Paluch Paulina, Kochański Bartosz, Ganc Małgorzata, Cieśla Katarzyna, Milner Rafał, Pluta Agnieszka, Lewandowska Monika
Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland.
Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland.
Int J Pediatr Otorhinolaryngol. 2019 Nov;126:109625. doi: 10.1016/j.ijporl.2019.109625. Epub 2019 Aug 8.
A cochlear implant (CI) has the potential to improve the functioning of a deaf child in many aspects. Nevertheless, the dynamics of the general development, beyond the typically measured language abilities, directly after CI, is still unknown, especially if a child is implanted early. In this study we present a methodological framework for assessment of different domains of development, as well as the central auditory nervous system (CANS) maturation in infants and toddlers with a CI.
Three children with bilateral congenital hearing loss and a unilateral CI, aged below 2.5 years, participated in a longitudinal study. Children were tested at three time points after cochlear implantation using the Polish Children Development Scale (CDS) consisting of a comprehensive battery of tests, as well as recordings of Cortical Auditory Evoked Potentials (CAEP).
All three children revealed gradual improvement in the overall CDS result as well as most of the CDS subscales. After 9 months of CI experience two younger children showed age-appropriate performance. In CAEP measurements a decrease of latency of the P1 component (an established biomarker of cortical auditory maturation) was observed in the same two children, with one achieving normal ranges of P1 latency after 9 months of CI use.
Our novel methodological framework can be successfully applied in small children with cochlear implants. It contributes to better understanding of the general development in early implanted children. The preliminary results indicate variability in children's performance in various developmental domains and thus the need to monitor the development of each child individually and holistically.
人工耳蜗植入（CI）有潜力在许多方面改善失聪儿童的功能。然而，在人工耳蜗植入后，除了通常测量的语言能力之外，整体发育的动态情况仍然未知，尤其是对于早期接受植入的儿童。在本研究中，我们提出了一个用于评估植入人工耳蜗的婴幼儿不同发育领域以及中枢听觉神经系统（CANS）成熟度的方法框架。
三名年龄在2.5岁以下、患有双侧先天性听力损失且单侧植入人工耳蜗的儿童参与了一项纵向研究。在人工耳蜗植入后的三个时间点，使用由一系列综合测试组成的波兰儿童发育量表（CDS）以及皮质听觉诱发电位（CAEP）记录对儿童进行测试。
所有三名儿童在CDS总体结果以及大多数CDS子量表上均显示出逐渐改善。在经历9个月的人工耳蜗植入后，两名年龄较小的儿童表现出与其年龄相符的水平。在CAEP测量中，在同样的两名儿童中观察到P1成分的潜伏期缩短（这是皮质听觉成熟的既定生物标志物），其中一名儿童在使用人工耳蜗9个月后P1潜伏期达到正常范围。
我们新颖的方法框架可成功应用于植入人工耳蜗的幼儿。它有助于更好地理解早期植入儿童的整体发育情况。初步结果表明儿童在各个发育领域的表现存在差异，因此需要对每个儿童的发育进行单独且全面的监测。
