Gordon Karen A, Deighton Michael R, Abbasalipour Parvaneh, Papsin Blake C
Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Ontario, Canada.
Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada.
PLoS One. 2014 Dec 22;9(12):e114841. doi: 10.1371/journal.pone.0114841. eCollection 2014.
There are significant challenges to restoring binaural hearing to children who have been deaf from an early age. The uncoordinated and poor temporal information available from cochlear implants distorts perception of interaural timing differences normally important for sound localization and listening in noise. Moreover, binaural development can be compromised by bilateral and unilateral auditory deprivation. Here, we studied perception of both interaural level and timing differences in 79 children/adolescents using bilateral cochlear implants and 16 peers with normal hearing. They were asked on which side of their head they heard unilaterally or bilaterally presented click- or electrical pulse- trains. Interaural level cues were identified by most participants including adolescents with long periods of unilateral cochlear implant use and little bilateral implant experience. Interaural timing cues were not detected by new bilateral adolescent users, consistent with previous evidence. Evidence of binaural timing detection was, for the first time, found in children who had much longer implant experience but it was marked by poorer than normal sensitivity and abnormally strong dependence on current level differences between implants. In addition, children with prior unilateral implant use showed a higher proportion of responses to their first implanted sides than children implanted simultaneously. These data indicate that there are functional repercussions of developing binaural hearing through bilateral cochlear implants, particularly when provided sequentially; nonetheless, children have an opportunity to use these devices to hear better in noise and gain spatial hearing.
对于自幼失聪的儿童来说，恢复双耳听力面临着重大挑战。人工耳蜗提供的不协调且欠佳的时间信息会扭曲双耳时间差的感知，而双耳时间差对于声音定位和噪声环境下的聆听通常很重要。此外，双耳发育可能会受到双侧和单侧听觉剥夺的影响。在此，我们研究了79名使用双侧人工耳蜗的儿童/青少年以及16名听力正常的同龄人对双耳声级差和时间差的感知。我们询问他们，在单侧或双侧呈现咔哒声或电脉冲序列时，声音是在头部的哪一侧听到的。大多数参与者，包括长期使用单侧人工耳蜗且几乎没有双侧植入经验的青少年，都能识别出双耳声级线索。与之前的证据一致，新的双侧植入的青少年使用者未检测到双耳时间线索。首次在植入时间更长的儿童中发现了双耳时间检测的证据，但特点是灵敏度低于正常水平，并且对植入体之间的电流水平差异存在异常强烈的依赖。此外，与同时植入的儿童相比，曾使用过单侧植入体的儿童对首次植入侧的反应比例更高。这些数据表明，通过双侧人工耳蜗发展双耳听力会产生功能上的影响，尤其是在顺序植入的情况下；尽管如此，儿童仍有机会使用这些设备在噪声环境中听得更清楚，并获得空间听觉。
