人工耳蜗术后力学特性改变对残余听力影响分析
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1. 南安普顿大学声音与振动研究所南安普顿SO17 1BJ;2. 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科 儿童耳鼻喉头颈外科疾病北京市重点实验室北京100045

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TH701

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Mechanical effects of cochlear implants on residual hearing
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1. Institute of Sound and Vibration Research, University of Southampton, Southampton, UK SO17 1BJ; 2. Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University. Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing 100045

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    摘要:

    人工耳蜗是一种植入式电子设备,是目前为重度、极度听力损失患者重建听力的最行之有效的临床治疗方法。人工耳蜗术后患者残余听力的水平取决于多种复杂因素,尚未被完全了解。本研究聚焦在人工耳蜗植入后对于耳蜗动力学特性产生的影响。通过建立的生物力学模型对比人工耳蜗植入前后基底膜响应,进而得到可能的听力损失情况。所采用的耳蜗模型为被动式,不存在对低声压级信号的放大过程,这是由于大部分人工耳蜗患者的听力阈值较高,耳蜗在高声压级信号激励时其响应具有线性、无主动增益特性。计算结果显示,由于人工耳蜗植入带来的淋巴液体积变化对基底膜振动速度影响不大,在低频范围内最多造成3 dB听力损失。还假设了两种极端情况,即部分或者全部植入的电极与基底膜相接触并阻止其产生响应。在全部电极与基底膜接触情况下,虽然接触部分的基底膜无法运动,但是镫骨位置的激励还是可以通过耳蜗内的不可压缩流体传递至基底膜剩余完好位置。在这些极端假设情况下,低频激励下的基底膜响应并未受到太大影响,仅是电极末端位置对应的听觉特征频率受影响较大。虽然研究不能解释造成人工耳蜗植入后残余听力损失的全部原因,但研究结果表明人工耳蜗植入带来的耳蜗动力学特性改变对残余听力的影响不大。

    Abstract:

    Cochlear implant is a surgically implanted electronic device that can provide a sense of sound to a person who is severely hard of hearing. The effect of a cochlear implant on residual, low frequency, hearing is complex and not well understood. This research focuses on changes of the cochlear mechanics due to a cochlear implant by comparing the basilar membrane, BM, response before and after the implantation using a computational model of the cochlea. In the model, cochlea implants were introduced into the lower cochlear fluid chamber and the active amplification process of the cochlear is not considered, since a passive cochlear model whose response does not depend on stimulus level can reasonably well represent the cochlea for subjects with hearing impairment. The results for the basilar membrane velocity show that the volume change in the fluid chambers due to the implant has a little effect, less than 3 dB at low frequencies, on the basilar membrane velocity. A more extreme condition, in which the cochlear implant is assumed to touch the basilar membrane at some or the whole positions and thus impeded its motion, was also studied. Although there is no travelling wave propagating in the basal region in the latter case, the remainder of the cochlea is still coupled to the stapes by the incompressible fluid. The basilar membrane velocity at low frequencies is relatively unaffected by the blocking of the basilar membrane motion in the basal region, although the effect is more dramatic for excitation frequency whose characteristic place is close to the end of the implant. Although this work does not model every aspect of the hearing loss after cochlear implantation as measured clinically, it does provide a way of predicting the possible mechanical effects of the implantation on the cochlear passive mechanics and residual hearing.

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倪广健,Alice A. Halpin,李颖,刘海红.人工耳蜗术后力学特性改变对残余听力影响分析[J].仪器仪表学报,2017,38(6):1390-1397

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  • 在线发布日期: 2017-07-21
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