Objective:This study aims to establish an economically viable and easily accessible adult animal model for optogenetic activation of auditory neurons using adeno-associated viruses(AAVs)carrying Ch R2(H134R)to explore...Objective:This study aims to establish an economically viable and easily accessible adult animal model for optogenetic activation of auditory neurons using adeno-associated viruses(AAVs)carrying Ch R2(H134R)to explore the potential of cochlear optogenetics as a hearing restoration technology.Methods:Healthy adult guinea pigs were used in the experiments.The viral vector AAV2/8-Ch R2(H134R)-h Syn-e YFP was administered to the right cochlea via the round window membrane.The confocal microscopy and reverse transcription polymerase chain reaction(RT-PCR)were utilized to analyze the Ch R2(H134R)expression localized to spiral ganglion neurons(SGNs).The auditory pathway activation was assessed by recording the optical compound action potential(oCAP)and acoustic compound action potential(a CAP)at various laser intensities.Results:The Ch R2(H134R)-e YFP expression was confirmed in 90%of the tested animals,localized to the SGNs of the injected ear.Higher m RNA levels of Ch R2(H134R)and e YFP were observed in the injected ear compared to the non-injected ear,while actin(Actb)m RNA levels were not significantly different.The o CAP was successfully elicited by a 470 nm blue light laser stimulus,with similar amplitudes and latency periods to those of a CAPs when the o CAP was evoked by 5.80 m W blue light and the a CAP was evoked by a 40 d B SPL click.The amplitudes of o CAPs increased with increasing laser intensity.Conclusion:This study demonstrates the viability of optogenetic activation of the auditory system in adult guinea pigs through the transduction of AAV-Ch R2(H134R)in SGNs.Cochlear optogenetics demonstrates potential as a hearing restoration technology,providing a basis for further clinical research and opening new avenues for investigation.展开更多
Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of deve...Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of developing a practical model that can accurately predict long-term vestibular function outcomes and identify associated risk factors.Methods:Clinical data,including imaging,vestibular evoked myogenic potentials(VEMPs),and auditory information,were collected from patients with sensorineural hearing loss(SNHL)before and after CI.The decision tree algorithm was employed to address missing values and screen pre-CI clinical features.Six machine learning methods were subsequently utilized to predict the relationships between the extracted features and post-CI vestibular dysfunction.The best-performing method determined the ranking of feature importance,which was regarded as risk factors for predicting symptoms and VEMPs results after CI.Results:Logistic regression models effectively predicted both post-CI vestibular dysfunction and abnormal cervical VEMP(c VEMP),with accuracies of 80%and 78%,respectively.The relative importance of the features,in descending order,was as follows:c VEMP latency,c VEMP amplitude,and residual hearing threshold.Moreover,the support vector machine(SVM)model attained an accuracy of 88%in predicting abnormal ocular VEMP(o VEMP)post-CI.For the SVM model,the feature importance ranking was as follows:o VEMP latency,o VEMP amplitude,and residual hearing threshold.Conclusions:This study successfully leverages machine learning techniques,specifically support vector machines(SVM)and logistic regression models,to predict the impact of CI on vestibular function.These predictive models provide valuable insights for presurgical planning and decision-making in CI procedures.Moreover,the findings highlight the critical risk factors associated with vestibular dysfunction,offering a robust reference for guiding vestibular rehabilitation strategies.展开更多
Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant ele...Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant electrodes in patients with inner ear malformations,and determine the value of 3D segmentation in predicting cochlear implant electrode insertion depth by simulating electrode implantation in a reconstructed 3D model.Methods:Data from 208 temporal bone CT scans of patients with a variety of inner ear malformations(including the CH,IP-Ⅰ,IP-Ⅱ,and IP-Ⅲtypes)who underwent cochlear implantation at our center were retrospectively analyzed.Preoperative temporal bone CT data were subjected to three-dimensional(3D)segmentation of the cochlea with a 3D slicer.Results:Cochlear malformation types,including IP typesⅠ(42 ears),Ⅱ(278ears),Ⅲ(20 ears),and CH(65 ears),were diagnosed and measured in 208 preoperative CT datasets.Cochlear anatomical parameters and electrode length were correlated,which partially explained the variations in electrode insertion angle.The mean angle of implantation among the enrolled patients was 564.33°,and the mean implantation angle prediction error in the 3D segmentation was|23.74|°.Conclusion:Three-dimensional segmentation from temporal bone CT is valuable for surgeons,especially in treating patients with inner ear malformation.Such insights will help surgeons understand overall anatomical variations,predict electrode implantation depth,and complete preoperative imaging assessments for cochlear implant insertion depth in patients with inner ear malformations.展开更多
PurposeThe study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.MethodsThe Ear Outcome Survey-1...PurposeThe study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.MethodsThe Ear Outcome Survey-16(EOS-16),which assesses ear-specific symptoms and quality of life(QoL),was administered before and after cochlear implantation along with the post-operative administration of the 15D questionnaire that evaluates general HRQoL.The authors investigated post-implantation changes in the EOS-16 total scores and its category responses,examining their relationship with pre-and post-operative hearing levels,speech perception in noise,and the follow-up period length(time elapsed since cochlear implantation).ResultsThere were positive changes noted for the hearing,need for care,and QoL categories of the EOS-16 after implantation.The length of the follow-up period was a significant factor associated with improvements in subjective outcome measures.Changes in self-perceived hearing and HRQoL post-implantation seem independent of pre-and post-implantation hearing performance.ConclusionThese results suggest that while patients regain their hearing abilities shortly after implant activation,their subjective hearing-related benefits and QoL improve over time.展开更多
This paper proposes a cochlear prosthetic system with an implanted digital signal processor （DSP）. This system transmits voice-band signals with a low data rate through the wireless link, free of the data-rate limit...This paper proposes a cochlear prosthetic system with an implanted digital signal processor （DSP）. This system transmits voice-band signals with a low data rate through the wireless link, free of the data-rate limitation and suitable for future development. By optimizing the speech processing algorithm and the DSP hardware design, the implanted DSP manages to execute the continuous interleaved sampling （CIS） algorithm at a clock frequency of 3MHz and a power consumption of only 1.91mW. With an analytic power-transmission efficiency of the wireless inductive link （40%）, the power overhead caused by the implanted DSP is derived as 2.87roW,which is trivial when compared with the power consumption of existing cochlear prosthetic systems （tens of milliwatts）. With the DSP implanted,this new system can.be easily developed into a fully implanted cochlear prosthesis.展开更多
