Killan Catherine F, Harman Sally, Killan Edward C
a Yorkshire Auditory Implant Service , Bradford Royal Infirmary , Bradford , UK.
b LICAMM, Faculty of Medicine and Health , University of Leeds , Leeds , UK.
Cochlear Implants Int. 2018 Sep;19(5):284-291. doi: 10.1080/14670100.2018.1479147. Epub 2018 May 29.
Sound localization is a valuable skill that children can develop to some extent via bilateral cochlear implants (biCIs). However, little is known regarding the change that can be expected in sound-source localization accuracy (SLA) pre- and post-biCI for children with bilateral, severe-to-profound hearing impairment who spent their early years listening via bilateral hearing aids (biHAs). This study therefore aimed to prospectively assess SLA in a group of children before, and at one year after, receiving simultaneous biCIs.
Ten children aged 5-18 years were tested. SLA was assessed using loudspeakers positioned at -60, -30, 0, +30, and +60 degrees azimuth. Root mean square (RMS) errors and percentage correct scores were calculated. Changes in SLA were analysed via paired t-tests and potential relationships between hearing threshold levels (HTLs) and SLA via correlation analyses. Response distributions via biHAs and biCIs were examined via scatterplots.
The mean within-subject changes in SLA were a significant improvement in RMS error of 11.9° (p < 0.05) and in per cent correct by 21.5% (p < 0.05). Scatterplots demonstrated a trend towards better localization of sounds from 0° azimuth via biCIs compared to via biHAs. No significant associations were found between any measures of SLA and HTLs.
The findings of the present study demonstrate that simultaneous biCIs lead to improved sound localization in children with bilateral, severe to profound sensorineural hearing loss who previously used biHAs. SLA via biHAs or biCIs could not be predicted from children's audiograms, and therefore should be measured directly.
声音定位是一项有价值的技能，儿童可通过双侧人工耳蜗（biCIs）在一定程度上得以发展。然而，对于早年通过双侧助听器（biHAs）聆听的双侧重度至极重度听力损失儿童，在植入双侧人工耳蜗前后，其声源定位准确性（SLA）的预期变化知之甚少。因此，本研究旨在前瞻性评估一组儿童在接受同期双侧人工耳蜗植入前及植入后一年的声源定位准确性。
对10名年龄在5至18岁的儿童进行测试。使用位于方位角-60°、-30°、0°、+30°和+60°的扬声器评估声源定位准确性。计算均方根（RMS）误差和正确得分百分比。通过配对t检验分析声源定位准确性的变化，并通过相关性分析探讨听力阈值水平（HTLs）与声源定位准确性之间的潜在关系。通过散点图检查双侧助听器和双侧人工耳蜗的反应分布。
受试者声源定位准确性的平均组内变化为均方根误差显著改善11.9°（p < 0.05），正确百分比提高21.5%（p < 0.05）。散点图显示，与通过双侧助听器相比，通过双侧人工耳蜗对来自0°方位声音的定位有更好的趋势。在声源定位准确性的任何测量指标与听力阈值水平之间未发现显著关联。
本研究结果表明，同期双侧人工耳蜗植入可改善先前使用双侧助听器的双侧重度至极重度感音神经性听力损失儿童的声音定位。无法从儿童听力图预测通过双侧助听器或双侧人工耳蜗的声源定位准确性，因此应直接进行测量。
