Tissue-engineered vocal fold replacement in swine: Methods for functional and structural analysis.

We have developed a cell-based outer vocal fold replacement (COVR) as a potential therapy to improve voice quality after vocal fold (VF) injury, radiation, or tumor resection. The COVR consists of multipotent human adipose-derived stem cells (hASC) embedded within a three-dimensional fibrin scaffold that resembles vocal fold epithelium and lamina propria layers. Previous work has shown improved wound healing in rabbit studies. In this pilot study in pigs, we sought to develop methods for large animal implantation and phonatory assessment. Feasibility, safety, and structural and functional outcomes of the COVR implant are described. Of eight pigs studied, six animals underwent COVR implantation with harvest between 2 weeks and 6 months. Recovery of laryngeal tissue structure was assessed by vibratory and histologic analyses. Recovery of voice function was assessed by investigating acoustic parameters that were derived specifically for pigs. Results showed improved lamina propria qualities relative to an injured control animal at 6 months. Acoustic parameters reflected voice worsening immediately after surgery as expected; acoustics displayed clear voice recovery in the animal followed for 6 months after COVR. These methods form the basis for a larger-scale long-term pre-clinical safety and efficacy study.

Evaluation of a Stereo Music Preprocessing Scheme for Cochlear Implant Users.

BACKGROUND: Although for most cochlear implant (CI) users good speech understanding is reached (at least in quiet environments), the perception and the appraisal of music are generally unsatisfactory. PURPOSE: The improvement in music appraisal was evaluated in CI participants by using a stereo music preprocessing scheme implemented on a take-home device, in a comfortable listening environment. The preprocessing allowed adjusting the balance among vocals/bass/drums and other instruments, and was evaluated for different genres of music. The correlation between the preferred settings and the participants' speech and pitch detection performance was investigated. RESEARCH DESIGN: During the initial visit preceding the take-home test, the participants' speech-in-noise perception and pitch detection performance were measured, and a questionnaire about their music involvement was completed. The take-home device was provided, including the stereo music preprocessing scheme and seven playlists with six songs each. The participants were asked to adjust the balance by means of a turning wheel to make the music sound most enjoyable, and to repeat this three times for all songs. STUDY SAMPLE: Twelve postlingually deafened CI users participated in the study. DATA COLLECTION AND ANALYSIS: The data were collected by means of a take-home device, which preserved all the preferred settings for the different songs. Statistical analysis was done with a Friedman test (with post hoc Wilcoxon signed-rank test) to check the effect of "Genre." The correlations were investigated with Pearson's and Spearman's correlation coefficients. RESULTS: All participants preferred a balance significantly different from the original balance. Differences across participants were observed which could not be explained by perceptual abilities. An effect of "Genre" was found, showing significantly smaller preferred deviation from the original balance for Golden Oldies compared to the other genres. CONCLUSIONS: The stereo music preprocessing scheme showed an improvement in music appraisal with complex music and hence might be a good tool for music listening, training, or rehabilitation for CI users.

A Stereo Music Preprocessing Scheme for Cochlear Implant Users.

OBJECTIVE: Listening to music is still one of the more challenging aspects of using a cochlear implant (CI) for most users. Simple musical structures, a clear rhythm/beat, and lyrics that are easy to follow are among the top factors contributing to music appreciation for CI users. Modifying the audio mix of complex music potentially improves music enjoyment in CI users. METHODS: A stereo music preprocessing scheme is described in which vocals, drums, and bass are emphasized based on the representation of the harmonic and the percussive components in the input spectrogram, combined with the spatial allocation of instruments in typical stereo recordings. The scheme is assessed with postlingually deafened CI subjects (N = 7) using pop/rock music excerpts with different complexity levels. RESULTS: The scheme is capable of modifying relative instrument level settings, with the aim of improving music appreciation in CI users, and allows individual preference adjustments. The assessment with CI subjects confirms the preference for more emphasis on vocals, drums, and bass as offered by the preprocessing scheme, especially for songs with higher complexity. CONCLUSION: The stereo music preprocessing scheme has the potential to improve music enjoyment in CI users by modifying the audio mix in widespread (stereo) music recordings. SIGNIFICANCE: Since music enjoyment in CI users is generally poor, this scheme can assist the music listening experience of CI users as a training or rehabilitation tool.

Music mixing preferences of cochlear implant recipients: a pilot study.

OBJECTIVE: Music perception and appraisal are generally poor in cochlear implant recipients. Simple musical structures, lyrics that are easy to follow, and clear rhythm/beat have been reported among the top factors to enhance music enjoyment. The present study investigated the preference for modified relative instrument levels in music with normal-hearing and cochlear implant subjects. DESIGN: In experiment 1, test subjects were given a mixing console and multi-track recordings to determine their most enjoyable audio mix. In experiment 2, a preference rating experiment based on the preferred relative level settings in experiment 1 was performed. STUDY SAMPLE: Experiment 1 was performed with four postlingually deafened cochlear implant subjects, experiment 2 with ten normal-hearing and ten cochlear implant subjects. RESULTS: A significant difference in preference rating was found between normal-hearing and cochlear implant subjects. The latter preferred an audio mix with larger vocals-to-instruments ratio. In addition, given an audio mix with clear vocals and attenuated instruments, cochlear implant subjects preferred the bass/drum track to be louder than the other instrument tracks. CONCLUSIONS: The original audio mix in real-world music might not be suitable for cochlear implant recipients. Modifying the relative instrument level settings potentially improves music enjoyment.