目的分析一体式蜗内耳蜗电图在人工耳蜗植入(CI)术中的应用情况,讨论其优势及局限,总结该技术的标准化流程。方法收集2023年3月~2025年8月于本团队实施人工耳蜗术中一体式蜗内耳蜗电图的全部临床资料及术中监测数据,对监测成功率、监测...目的分析一体式蜗内耳蜗电图在人工耳蜗植入(CI)术中的应用情况,讨论其优势及局限,总结该技术的标准化流程。方法收集2023年3月~2025年8月于本团队实施人工耳蜗术中一体式蜗内耳蜗电图的全部临床资料及术中监测数据,对监测成功率、监测指标变化规律等进行分析,建立术中监测三阶段分型(植入早期、中期和晚期;上升型、下降型、稳定型、波动型)。结果共有44例(45耳)患者应用该技术(男24,女20),平均年龄27.3±19.2岁,术前低频平均听力为86.6±21.1 dB HL,无明显的耳蜗畸形,均完成全部电极植入。15耳成功在术中引出CM波形,9耳于术毕或术后第2天引出波形,21耳未引出波形(其中9耳术中干扰严重,2耳术中耳机脱落)。在去除术中干扰严重的9耳和术中耳机脱落的2耳后,34耳的术中CM波形引出率与术前低频平均听力之间无统计学意义(n=34,χ^(2)=1.145,P=0.451),且该34耳以及术中成功引出15耳耳蜗微音电位(cochlear microphonics,CM)波形最大幅值与术前低频平均听力无明显相关(n=34,r=-0.015,P=0.931;n=15,r=0.237,P=0.395)。15耳中,植入早期最常见为波动型[7耳(46.7%)],其中4耳依据波形变化采用优化植入干预方案;在中期为稳定型和波动型居多[均为5耳(33.3%)];在晚期,各类型比例相近,且波形下降趋势难以通过干预方案得到恢复。在本院完成术后开机随访且具有术前可测听力的12例(12耳)患者,术后低频听力完全保留率为75%,部分保留率为25%。术毕/术中最高幅值比与术后低频听力阈移呈显著负相关(r=-0.707,P=0.01)。结论术中应用ECochG技术可实时反馈电极植入对内耳的创伤,及时在损伤可逆期内进行微创化调整,有助于术后残余听力的保留。术中标准化流程的建立有助于提升该技术的术中引出率。术中监测三阶段分型的建立有助于电极植入对内耳创伤的机制分析。术中CM波形引出率、引出幅值与术前低频平均听力的关系仍待进一步探讨分析。展开更多
目的本研究通过文献计量学方法,系统分析1999~2025年听觉诱发电位(AEP)在人工耳蜗(CI)领域的研究现状、热点及发展趋势,为该领域的科研布局与临床实践提供参考。方法基于Web of science核心合集数据库检索相关文献,运用VOS viewer和cite...目的本研究通过文献计量学方法,系统分析1999~2025年听觉诱发电位(AEP)在人工耳蜗(CI)领域的研究现状、热点及发展趋势,为该领域的科研布局与临床实践提供参考。方法基于Web of science核心合集数据库检索相关文献,运用VOS viewer和citespace等工具对纳入的568篇文献进行年度分布、国家/机构合作、核心作者、高被引文献及关键词共现与突现分析。结果该领域年发文量呈波动上升趋势,2022年与2024年为发文高峰期。多伦多大学和美国为核心研究力量。高被引文献集中于听觉发育关键期、电生理评估标准等主题。关键词分析表明,该领域研究从初期的电刺激和神经机制探讨,逐步演进至听力保留、腔内电耳蜗图等精细技术及多学科交叉方向。结论AEP在CI领域的研究从基础机制向临床应用与多模态评估拓展,未来需进一步融合神经认知与大数据,以实现精准的术前预测和全程康复管理。展开更多
基金supported by the Beijing Natural Science Foundation of China under Grant 7222185。
文摘Objective:This study aims to establish an economically viable and easily accessible adult animal model for optogenetic activation of auditory neurons using adeno-associated viruses(AAVs)carrying Ch R2(H134R)to explore the potential of cochlear optogenetics as a hearing restoration technology.Methods:Healthy adult guinea pigs were used in the experiments.The viral vector AAV2/8-Ch R2(H134R)-h Syn-e YFP was administered to the right cochlea via the round window membrane.The confocal microscopy and reverse transcription polymerase chain reaction(RT-PCR)were utilized to analyze the Ch R2(H134R)expression localized to spiral ganglion neurons(SGNs).The auditory pathway activation was assessed by recording the optical compound action potential(oCAP)and acoustic compound action potential(a CAP)at various laser intensities.Results:The Ch R2(H134R)-e YFP expression was confirmed in 90%of the tested animals,localized to the SGNs of the injected ear.Higher m RNA levels of Ch R2(H134R)and e YFP were observed in the injected ear compared to the non-injected ear,while actin(Actb)m RNA levels were not significantly different.The o CAP was successfully elicited by a 470 nm blue light laser stimulus,with similar amplitudes and latency periods to those of a CAPs when the o CAP was evoked by 5.80 m W blue light and the a CAP was evoked by a 40 d B SPL click.The amplitudes of o CAPs increased with increasing laser intensity.Conclusion:This study demonstrates the viability of optogenetic activation of the auditory system in adult guinea pigs through the transduction of AAV-Ch R2(H134R)in SGNs.Cochlear optogenetics demonstrates potential as a hearing restoration technology,providing a basis for further clinical research and opening new avenues for investigation.
