听神经病谱系障碍儿童双侧人工耳蜗植入后的空间听觉
Spatial hearing in a child with auditory neuropathy spectrum disorder and bilateral cochlear implants.
机构信息
University of Tennessee Health Science Center, Department of Audiology and Speech Pathology, College of Allied Health Sciences, Knoxville, TN 37996-0740, USA.
出版信息
Int J Audiol. 2013 Jun;52(6):400-8. doi: 10.3109/14992027.2013.779755. Epub 2013 Apr 16.
OBJECTIVE
The neural dys-synchrony associated with auditory neuropathy spectrum disorder (ANSD) causes a temporal impairment that could degrade spatial hearing, particularly sound localization accuracy (SLA) and spatial release from masking (SRM). Unilateral cochlear implantation has become an accepted treatment for ANSD but treatment options for the contralateral ear remain controversial. We report spatial hearing measures in a child with ANSD before and after receiving a second cochlear implant (CI).
STUDY SAMPLE
An 11-year-7-month old boy with ANSD and expressive and receptive language delay received a second CI eight years after his first implant.
DESIGN
The SLA and SRM were measured four months before sequential bilateral CIs (with the contralateral ear plugged and unplugged), and after nine months using both CIs.
RESULTS
Testing done before the second CI, with the first CI alone, suggested that residual hearing in the contralateral ear contributed to sound localization accuracy, but not word recognition in quiet or noise. Nine-months after receiving a second CI, SLA improved by 12.76° and SRM increased to 3.8-4.2 dB relative to pre-operative performance. Results were compared to published outcomes for children with bilateral CIs.
CONCLUSIONS
The addition of a second CI in this child with ANSD improved spatial hearing.
目的
与听觉神经病谱系障碍(ANSD)相关的神经不同步会导致时间损伤,从而降低空间听力,特别是声音定位准确性(SLA)和空间掩蔽释放(SRM)。单侧人工耳蜗植入已成为 ANSD 的一种公认治疗方法,但对侧耳的治疗选择仍存在争议。我们报告了一名 ANSD 儿童在接受第二次耳蜗植入(CI)前后的空间听力测量结果。
研究样本
一名 11 岁 7 个月大的男孩患有 ANSD 和表达性和接受性语言延迟,在第一次植入 8 年后接受了第二次 CI。
设计
在接受双侧 CI(对侧耳朵插入和拔出)的顺序之前四个月和使用两个 CI 后九个月测量 SLA 和 SRM。
结果
在第二次 CI 之前进行的测试,仅使用第一个 CI,表明对侧耳的残余听力有助于声音定位准确性,但不能在安静或嘈杂环境中识别单词。接受第二次 CI 九个月后,SLA 提高了 12.76°,SRM 增加了 3.8-4.2dB,与术前表现相比。结果与双侧 CI 儿童的已发表结果进行了比较。
结论
在这名 ANSD 儿童中添加第二个 CI 可改善空间听力。