations in the ALMS1 gene. Sensorineural hearing loss occurs in greater than 85% of patients. Histopathology of the inner ear abnormalities in the human has not previously been fully described. Histopathology of the inner ear in Alström syndrome is presented in two genetically confirmed cases. The predominant histopathologic correlates of the sensorineural loss were degeneration of the organ of Corti, both inner and outer hair cells, degeneration of spiral ganglion cells, and atrophy of the stria vascularis and spiral ligament.
  • 13.

    【2hr】Quantification of Speech-in-Noise and Sound Localisation Abilities in Children with Unilateral Hearing Loss and Comparison to Normal Hearing Peers

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    机译 单侧听力损失儿童的语音和声音定位能力的量化及与正常听力同伴的比较
    摘要：The study objective was to quantify abilities of children with unilateral hearing loss (UHL) on measures that address known deficits for this population; that is, speech understanding in quiet and noise, and sound localisation. Noise conditions varied by noise type and source location. Parent reports of real-world abilities were also obtained. Performance was compared to gender- and age-matched normal hearing (NH) peers. UHL performance was poorer and more varied compared to NH peers. Among the findings, age correlated with localisation ability for UHL but not NH participants. Low frequency hearing in the better ear of UHL children was associated with performance in noise; however, there was no relation for NH children. Considerable variability was evident in the outcomes of children with UHL and needs to be understood as future treatment options are considered.
  • 14.

    【2hr】Interaural Level Difference Cues Determine Sound Source Localization by Single-Sided Deaf Patients Fit with a Cochlear Implant

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    机译 双耳水平差提示确定单耳聋患者佩戴人工耳蜗的声源定位
    摘要：In this report, we used filtered noise bands to constrain listeners’ access to interaural level differences (ILDs) and interaural time differences (ITDs) in a sound source localization task. The samples of interest were listeners with single-sided deafness (SSD) who had been fit with a cochlear implant in the deafened ear (SSD-CI). The comparison samples included listeners with normal hearing and bimodal hearing, i.e. with a cochlear implant in 1 ear and low-frequency acoustic hearing in the other ear. The results indicated that (i) sound source localization was better in the SSD-CI condition than in the SSD condition, (ii) SSD-CI patients rely on ILD cues for sound source localization, (iii) SSD-CI patients show functional localization abilities within 1–3 months after device activation and (iv) SSD-CI patients show better sound source localization than bimodal CI patients but, on average, poorer localization than normal-hearing listeners. One SSD-CI patient showed a level of localization within normal limits. We provide an account for the relative localization abilities of the groups by reference to the differences in access to ILD cues.
  • 15.

    【2hr】The Development of Auditory Perception in Children Following Auditory Brainstem Implantation

    包量

    机译 听觉脑干植入后儿童听觉知觉的发展
    摘要：Auditory brainstem implants (ABI) can provide useful auditory perception and language development in deaf children who are not able to use a cochlear implant (CI). We prospectively followed-up a consecutive group of 64 deaf children up to 12 years following ABI implantation. The etiology of deafness in these children was: cochlear nerve aplasia in 49, auditory neuropathy in 1, cochlear malformations in 8, bilateral cochlear post-meningitic ossification in 3, NF2 in 2, and bilateral cochlear fractures due to a head injury in 1. Thirty five children had other congenital non-auditory disabilities. Twenty two children had previous CIs with no benefit. Fifty eight children were fitted with the Cochlear 24 ABI device and six with the MedEl ABI device and all children followed the same rehabilitation program. Auditory perceptual abilities were evaluated on the Categories of Auditory Performance (CAP) scale. No child was lost to follow-up and there were no exclusions from the study. All children showed significant improvement in auditory perception with implant experience. Seven children (11%) were able to achieve the highest score on the CAP test; they were able to converse on the telephone within 3 years of implantation. Twenty children (31.3%) achieved open set speech recognition (CAP score of 5 or greater) and 30 (46.9%) achieved a CAP level of 4 or greater. Of the 29 children without non-auditory disabilities, 18 (62%) achieved a CAP score of 5 or greater with the ABI. All children showed continued improvements in auditory skills over time. The long-term results of ABI implantation reveal significant auditory benefit in most children, and open set auditory recognition in many.
  • 16.

    【2hr】Sustained Release of Triamcinolone Acetonide from an Intratympanically Applied Hydrogel Designed for the Delivery of High Glucocorticoid Doses

    包量

    机译 鼓膜内应用的水凝胶为高糖皮质激素剂量的输送而持续释放曲安西龙乙酰丙酮。
    摘要：The pharmacokinetic properties and tolerability of a triamcinolone acetonide poloxamer 407 hydrogel for intratympanic application were investigated in a guinea pig model. Evaluation of in vivo release kinetics showed very high initial perilymph drug levels, with clinically relevant levels present for a minimum of 10 days. Assessment of auditory brainstem response thresholds showed a minimal, delayed and transient threshold shift, which was apparent on day 3 and resolved by day 10. No relevant histological changes of the middle and inner ear structures were noted, and hair cell counts showed no significant differences between treated and untreated ears. Thus, the triamcinolone-acetonide-loaded poloxamer 407 hydrogel is an effective vehicle for sustained high-dose inner ear glucocorticoid delivery.
  • 17.