基金a grant from the Beijing Hospitals Authority Youth Programme(grant:QML20230204)a grant from National Natural Science Foundation of China(No.82471179)a grant from the National Key Research and Development Plan(grant:2022YFC2402705)。
文摘Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of developing a practical model that can accurately predict long-term vestibular function outcomes and identify associated risk factors.Methods:Clinical data,including imaging,vestibular evoked myogenic potentials(VEMPs),and auditory information,were collected from patients with sensorineural hearing loss(SNHL)before and after CI.The decision tree algorithm was employed to address missing values and screen pre-CI clinical features.Six machine learning methods were subsequently utilized to predict the relationships between the extracted features and post-CI vestibular dysfunction.The best-performing method determined the ranking of feature importance,which was regarded as risk factors for predicting symptoms and VEMPs results after CI.Results:Logistic regression models effectively predicted both post-CI vestibular dysfunction and abnormal cervical VEMP(c VEMP),with accuracies of 80%and 78%,respectively.The relative importance of the features,in descending order,was as follows:c VEMP latency,c VEMP amplitude,and residual hearing threshold.Moreover,the support vector machine(SVM)model attained an accuracy of 88%in predicting abnormal ocular VEMP(o VEMP)post-CI.For the SVM model,the feature importance ranking was as follows:o VEMP latency,o VEMP amplitude,and residual hearing threshold.Conclusions:This study successfully leverages machine learning techniques,specifically support vector machines(SVM)and logistic regression models,to predict the impact of CI on vestibular function.These predictive models provide valuable insights for presurgical planning and decision-making in CI procedures.Moreover,the findings highlight the critical risk factors associated with vestibular dysfunction,offering a robust reference for guiding vestibular rehabilitation strategies.
基金supported by the National Key Research and Development Program of China(grant no.2022YFC2402705)National Municipal Natural Science Foundation(grant no.82471161)Beijing Municipal Natural Science Foundation(grant no.7244308)。
文摘Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant electrodes in patients with inner ear malformations,and determine the value of 3D segmentation in predicting cochlear implant electrode insertion depth by simulating electrode implantation in a reconstructed 3D model.Methods:Data from 208 temporal bone CT scans of patients with a variety of inner ear malformations(including the CH,IP-Ⅰ,IP-Ⅱ,and IP-Ⅲtypes)who underwent cochlear implantation at our center were retrospectively analyzed.Preoperative temporal bone CT data were subjected to three-dimensional(3D)segmentation of the cochlea with a 3D slicer.Results:Cochlear malformation types,including IP typesⅠ(42 ears),Ⅱ(278ears),Ⅲ(20 ears),and CH(65 ears),were diagnosed and measured in 208 preoperative CT datasets.Cochlear anatomical parameters and electrode length were correlated,which partially explained the variations in electrode insertion angle.The mean angle of implantation among the enrolled patients was 564.33°,and the mean implantation angle prediction error in the 3D segmentation was|23.74|°.Conclusion:Three-dimensional segmentation from temporal bone CT is valuable for surgeons,especially in treating patients with inner ear malformation.Such insights will help surgeons understand overall anatomical variations,predict electrode implantation depth,and complete preoperative imaging assessments for cochlear implant insertion depth in patients with inner ear malformations.
文摘PurposeThe study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.MethodsThe Ear Outcome Survey-16(EOS-16),which assesses ear-specific symptoms and quality of life(QoL),was administered before and after cochlear implantation along with the post-operative administration of the 15D questionnaire that evaluates general HRQoL.The authors investigated post-implantation changes in the EOS-16 total scores and its category responses,examining their relationship with pre-and post-operative hearing levels,speech perception in noise,and the follow-up period length(time elapsed since cochlear implantation).ResultsThere were positive changes noted for the hearing,need for care,and QoL categories of the EOS-16 after implantation.The length of the follow-up period was a significant factor associated with improvements in subjective outcome measures.Changes in self-perceived hearing and HRQoL post-implantation seem independent of pre-and post-implantation hearing performance.ConclusionThese results suggest that while patients regain their hearing abilities shortly after implant activation,their subjective hearing-related benefits and QoL improve over time.
