Sie sind auf Seite 1von 2

Terminology

Teacher's Guide: Understanding Nucleus Cochlear Implant Terminology

A basic understanding of the terminology and concepts associated with Nucleus


cochlear implant programming will be helpful as you work with the child, family, and
implant team members.
The MAP. This is the term used to describe the "listening program" stored in the
memory of the speech processor. It is based on the child's responses to quiet and
louder sounds to provide optimal access to the speech spectrum. The Nucleus 22
speech processor can store only one listening program while the Nucleus 24 speech
processor may store up to four listening programs.
Speech Coding Strategy. A coding strategy refers to how a speech processor translates
the pitch, loudness, and timing of sound into electrical signals. This coded
information is sent to the electrodes in the cochlea. Both the Nucleus 22 and Nucleus
24 Systems implement the SPEAK coding strategy. SPEAK coding strategy divides
the incoming signal into 20 frequency (pitch) bands. Each band or filter is assigned to
one of the 22 electrodes along the electrode array. The sound information with the
largest amplitude (maxima) is selected and presented to the appropriate electrodes.
The stimulation rate of the electrodes varies according to the number of maxima
selected. More transient and soft sounds such as consonants may result in activation
of fewer electrodes. This adaptive stimulation rate allows for representation of both
pitch/frequency and timing cues.
The Nucleus 24 implant with the powerful digital SPrint speech processor offers other
coding strategies as well, enabling the system to be individualized to meet the
person's listening requirements. The SPrint can use other speech coding strategies,
such as Continuous Interleaved Sampling (CIS) and a family of strategies called
Advanced Combination Encoders (ACE). When using CIS, a limited number of
electrodes or sites in the cochlea are stimulated. These same sites are always
stimulated regardless of the incoming sound information. This is very different from
SPEAK where the electrodes or sites that are stimulated change, depending on the
various sounds. However, CIS strategies stimulate the electrodes at a higher rate than
SPEAK. This higher stimulation rate provides detail about the timing information of
speech. The Nucleus 24 can stimulate the electrodes used in CIS strategies at different
rates, up to a maximum of 14,400 pps across all electrodes.
ACE provides the clinician with additional ways to customize sound to meet each
individual's unique needs. With ACE, the audiologist can choose the number of
maxima and the rate of stimulation. The rate of stimulation can be varied up to the
maximum of 14,400 pps across all electrodes. ACE takes advantage of the best
characteristics of both SPEAK and CIS, providing the optimal in both pitch and
timing information.
Electrode Array. Both the Nucleus 22 and 24 consist of a 22 channel electrode array.
The electrodes are numbered from 1-22. Low numbered electrodes are located near
the base of the cochlea (closest to the middle ear space, they stimulate the high
frequency region of the auditory nerve) while higher numbered electrodes are located
nearer the apex of the cochlea (they stimulate the low frequency region of the auditory
nerve). A full insertion refers to all 22 electrodes and 10 supporting rings being
successfully inserted into the cochlea. A full insertion does not guarantee that all 22
electrodes will be activated. The audiologist may decide to deactivate electrodes if
stimulation elicits an unpleasant or non-auditory sensation. On occasion an electrode
may be deactivated because it does not appear to be working.

Threshold Level (T Level). The minimum level of electrical stimulation required at


each electrode for the child to first hear a sound. These stimulation levels are
measured in microamperes (A). Every child will respond to electrical stimulation at
different levels and this does not correspond in any way to their hearing levels prior to
implantation.
Maximum Comfort Level (C Level). The maximum stimulation level refers to the
highest electrical stimulation level that does not produce an uncomfortable loudness
sensation for the child. As the electrical stimulation level is increased, the perception
of loudness grows. Like thresholds, this must be measured for each active electrode.
These levels may be set conservatively at first to ensure acceptance of the device.
Dynamic Range. The number of electrical stimulation units between the threshold and
comfort levels. Children with smaller electrical dynamic ranges require smaller
amounts of electrical current to mark a change in loudness percept. Larger dynamic
ranges are not necessarily better. Just as with T and C levels, accurate measurement is
more important than absolute values.

Stimulation Mode. Electrical stimulation produces current flow between two points,
an active and a ground electrode. Stimulation mode describes the location of the
active electrode relative to the ground electrode and determines the spread of
electrical activity over the electrode array. The active electrode and the ground
electrode are in close proximity within the cochlea with bipolar stimulation.
Monopolar stimulation provides a wider current spread as current flows between an
active electrode and a remote ground located outside the cochlea. Monopolar
stimulation is only possible with the Nucleus 24. The audiologist may select a wider
stimulation mode in order to lower the amount of electrical current required to obtain
T and C levels. In this case more auditory neural elements are excited by the electrical
stimulation, and less current is required to obtain these levels.
Microphone Sensitivity Control. The microphone sensitivity controls the softest level
of sound picked up by the microphone. With a low sensitivity setting the sound source
must be very close to the microphone, as the speech processor will not detect soft
sounds. Reducing the sensitivity will help filter out background noise. Conversely,
with a high sensitivity setting the sound source can be a further distance from the
microphone. Increasing the sensitivity in quiet environments may help the child hear
very soft sounds. The sensitivity control is set for optimal access to normal speech at a
distance of 3 to 6 feet. If you or the child consistently changes the sensitivity setting,
consult your Nucleus implant center to inquire if re-MAPping may be warranted.

The Nucleus 24's SPrint speech processor features a digital microphone sensitivity
control. The optimal setting is 8, although the programming audiologist may create
specific programs to include a higher sensitivity setting.

Das könnte Ihnen auch gefallen