McKay Colette M
Adv Otorhinolaryngol. 2018;81:57-65. doi: 10.1159/000485586. Epub 2018 Apr 6.
The functional changes that occur in the brain due to deafness may affect the way the auditory system processes sound after cochlear implantation. Brain plasticity plays a crucial role in the success of cochlear implantation to facilitate or develop spoken language in profoundly deaf individuals. The functional plasticity that occurs in postlingually deaf adults during periods of deafness can both support and hinder speech understanding with a cochlear implant, depending on the nature and degree of functional changes. Evidence so far suggests that the strategies people use to communicate while deaf may influence whether the functional changes are adaptive or maladaptive. In the case of children with congenital deafness, evidence is very strong for a sensitive period in which auditory input must be restored if subsequent oral language is to be developed successfully. Successful oral language use and speech understanding in individuals implanted after 7 years of age depends strongly on the pre-implant use of hearing aids and auditory-verbal communication. Future research should focus on how to harness our growing knowledge of brain plasticity to optimize the outcomes of cochlear implantation in each individual.
耳聋导致的大脑功能变化可能会影响人工耳蜗植入后听觉系统处理声音的方式。大脑可塑性在人工耳蜗植入成功以促进或发展极重度聋患者的口语方面起着至关重要的作用。语后聋成年人在耳聋期间发生的功能可塑性，根据功能变化的性质和程度，既可以支持也可以阻碍人工耳蜗的言语理解。迄今为止的证据表明，人们在耳聋时用于交流的策略可能会影响功能变化是适应性的还是适应不良的。对于先天性耳聋儿童，有非常有力的证据表明存在一个敏感期，如果要成功发展后续的口语，必须恢复听觉输入。7岁以后接受植入的个体，成功使用口语和言语理解很大程度上取决于植入前助听器的使用和听觉-言语交流。未来的研究应侧重于如何利用我们对大脑可塑性不断增长的认识，来优化每个人的人工耳蜗植入效果。
