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双侧人工耳蜗植入儿童的水平声音定位:听觉经验和植入年龄的影响。

Horizontal sound localization in children with bilateral cochlear implants: effects of auditory experience and age at implantation.

机构信息

Department of Cochlear Implants, Karolinska University Hospital, Stockholm, Sweden.

出版信息

Otol Neurotol. 2011 Jun;32(4):558-64. doi: 10.1097/MAO.0b013e318218cfbd.

DOI:10.1097/MAO.0b013e318218cfbd
PMID:21451427
Abstract

OBJECTIVE

To study sound localization performance in relation to auditory experience and age at implantation in children with bilateral cochlear implants.

STUDY DESIGN

Clinical study.

SETTING

University hospital.

PATIENTS

Sixty-two sequentially and 4 simultaneously bilaterally implanted children participated in this clinical sound localization study, at a median age of 5.6 years. They underwent sequential implantations at median ages of 1.9 and 4.2 years, respectively. Simultaneous implantations were performed at a median age of 2.0 years.

METHODS

Localization performance was measured with pink noise presented in random order from 5 loudspeakers in the frontal horizontal plane. Twenty-one subjects participated in repeated testing.

MAIN OUTCOME MEASURE

Sound localization performance as quantified with an Error Index.

RESULTS

On group level, bilaterally implanted children pinpointed the sounding loudspeaker in the frontal horizontal plane. Sound localization performance improved significantly with increasing bilateral cochlear implant experience, as observed in the entire study group and intraindividually, albeit large interindividual variability existed. Regression analyses in the entire study group and in the sequentially implanted children did not reveal any relationship between sound localization performance and ages at first and second implantation, interimplant interval, or age. However, second implantation before 4 years of age contributed to faster sound localization improvement with increasing bilateral cochlear implant experience.

CONCLUSION

Median perceived azimuths coincided with presented azimuths. We suggest that listening experience after bilateral cochlear implantation affects sound localization performance, possibly owing to the ongoing stimulus-driven maturation of the central auditory system. The amount of time listening with bilateral implants has methodologic implications on sound localization assessment in bilaterally implanted children.

摘要

目的

研究双侧人工耳蜗植入儿童的听觉经验和植入年龄与声源定位表现的关系。

研究设计

临床研究。

设置

大学医院。

患者

共有 62 名连续植入和 4 名同期双侧植入的儿童参与了这项临床声源定位研究,中位年龄为 5.6 岁。他们分别在 1.9 岁和 4.2 岁时接受了连续植入,同期双侧植入的中位年龄为 2.0 岁。

方法

使用随机顺序从 5 个扬声器在额状面呈现粉红噪声来测量定位性能。21 名受试者参与了重复测试。

主要观察指标

用误差指数量化的声源定位表现。

结果

在组水平上,双侧植入的儿童能够精确定位额状面中的发声扬声器。正如在整个研究组和个体内观察到的那样,双侧人工耳蜗植入经验的增加导致声源定位表现显著改善,尽管存在较大的个体间变异性。在整个研究组和连续植入儿童中进行的回归分析显示,声源定位表现与首次和第二次植入的年龄、植入间隔或年龄之间没有关系。然而,4 岁前进行第二次植入有助于在双侧人工耳蜗植入经验增加的情况下更快地改善声源定位。

结论

中位感知方位与呈现方位一致。我们认为,双侧人工耳蜗植入后的听觉经验会影响声源定位表现,这可能是由于中枢听觉系统持续受到刺激驱动的成熟。双侧植入儿童的声源定位评估方法学受到双侧植入聆听时间的影响。

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