Killan Catherine F, Royle Nicola, Totten Catherine L, Raine Christopher H, Lovett Rosemary E S
Yorkshire Auditory Implant Service, Bradford Royal Infirmary, Bradford, UK.
Yorkshire Auditory Implant Service, Bradford Royal Infirmary, Bradford, UK.
Int J Pediatr Otorhinolaryngol. 2015 Dec;79(12):2159-65. doi: 10.1016/j.ijporl.2015.09.039. Epub 2015 Oct 8.
Both electrophysiological and behavioural studies suggest that auditory deprivation during the first months and years of life can impair listening skills. Electrophysiological studies indicate that 3½ years may be a critical age for the development of symmetrical cortical responses in children using bilateral cochlear implants. This study aimed to examine the effect of auditory experience during the first 3½ years of life on the behavioural spatial listening abilities of children using bilateral cochlear implants, with reference to normally hearing children. Data collected during research and routine clinical testing were pooled to compare the listening skills of children with bilateral cochlear implants and different periods of auditory deprivation.
Children aged 4-17 years with bilateral cochlear implants were classified into three groups. Children born profoundly deaf were in the congenital early bilateral group (received bilateral cochlear implants aged ≤3½ years, n=28) or congenital late bilateral group (received first implant aged ≤3½ years and second aged >3½ years, n=38). Children with some bilateral acoustic hearing until the age of 3½ years, who subsequently became profoundly deaf and received bilateral cochlear implants, were in the acquired/progressive group (n=16). There were 32 children in the normally hearing group. Children completed tests of sound-source localization and spatial release from masking (a measure of the ability to use both ears to understand speech in noise).
The acquired/progressive group localized more accurately than both groups of congenitally deaf children (p<0.05). All three groups of children with cochlear implants showed similar spatial release from masking. The normally hearing group localized more accurately than all groups with bilateral cochlear implants and displayed more spatial release from masking than the congenitally deaf groups on average (p<0.05).
Children with bilateral cochlear implants and early experience of acoustic hearing showed more accurate localization skills, on average, than children born profoundly deaf.
电生理和行为学研究均表明，生命最初几个月和几年的听觉剥夺会损害听力技能。电生理研究表明，3.5岁可能是使用双侧人工耳蜗的儿童对称皮质反应发育的关键年龄。本研究旨在探讨生命最初3.5年的听觉经验对使用双侧人工耳蜗的儿童行为空间听力能力的影响，并与听力正常的儿童进行对照。将研究和常规临床测试期间收集的数据汇总，以比较双侧人工耳蜗植入儿童和不同听觉剥夺期儿童的听力技能。
将4至17岁使用双侧人工耳蜗的儿童分为三组。先天性重度耳聋儿童分为先天性早期双侧植入组（≤3.5岁接受双侧人工耳蜗植入，n = 28）或先天性晚期双侧植入组（≤3.5岁接受首次植入，>3.5岁接受第二次植入，n = 38）。3.5岁前有一定双侧听觉听力，随后发展为重度耳聋并接受双侧人工耳蜗植入的儿童为后天/进行性组（n = 16）。听力正常组有32名儿童。儿童完成了声源定位和掩蔽下空间解脱（一种衡量使用双耳在噪声中理解语音能力的指标）测试。
后天/进行性组的定位比两组先天性耳聋儿童更准确（p<0.05）。三组人工耳蜗植入儿童的掩蔽下空间解脱情况相似。听力正常组的定位比所有双侧人工耳蜗植入组更准确，平均掩蔽下空间解脱比先天性耳聋组更多（p<0.05）。
平均而言，有早期听觉听力经验的双侧人工耳蜗植入儿童比先天性重度耳聋儿童表现出更准确的定位技能。
