現行的人工電子耳透過植入式電極對聽覺神經電刺激，使全聾患者感受到電世界之聽覺，但其缺點包括手術之風險，與刺激電極長時間放入耳蝸內，對聽損患者耳蝸造成的傷害，並會破壞患者殘存之聽力。因此本研究延續鄒宗杰學長之研究，將刺激電極改放置於耳蝸骨與圓窗膜上，當於刺激電極施加刺激電流時，其產生之電場可誘發基底膜上聽覺神經產生動作電位，其優點為不破壞耳蝸，亦可保留患者低頻的殘留聽力。
本文利用有限元素模擬骨導式耳蝸外單一電極電刺激對耳蝸內基底膜上的影響，發現不論刺激電極距離圓窗多遠，最大電場都出現在圓窗附近。並配合天竺鼠動物實驗，利用聽性腦幹誘發反應測量天竺鼠之聽覺神經反應，並改變刺激電極之大小、改變刺激電極之金屬材料，包含金、白金、氧化銥三種材料，尋找最佳的刺激電極，其中電極大小對電刺激之結果影響不大，在三種材料裡，氧化銥具有較低的刺激電流閾值，因此即為較佳之材料；透過大分貝之白噪音間接使天竺鼠耳聾，並進行骨導式耳蝸外電刺激，可觀察出其可成功誘發聽覺神經產生腦波電位反應；透過長時間的電刺激，模擬長時間配戴人工電子耳對耳蝸造成的傷害，而由耳蝸切片結果可知並不會有太大的損害。
再者因為耳蝸具有分頻刺激聽覺神經之現象，故須達到分區段刺激耳蝸之聽覺神經，故先利用有限元素模擬多通道電刺激對耳蝸內基底膜之影響，可觀察出其可利用添加一反相電流，抵銷圓窗附近較大之電場。再配合天竺鼠動物實驗，採用多通道之刺激電極，利用反相電流，削弱其他區段之電場，使愈刺激之區段有較大的電場值，結果證實在旁添加反相電流，即可削弱電場，使其聽覺神經反應減弱。

Cochlear implants put electrode arrays into the cochlea by round window and use electrical signals to stimulate the auditory nerves. However, it has the risk of surgery by placing the electrode into the cochlea and damages the cochlea permanently that will make patients who wear cochlear implant loss their residual hearing. Therefore, this study put the stimulus electrodes on the cochlear bone and round window membrane instead of inside the cochlea. In this way, it can maintain the residual hearing for the patients.
In this study, the result of the single electrode stimulation through cochlear bone by Ansys Maxwell software shows that it will have the largest electric field near round window no matter what distance. In order to stimulate specific regions, it must be multi-channel electrodes. If there is an upside stimulus current through the electrode around the round window, it may decrease the largest electric field near round window.
Besides, to compare the size and three materials of the electrodes (gold, platinum, and iridium oxide), it takes an animal experiment by measuring the auditory brainstem response on Guinea pigs after the electrical stimulation. In this study, the size of the electrodes doesn’t affect the stimulations and iridium oxide has the lower threshold stimulus current. In order to prove the feasibility of the stimulation on cochlear bone for the deaf, using the loud white noise indirectly make the Guinea pigs deaf. Then, the result of the deaf mouse shows it successfully induce the auditory nerves. Through long-term stimulation, it hasn’t have any damage to the cochlea. Finally, it reduces the electric field when there is an upside stimulus current near round window by multi-channel electrodes.

口試委員審定書 #
致謝 i
中文摘要 ii
Abstract iii
目錄 iv
圖目錄 vii
表目錄 xiv
第一章 緒論 1
1.1 研究動機 1
1.2 文獻回顧 2
1.2.1 人工電子耳之發展 2
1.2.2 刺激電極與材料 6
1.2.3 聽性腦幹誘發反應(Auditory brainstem response) 10
1.3 本文內容 14
第二章 聽覺系統與助聽器介紹 15
2.1 聽覺構造 15
2.1.1 聽覺系統 15
2.1.2 耳蝸結構 17
2.2 聽覺學說 18
2.2.1 行波學說(Travelling-wave Theory) 18
2.2.2 頻率學說(Frequency Theory) 19
2.3 助聽器 21
2.3.1 非侵入式助聽器(Hearing aid) 21
2.3.2 人工電子耳(Cochlear) 22
第三章 電刺激模擬 26
3.1 簡易耳蝸模型 26
3.1.1 單一電極電刺激 29
3.1.2 多通道電極電刺激 37
3.2 真實耳蝸模型 49
3.2.1 單一電極電刺激 51
3.2.2 多通道電極電刺激 54
第四章 實驗架構與結果 57
4.1 實驗架構 57
4.1.1 自然聽力實驗 57
4.1.2 電刺激實驗 59
4.2 自然聽力實驗結果 63
4.3 刺激電極大小比較 70
4.4 刺激電極之金屬材料比較 74
4.5 受損耳蝸之電刺激實驗 83
4.6 長時間電刺激實驗 98
4.7 多通道電刺激 102
第五章 結論與展望 111
5.1 結論 111
5.2 未來展望 112
5.2.1 更改刺激電極基板材料 112
5.2.2 自然聽力與電刺激同時刺激 113
5.2.3 大型動物骨導式耳蝸外電刺激實驗 115
參考文獻 116

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