    【2hr】The Benefits of Bimodal Hearing: Effect of Frequency Region and Acoustic Bandwidth

    包量

    机译 双峰听觉的好处：频率区域和声带宽的影响
    摘要：We examined the effects of acoustic bandwidth on bimodal benefit for speech recognition in adults with a cochlear implant (CI) in one ear and low-frequency acoustic hearing in the contralateral ear. The primary aims were to (1) replicate with a steeper filter roll-off to examine the low-pass bandwidth required to obtain bimodal benefit for speech recognition and expand results to include different signal-to-noise ratios (SNRs) and talker genders, (2) determine whether the bimodal benefit increased with acoustic low-pass bandwidth and (3) determine whether an equivalent bimodal benefit was obtained with acoustic signals of similar low-pass and pass band bandwidth, but different center frequencies. Speech recognition was assessed using words presented in quiet and sentences in noise (+10, +5 and 0 dB SNRs). Acoustic stimuli presented to the nonimplanted ear were filtered into the following bands: <125, 125–250, <250, 250–500, <500, 250–750, <750 Hz and wide-band (full, nonfiltered bandwidth). The primary findings were: (1) the minimum acoustic low-pass bandwidth that produced a significant bimodal benefit was <250 Hz for male talkers in quiet and for female talkers in multitalker babble, but <125 Hz for male talkers in background noise, and the observed bimodal benefit did not vary significantly with SNR; (2) the bimodal benefit increased systematically with acoustic low-pass bandwidth up to <750 Hz for a male talker in quiet and female talkers in noise and up to <500 Hz for male talkers in noise, and (3) a similar bimodal benefit was obtained with low-pass and band-pass-filtered stimuli with different center frequencies (e.g. <250 vs. 250–500 Hz), meaning multiple frequency regions contain useful cues for bimodal benefit. Clinical implications are that (1) all aidable frequencies should be amplified in individuals with bimodal hearing, and (2) verification of audibility at 125Hz is unnecessary unless it is the only aidable frequency.
  • 18.

    【2hr】Clinical evaluation of an image-guided cochlear implant programming strategy

    包量

    机译 图像引导式人工耳蜗编程策略的临床评估
    摘要：The cochlear implant (CI) has been labeled the most successful neural prosthesis. Despite this success, a significant number of CI recipients experience poor speech understanding, and, even among the best performers, restoration to normal auditory fidelity is rare. While significant research efforts have been devoted to improving stimulation strategies, few developments have led to significant hearing improvement over the past two decades. We have recently introduced image processing techniques that open a new direction for advancement in this field by making it possible, for the first time, to determine the position of implanted CI electrodes relative to the nerves they stimulate using CT images. In this article, we present results of an image-guided, patient-customized approach to stimulation that utilizes the electrode position information our image processing techniques provide. This approach allows us to identify electrodes that cause overlapping stimulation patterns and to deactivate them from a patient's map. This individualized mapping strategy yields significant improvement in speech understanding in both quiet and noise as well as improved spectral resolution in the 68 adult CI recipients studied to date. Our results indicate that image-guidance can improve hearing outcomes for many existing CI recipients without requiring additional surgery or the use of “experimental” stimulation strategies, hardware or software.
  • 19.

    【2hr】Optimizing Ocular Vestibular Evoked Myogenic Potential Testing for Superior Semicircular Canal Dehiscence Syndrome: Electrode Placement

    包量

    机译 优化上半圆形管干裂综合征的眼前庭诱发肌源性测试：电极放置
    摘要：ObjectiveTo compare the sensitivity and specificity of ocular vestibular evoked myogenic potentials (oVEMP) using two electrode montages for the diagnosis of superior canal dehiscence syndrome (SCDS).
  • 20.

    【2hr】Bimodal cochlear implants: The role of acoustic signal level in determining speech perception benefit

    包量

    机译 双峰式人工耳蜗：声音信号水平在确定语音感知收益中的作用
    摘要：The aim of this project was to determine, for bimodal cochlear implant (CI) patients, i.e., patients with low-frequency hearing in the ear contralateral to the implant, how speech understanding varies as a function of the difference in level between the CI signal and the acoustic signal. The data suggest that (i) acoustic signals perceived as significantly softer than a CI signal can contribute to speech understanding in the bimodal condition, (ii) acoustic signals that are slightly softer than, or balanced with, a CI signal provide the largest benefit to speech understanding and (iii) acoustic signals presented at MCL provide nearly as much benefit as signals that have been balanced with a CI signal.
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