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术前佩戴助听器儿童人工耳蜗开机当天的听觉失配响应初步研究。

A preliminary study of auditory mismatch response on the day of cochlear implant activation in children with hearing aids prior implantation.

机构信息

China-Japan Friendship Hospital, Beijing, China.

China Rehabilitation Research Center for Hearing and Speech Impairment, Beijing, China.

出版信息

PLoS One. 2019 Jan 7;14(1):e0210457. doi: 10.1371/journal.pone.0210457. eCollection 2019.

Abstract

OBJECTIVE

The study aimed to explore the characteristics of auditory mismatch response (MMR) in hearing-impaired children on the day when the cochlear implant (CI) was started (power-up) and the speech processor was programmed, and to investigate the effects of wearing hearing aids (HAs) before cochlear implantation on the early stage of postoperative auditory cortex plasticity, providing some demonstrative data for the objective evaluation of postoperative early auditory ability in children who underwent cochlear implantation.

METHODS

The participants were 34 children with profound sensorineural hearing loss, who underwent cochlear implantation. The classical passive Oddball paradigm was adopted, using a pair of vowels which only have different lexical tones. The standard stimulus was /a2/ and the devious stimulus was /a4/.

RESULTS

  1. On the day of CI activation, the auditory MMR has been elicited in 30 children; the MMR incidence was 88%. 2) We observed both positive and negative auditory MMR waveforms. And logistic regression analysis showed that it was influenced by the age at cochlear implantation. 3) The duration with HA before surgery significantly influenced the MMR latency. The children with longer duration of HA use have much earlier latency of MMR. 4) There was a significant positive correlation between the age at HA use initiation and MMR amplitude. Earlier initial HA use was associated with smaller amplitude.

CONCLUSIONS

MMR in response to Mandarin lexical tone can be recorded in most pediatric patients who had experience with HA on the day of CI power up. MMR is closely associated with the age at cochlear implantation, duration of HA use, and the age at HA use initiation. Hearing-impaired children should wear HA as early as possible and ensure consistent usage.

摘要

目的

本研究旨在探讨人工耳蜗植入(CI)开机当天及言语处理器编程时听力障碍儿童听觉失配响应(MMR)的特点,并探讨植入前使用助听器(HA)对术后早期听觉皮层可塑性的影响,为评估植入术后儿童早期听觉能力提供客观依据。

方法

研究对象为 34 名重度感音神经性听力损失的儿童,采用经典的被动 Oddball 范式,使用一对只有不同声调的元音。标准刺激为/a2/,偏差刺激为/a4/。

结果

1)在 CI 激活当天,30 名儿童诱发出听觉 MMR,发生率为 88%。2)我们观察到了正负两种听觉 MMR 波形,逻辑回归分析显示其受到植入年龄的影响。3)术前使用 HA 的时间长短显著影响 MMR 潜伏期,使用 HA 时间越长,MMR 潜伏期越早。4)HA 使用起始年龄与 MMR 振幅呈显著正相关,HA 使用起始年龄越早,振幅越小。

结论

在 CI 开机当天,大多数有 HA 使用史的儿童可以记录到对普通话声调的 MMR。MMR 与植入年龄、HA 使用时间长短和 HA 使用起始年龄密切相关。听力障碍儿童应尽早佩戴 HA,并确保持续使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32a3/6322786/1a2737c03612/pone.0210457.g001.jpg

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