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使用辅助皮质评估作为客观工具评估单侧聋患者的人工耳蜗植入拟合。

Using aided cortical assessment as an objective tool to evaluate cochlear implant fitting in users with single-sided deafness.

机构信息

Otolaryngology, Head & Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia.

Fiona Stanley Hospital, Perth, Australia.

出版信息

PLoS One. 2018 Feb 22;13(2):e0193081. doi: 10.1371/journal.pone.0193081. eCollection 2018.

Abstract

OBJECTIVES

To assess the use of cortical auditory evoked potentials (CAEPs) to verify, and if necessary, optimize the cochlear implant (CI) fitting of adult CI users with postlingual single-sided deafness (SSD).

METHODS

Sound field cortical responses to the speech tokens /m/, /g/, /t/, and /s/ were recorded from input to the CI while the normal hearing ear was masked. Responses were evaluated by visual inspection and classified as presence or absence of the CAEPs components P1, N1, P2. In case of an absence fitting was adjusted accordingly. After fitting, subjects were asked to use their new setting for 2-3 weeks for acclimatization purposes and then return for retesting. At retesting, new CAEP recordings were performed to objectively ensure that the new fitting maps effectively activated the auditory cortex.

RESULTS

In 14/19 subjects, as per visual inspection, clear CAEPs were recorded by each speech token and were, therefore, not refit. In the other 5 subjects, CAEPs could not be evoked for at least one speech token. The fitting maps in these subjects were adjusted until clear CAEPs were evoked for all 4 speech tokens.

CONCLUSIONS

CAEP can be used to quickly and objectively verify the suitability of CI fitting in experienced adult CI users with SSD. If used in the early post-implantation stage, this method could help CI users derive greater benefit for CI use and, therefore, be more committed to auditory training.

摘要

目的

评估皮质听觉诱发电位(CAEPs)在验证和必要时优化成年后天性单侧聋(SSD)人工耳蜗植入(CI)使用者的 CI 适配中的作用。

方法

在正常听力耳被掩蔽的情况下,从 CI 输入记录言语令牌 /m/、/g/、/t/和 /s/ 的声场皮质反应。通过视觉检查评估反应,并将其分类为存在或不存在 CAEP 成分 P1、N1、P2。如果不存在,则相应调整适配。适配后,要求受试者使用新设置适应 2-3 周,然后返回进行重新测试。在重新测试时,进行新的 CAEP 记录以客观确保新的适配图有效地激活听觉皮层。

结果

在 19 名受试者中的 14 名中,根据视觉检查,每个言语令牌都记录到了清晰的 CAEPs,因此无需重新适配。在另外 5 名受试者中,至少有一个言语令牌无法诱发 CAEPs。调整这些受试者的适配图,直到为所有 4 个言语令牌都能诱发清晰的 CAEPs。

结论

CAEP 可用于快速和客观地验证 SSD 成年经验丰富的 CI 用户的 CI 适配是否合适。如果在植入后的早期阶段使用,这种方法可以帮助 CI 用户从 CI 中获得更大的收益,从而更愿意接受听觉训练。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba0e/5823436/7b10ead3c06b/pone.0193081.g001.jpg

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