人工耳蜗术后力学特性改变对残余听力影响分析（英文）

发布时间：2018-08-28 17:12

【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 an implantable electronic device, which is the most effective clinical treatment for severe and severe hearing loss patients. The level of residual hearing in patients after cochlear implantation depends on a variety of complex factors and is not fully understood. This study focuses on the effect of cochlear implants on the dynamic characteristics of cochlea. The response of basal membrane before and after cochlear implantation was compared with the established biomechanical model, and the possible hearing loss was obtained. The cochlear model adopted is passive, and there is no amplification process of low sound pressure level signal. This is because the hearing threshold of most cochlear implant patients is high, and the response of cochlea is linear when it is excited by high acoustic pressure level signal. No active gain characteristic. The results showed that the change of lymphatic volume caused by cochlear implantation had little effect on the vibration velocity of the basement membrane, and the hearing loss was at most 3 dB in the low frequency range. Two extreme scenarios were also assumed: partially or wholly implanted electrodes contacting the basement membrane and preventing them from responding. When all the electrodes were in contact with the basement membrane, although the base membrane of the contact part could not move, the excitation of stapes position could be transferred to the remaining intact position of the basement membrane through the incompressible fluid in the cochlea. Under these extreme assumptions, the response of the basement membrane under low frequency excitation is not greatly affected, only the auditory characteristic frequency corresponding to the end of the electrode is greatly affected. Although the study can not explain all the causes of residual hearing loss after cochlear implantation, the results show that the change of cochlear dynamic characteristics caused by cochlear implant has little effect on residual hearing.
【作者单位】：南安普顿大学声音与振动研究所;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;
【基金】：supported by National Natural Science Foundation of China(81541109)
【分类号】：R764.9

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