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Sahwan M, Abdelsamad Y, Alasfoor F, Alfayez F, Binkhamis G, Nichani J. Cochlear implantation in children with auditory neuropathy spectrum disorder: an updated systematic review. Eur Arch Otorhinolaryngol 2024; 281:1149-1162. [PMID: 37638998 DOI: 10.1007/s00405-023-08194-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND The goal of managing auditory neuropathy spectrum disorder (ANSD) is to restore the children's ability to discriminate auditory information. Children who are not making sufficient progress in speech comprehension, and speech and language development after receiving adequate auditory re/habilitation and/or acoustic amplification may be candidates for cochlear implantation (CI). Despite the growing number of published literature on CI outcomes in children with ANSD, the current evidence is primarily based on case reports or retrospective chart reviews some of which had a limited number of children. In addition, the outcomes of CI seem to vary between children with ANSD. Thus, compelling evidence is lacking. This updated systematic review evaluated the speech perception, language, and speech intelligibility outcomes of children with ANSD post-CI. METHODS An online bibliographic search was conducted in PubMed, Scopus, Web of Science, and CENTRAL databases. We included both interventional and observational studies that assessed the outcomes of the CI in children with ANSD. RESULTS Thirty-three studies were included in this systematic review. Several tests were used to assess speech perception following CI in children with ANSD. The findings of this study revealed that children with ANSD had mean Categories of Auditory Performance scores ranging from 4.3 to 7 post-operatively, this result was better than the pre-operative scores which ranged between 0.4 to 2.5. Likewise, the Infant-Toddler Meaningful Auditory Integration Scale, Phonetically Balanced Kindergarten, and multisyllabic lexical neighborhood test showed clinically relevant improvement after CI. The same findings were reported for language and speech intelligibility scores. One study investigated the quality of life/children satisfaction after CI and showed overall good satisfaction with the outcomes. CONCLUSIONS The present systematic review suggests that CI is a feasible and effective hearing rehabilitation modality for children with ANSD. REGISTRATION AND PROTOCOL PROSPERO ID: CRD42021279140.
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Affiliation(s)
- Maryam Sahwan
- ENT Department, Government Hospitals, Manama, Kingdom of Bahrain.
| | | | - Fatema Alasfoor
- ENT Department, Government Hospitals, Manama, Kingdom of Bahrain
| | - Fatema Alfayez
- ENT Department, Government Hospitals, Manama, Kingdom of Bahrain
| | - Ghada Binkhamis
- Communication and Swallowing Disorders Department, King Fahad Medical City, Riyadh, Saudi Arabia
- Manchester Centre for Audiology & Deafness (ManCAD), Division of Human Communication, Development and Hearing, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jaya Nichani
- Royal Manchester Children's Hospital, Manchester, UK
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Raza AF, Aryal S, Prabhu P. Indicators for cochlear implantation in children with auditory neuropathy spectrum disorder: A systematic review. Int J Pediatr Otorhinolaryngol 2023; 174:111737. [PMID: 37748323 DOI: 10.1016/j.ijporl.2023.111737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE ANSD refers to a group of auditory diseases demonstrating intact outer hair cells and desynchronized neural firings of the auditory nerve. A cochlear implant is a promising intervention strategy for severe to profound sensorineural hearing loss (SNHL). However, due to its variable outcomes in children with ANSD, a consensus has yet to be reached on its performance. This study aimed to review the literature to determine the efficacy of cochlear implants in children with ANSD and to determine prognostic indicators. The study identifies the pre-operative and post-operative predictors of success for CI in children with ANSD. METHOD The review was carried out using PRISMA guidelines. This resulted in 9630 topic-related articles. Among these, 17 articles met the inclusion and exclusion criteria that were included for the study. The quality and potential risks associated with each article were evaluated using the quality impact assessment protocol (QUIPS) tool. RESULTS A review of 17 articles was conducted to highlight these predictors. Most selected studies included case reports, case series, cohorts, and comparisons between children with ANSD and SNHL. Assessment of study quality reported an overall low risk of bias. The overall result showed cochlear implant would be an effective option for children with ANSD. However, there are specific prognostic indicators about which clinician needs to be aware before recommending CI for children with ANSD. Our review study identified a set of pre-operative and post-operative indicators that predicted speech and auditory performance and gave some insight into the lesion site in ANSD individuals. CONCLUSION This review concludes CI is an effective option for children with ANSD. However, before recommending CI, a detailed assessment is required from different perspectives, which could serve as predictors of postoperative outcomes. This review highlights the need to include more precise tools, such as genetic testing to describe the lesion site to choose the most appropriate management strategy for children with ANSD. Knowledge about the prognostic indicators and the effective assessment protocols would help clinicians for the better candidacy selection.
