双侧人工耳蜗植入者声源定位能力研究
Study on the Ability of Sound Source Localization in Patients with Bilateral Cochlear Implants
龙越;王伟;刘娇;龚树生
1:首都医科大学附属北京友谊医院耳鼻咽喉头颈外科
2:首都医科大学耳聋疾病临床诊治与研究中心
摘要[Abstract] Objective To study the correlation between the ability of localization and the difference of aided hearing threshold and dynamic range(DR) in bilateral cochlear implants (CIs) by comparing the ability of sound localization of participants with normal hearing (NH) and recipients with bilateral cochlear implants (BCI) Methods Seventeen subjects with BCI and 40 participants with normal hearing (NH) were recruited in the study. A sound source recognition task was performed. During the test, a total of 37 stimuli were produced. Each speaker played only once. The stimulus signal was the monosyllable “Song” with an intensity of 60 dB SPL. The BCI subjects were tested using unilateral or bilateral Cls. The root-mean-square error (RMSE) was used as the evaluation index. The independent sample t-test was used to compare the results of NH and BCI group. The paired sample t-test was used to compare the results of BC1 participants using unilateral or bilateral CIs. The Pearson was used for correlation analysis. Results The localization ability of NH group was significantly better than that of BC1 group (NH: 7.12°±2. 29°，BC1:52. 98°±20.89°) (t=9.025, P<0.001). The localization ability in bilateral condition was significantly better than that in unilateral condition ( bilateral: 52.98°士20.89"，unilateral: 71.70°±13.22°) (t=3.397，P=0.004) of the BC1 group. The RMSE score of BCI subjects was positively correlated with the differences of aided hearing threshold in two ears (r=0.489,P=0.046).The bilateral superiority of sound localization was negatively correlated with the DR difference of the two devices (r=-0.505,P=0.039).Conclusion BCI subjects signifi- cantly benefited from bilateral hearing in sound source localization, but there was still a significant gap with NH subjects. Reducing the difference of binaural hearing aided threshold or the difference of DR between two devices could help BCI patients obtain better ability of sound localization.
关键词基金项目(Foundation):作者参考文献1 Killan C,Scally A,Killan E,et al.Factors affecting sound-source localization in children with simultaneous or sequential bilateral cochlear implants[J].Ear Hear,2019,40(4):870-877.
2 Stakhovskaya OA,Goupell MJ.Lateralization of interaural level differences with multiple electrode stimulation in bilateral cochlear-implant listeners[J].Ear Hear,2017,38(1):e22-e38.
3 龙越，龚树生.声源定位实验研究进展[J].中华耳科学杂志，2022,20(1):136-140.
4 Aronoff JM,Yoon YS,Freed DJ,et al.The use of interaural time and level difference cues by bilateral cochlear implant users[J].The Journal of the Acoustical Society of America,2010,127(3):El87-92.
5 Gajecki T,Nogueira W.Enhancement of interaural level differences for bilateral cochlear implant users[J].Hear Res,2021,409:108313.
6 Anderson SR,Easter K,Goupell MJ.Effects of rate and age in processing interaural time and level differences in normal-hearing and bilateral cochlear-implant listeners[J].The Journal of the Acoustical Society of America,2019,146(5):3232.
7 Ausili SA,Agterberg MJH,Engel A,et al.Spatial hearing by bilateral cochlear implant users with temporal fine-structure processing[J].Front Neurol,2020,11:915.
8 Litovsky RY,Parkinson A,Arcaroli J.Spatial hearing and speech intelligibility in bilateral cochlear implant users[J].Ear Hear,2009,30(4):419-431.
9 乔宇斐，郝文洋，商莹莹，等.单侧耳聋病程对声源定位及噪声下言语识别的影响[J].听力学及言语疾病杂志，2019,27(2):134-139.
10 任柳杰，段雅珊，谢友舟，等.骨导助听患者声源定位能力研究进展[J].听力学及言语疾病杂志，2022,30(3):323-327.
11 Jones H,Kan A,Litovsky RY.Comparing sound localization deficits in bilateral cochlear-implant users and vocoder simulations with normal-hearing listeners[J].Trends Hear,2014,18.2331216514554574.
12 Kirby B,Brown C,Abbas P,et al.Relationships between electrically evoked potentials and loudness growth in bilateral cochlear implant users[J].Ear Hear,2012,33(3):389-398.
13 Pfingst BE,Bowling SA,Colesa DJ,et al.Cochlear infrastructure for electrical hearing[J].Hear Res,2011,281(1-2):65-73.
14 Easwar V,Yamazaki H,Deighton M,et al.Cortical processing of level cues for spatial hearing is impaired in children with prelingual deafness despite early bilateral access to sound[J].Brain Topography,2018,31(2):270-287.
15 Easwar V,Yamazaki H,Deighton M,et al.Cortical representation of interaural time difference is impaired by deafness in development:evidence from children with early long-term access to sound through bilateral cochlear implants provided simultaneously[J].J Neurosci,2017,37(9):2349-2361.
16 Fitzgerald MB,Kan A,Goupell MJ.Bilateral loudness balancing and distorted spatial perception in recipients of bilateral cochlear implants[J].Ear Hear,2015,36(5):e225-236.
17 Bierer JA,Nye AD.Comparisons between detection threshold and loudness perception for individual cochlear implant channels[J].Ear Hear,2014,35(6):641-651.
18 Todd AE,Goupell MJ,Litovsky RY.The relationship between intensity coding and binaural sensitivity in adults with cochlear implants[J].Ear Hear,2017,38(2):e128-e141.
19 Goupell MJ,Kan A,Litovsky RY.Mapping procedures can produce non-centered auditory images in bilateral cochlear implantees[J].The Journal of the Acoustical Society of America,2013,133(2):El101-107.