Otorhinolaryngology Department, Head and Neck Surgery, Hanover Medical University, Hannover, Germany.
Eur Arch Otorhinolaryngol. 2021 Nov;278(11):4187-4197. doi: 10.1007/s00405-020-06498-3. Epub 2020 Dec 18.
The objective of this study was to investigate the auditory pathway maturation monitored by auditory brainstem responses (ABR) in infants with hearing loss during the first year of life. ABR were used to estimate hearing thresholds and the effect of early intervention strategies using hearing aids (HA).
Click-evoked ABRs were measured in 102 infants aged from 0 to 12 months to determine their individual auditory threshold. Early therapy intervention was recommended before 12 months of age and analyzed. To evaluate the effect of hearing amplification on auditory maturation, different subgroups of infants with moderate hearing loss were analyzed and the auditory pathway maturation was determined based on IPL I-V shortening.
Overall, 110 ears (54.0% of 204 ears) with mild to profound HL showed threshold changes of 10 dB up to 60 dB in the follow-up ABR testing. HA were prescribed at the age of 3.8 ± 3.9 months. Cochlear implantation (CI) was performed in cases of repeated profound HL at the age of 9.9 months ± 4.5 months. A significant shortening of IPL I-V in all subgroups of infants (with and without risk factors) who received HA was shown and assumed auditory pathway maturation.
An early intervention using optimally fitted HA influenced auditory pathway maturation and may lead to improvements of hearing thresholds during the first year of life in infants. This study underscores the importance of not only providing HAs to infants, but also controlling for hearing threshold changes ensuring that HAs provide the optimal level of intervention or CI is indicated.
本研究旨在探讨听力损失婴儿在生命的第一年中通过听性脑干反应(ABR)监测的听觉通路成熟情况。ABR 用于估计听力阈值和使用助听器(HA)进行早期干预策略的效果。
对 102 名 0 至 12 个月大的婴儿进行了 click-evoked ABR 测量,以确定其个体听觉阈值。建议在 12 个月之前进行早期治疗干预,并进行分析。为了评估听力放大对听觉成熟的影响,对具有中度听力损失的不同婴儿亚组进行了分析,并根据 IPL I-V 缩短来确定听觉通路成熟情况。
总体而言,110 只耳朵(204 只耳朵中的 54.0%)表现出从轻度到重度 HL 的阈值变化为 10-60dB。在随访的 ABR 测试中,在 3.8±3.9 个月龄时处方 HA。在 9.9±4.5 个月龄时,对反复出现深度 HL 的病例进行了人工耳蜗植入(CI)。接受 HA 的所有婴儿(有和没有风险因素的婴儿)的 IPL I-V 均显著缩短,这被认为是听觉通路成熟的标志。
使用最佳适配的 HA 进行早期干预会影响听觉通路成熟,并可能导致婴儿在生命的第一年中听力阈值的改善。本研究强调了不仅要为婴儿提供 HA,还要控制听力阈值变化的重要性,以确保 HA 提供最佳干预水平或需要 CI。