基金the National Natural Science Foundation of China(No.60475018)~~
文摘This paper proposes a cochlear prosthetic system with an implanted digital signal processor （DSP）. This system transmits voice-band signals with a low data rate through the wireless link, free of the data-rate limitation and suitable for future development. By optimizing the speech processing algorithm and the DSP hardware design, the implanted DSP manages to execute the continuous interleaved sampling （CIS） algorithm at a clock frequency of 3MHz and a power consumption of only 1.91mW. With an analytic power-transmission efficiency of the wireless inductive link （40%）, the power overhead caused by the implanted DSP is derived as 2.87roW,which is trivial when compared with the power consumption of existing cochlear prosthetic systems （tens of milliwatts）. With the DSP implanted,this new system can.be easily developed into a fully implanted cochlear prosthesis.
文摘目的分析一体式蜗内耳蜗电图在人工耳蜗植入(CI)术中的应用情况,讨论其优势及局限,总结该技术的标准化流程。方法收集2023年3月~2025年8月于本团队实施人工耳蜗术中一体式蜗内耳蜗电图的全部临床资料及术中监测数据,对监测成功率、监测指标变化规律等进行分析,建立术中监测三阶段分型(植入早期、中期和晚期;上升型、下降型、稳定型、波动型)。结果共有44例(45耳)患者应用该技术(男24,女20),平均年龄27.3±19.2岁,术前低频平均听力为86.6±21.1 dB HL,无明显的耳蜗畸形,均完成全部电极植入。15耳成功在术中引出CM波形,9耳于术毕或术后第2天引出波形,21耳未引出波形(其中9耳术中干扰严重,2耳术中耳机脱落)。在去除术中干扰严重的9耳和术中耳机脱落的2耳后,34耳的术中CM波形引出率与术前低频平均听力之间无统计学意义(n=34,χ^(2)=1.145,P=0.451),且该34耳以及术中成功引出15耳耳蜗微音电位(cochlear microphonics,CM)波形最大幅值与术前低频平均听力无明显相关(n=34,r=-0.015,P=0.931;n=15,r=0.237,P=0.395)。15耳中,植入早期最常见为波动型[7耳(46.7%)],其中4耳依据波形变化采用优化植入干预方案;在中期为稳定型和波动型居多[均为5耳(33.3%)];在晚期,各类型比例相近,且波形下降趋势难以通过干预方案得到恢复。在本院完成术后开机随访且具有术前可测听力的12例(12耳)患者,术后低频听力完全保留率为75%,部分保留率为25%。术毕/术中最高幅值比与术后低频听力阈移呈显著负相关(r=-0.707,P=0.01)。结论术中应用ECochG技术可实时反馈电极植入对内耳的创伤,及时在损伤可逆期内进行微创化调整,有助于术后残余听力的保留。术中标准化流程的建立有助于提升该技术的术中引出率。术中监测三阶段分型的建立有助于电极植入对内耳创伤的机制分析。术中CM波形引出率、引出幅值与术前低频平均听力的关系仍待进一步探讨分析。
文摘目的本研究通过文献计量学方法,系统分析1999~2025年听觉诱发电位(AEP)在人工耳蜗(CI)领域的研究现状、热点及发展趋势,为该领域的科研布局与临床实践提供参考。方法基于Web of science核心合集数据库检索相关文献,运用VOS viewer和citespace等工具对纳入的568篇文献进行年度分布、国家/机构合作、核心作者、高被引文献及关键词共现与突现分析。结果该领域年发文量呈波动上升趋势,2022年与2024年为发文高峰期。多伦多大学和美国为核心研究力量。高被引文献集中于听觉发育关键期、电生理评估标准等主题。关键词分析表明,该领域研究从初期的电刺激和神经机制探讨,逐步演进至听力保留、腔内电耳蜗图等精细技术及多学科交叉方向。结论AEP在CI领域的研究从基础机制向临床应用与多模态评估拓展,未来需进一步融合神经认知与大数据,以实现精准的术前预测和全程康复管理。
