管理人工耳蜗刺激副作用的定制策略。

IF 1.4 Q2 OTORHINOLARYNGOLOGY
Xianhui Wang, Phillip Tran, Michelle R Kapolowicz, Thomas Lu, Ginger Stickney, Arnold Starr, Hamid Djalilian, Fan-Gang Zeng
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引用次数: 0

摘要

目的:人工耳蜗可恢复功能性听力,但可能引起面神经刺激、声音敏感或反应性耳鸣等副作用。本研究旨在建立一个优化刺激参数的总体框架,以控制这些副作用,同时最大限度地提高语音感知性能。第二个目标是了解副作用来源如何影响治疗结果。方法:8例成人人工耳蜗患者出现了难以忍受的副作用,使其难以使用,甚至无法使用。通过降低刺激水平、增加脉冲持续时间、降低刺激速率、改变通道增益和频率图、停用有问题的电极或以上几种方法的结合,可以创建新的图。结果是根据副作用的减少和语言表现的变化来衡量的。结果:5例受试者中有5例面部神经刺激减少或消除。两名受试者中有两名消除了声音过敏。4名受试者中有3名耳鸣减轻,而其余小脑畸形患者耳鸣无变化。所有受试者的语言表现都得到了维持或改善。除了患有小脑畸形的受试者选择移植装置外,所有受试者都能有效地使用植入物,没有烦人的副作用。讨论:面神经刺激通常与同侧电流扩散有关,可通过定制策略进行有效管理。相比之下,声音敏感和反应性耳鸣的起源是可变的,可能更难以管理。结论:在不影响语音表现的情况下,定制化定位可以减轻人工耳蜗的副作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Customized strategies for managing cochlear implant stimulation side effects.

Objectives: Cochlear implants restore functional hearing but may cause side effects like facial nerve stimulation, sound sensitivity or reactive tinnitus. The present study aimed to establish a general framework for optimizing stimulation parameters to manage these side effects while maximizing speech perception performance. A second objective was to understand how side effect origins impact treatment outcomes.

Methods: Eight adult cochlear implant subjects had intolerable side effects that rendered device usage difficult or even impossible. New maps were created by reducing stimulation levels, increasing pulse duration, reducing stimulation rate, altering channel gains and frequency maps, deactivating problematic electrodes, or a combination of the above. Outcomes were measured in terms of side effect reduction and changes in speech performance.

Results: Facial nerve stimulation was reduced or eliminated in five of five subjects. Sound hypersensitivity was eliminated in two of two subjects. Tinnitus was alleviated in three of four subjects, while the remaining one with cerebellar malformation experienced no change. Speech performance was either maintained or improved in all subjects. Except for the subject with cerebellar malformation who chose to explant the device, all subjects were able to use the implant effectively without bothersome side effects.

Discussion: Facial nerve stimulation is usually related to electric current spread on the same side, which can be effectively managed by customized strategies. In contrast, the origins of sound sensitivity and reactive tinnitus are more variable and likely more difficult to manage.

Conclusion: Customized mapping can alleviate cochlear implant side effects without compromising speech performance.

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来源期刊
COCHLEAR IMPLANTS INTERNATIONAL
COCHLEAR IMPLANTS INTERNATIONAL Medicine-Otorhinolaryngology
CiteScore
3.10
自引率
0.00%
发文量
29
期刊介绍: Cochlear Implants International was founded as an interdisciplinary, peer-reviewed journal in response to the growing number of publications in the field of cochlear implants. It was designed to meet a need to include scientific contributions from all the disciplines that are represented in cochlear implant teams: audiology, medicine and surgery, speech therapy and speech pathology, psychology, hearing therapy, radiology, pathology, engineering and acoustics, teaching, and communication. The aim was to found a truly interdisciplinary journal, representing the full breadth of the field of cochlear implantation.
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