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Affiliation(s)
- Aiza Fatima Raza
- All India Institute of Speech and Hearing, Mysore, 570006, India
| | - Sajana Aryal
- All India Institute of Speech and Hearing, Mysore, 570006, India.
| | - Prashanth Prabhu
- All India Institute of Speech and Hearing, Mysore, 570006, India
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Morlet T, O'Reilly R, Pritchett C, Venskytis E, Parkes W. A 15-year Review of 260 Children With Auditory Neuropathy Spectrum Disorder: II. Management and Outcomes. Ear Hear 2023; 44:979-989. [PMID: 37036283 DOI: 10.1097/aud.0000000000001366] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
OBJECTIVES Following a review of the demographic and clinical characteristics of all pediatric patients diagnosed with auditory neuropathy spectrum disorder (ANSD) by a pediatric health care system from 2005 to 2020, the present report highlights the type and timing of intervention and outcomes in the same 260 patients with ANSD. DESIGN This was a retrospective study reviewing the demographic data, medical history, imaging studies, audiological and speech language data, type of audiological intervention (hearing aids or cochlear implants), and mode of communication in 260 pediatric patients diagnosed with ANSD over a 15-year period. RESULTS A significant decrease over time in the age at hearing aid fitting was observed. While a similar reduction in the age at implantation occurred over time, cochlear implantation is still rarely performed by 12 months of age in most ANSD patients. Among bilateral ANSD patients fitted with hearing aids, the majority (89.2%) did not benefit from conventional amplification and most received cochlear implants. Some hearing aid benefit for speech and language development was observed in 5.8%, though communication difficulties were persistent and most used a combination of oral and sign language for communication. Only six patients (5%) received significant benefit from their hearing aids for speech and language development. CONCLUSIONS This review of ANSD management over a 15-year period reveals that hearing aids are not a viable option to develop speech and language for most infants and children with ANSD. This finding confirms previous reports and suggest that while hearing aid trials are warranted, children must be tracked closely so as to avoid delays in decision making. Cochlear implantation constitutes the major (if not only) rehabilitative intervention that allows for speech perception in patients who do not benefit from conventional amplification.
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Affiliation(s)
- Thierry Morlet
- Auditory Physiology and Psychoacoustics Research Laboratory, Nemours Children Health, Wilmington, Delaware, USA
- Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark, Delaware, USA
- Osborne College of Audiology, Salus University, Elkins Park, Pennsylvania, USA
| | - Robert O'Reilly
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Cedric Pritchett
- Department of Otolaryngology, Nemours Children Hospital, Orlando, Florida, USA
| | - Emily Venskytis
- Department of Audiology and Speech-Language Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - William Parkes
- Department of Otolaryngology, Nemours Children Hospital, Wilmington, Delaware, USA
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Keintzel T, Raffelsberger T, Niederwanger L, Gundacker G, Rasse T. Systematic Literature Review and Early Benefit of Cochlear Implantation in Two Pediatric Auditory Neuropathy Cases. J Pers Med 2023; 13:jpm13050848. [PMID: 37241018 DOI: 10.3390/jpm13050848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Approximately 1 in 10 children with hearing loss is affected by auditory neuropathy spectrum disorder (ANSD). People who have ANSD usually have great difficulty understanding speech or communicating. However, it is possible for these patients to have audiograms that may indicate profound hearing loss up to normal hearing. This disorder is prognosed with positive, intact or present otoacoustic emissions (OAE) and/or cochlear microphonics (CM) as well as abnormal or absent auditory brainstem responses (ABR). Treatment methods include conventional hearing aids as well as cochlear implants. Cochlear implants (CI) usually promise better speech understanding for ANSD patients. We performed a systematic literature review aiming to show what improvements can effectively be achieved with cochlear implants in children with ANSD and compare this with our experience with two cases of ANSD implanted at our clinic. The retrospective review of two young CI patients diagnosed with ANSD during infancy demonstrated improvements over time in speech development communicated by their parents.
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Affiliation(s)
- Thomas Keintzel
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Tobias Raffelsberger
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Lisa Niederwanger
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Gina Gundacker
- Department Health and Rehabilitation Engineering, University of Applied Sciences Technikum Wien, 1200 Vienna, Austria
| | - Thomas Rasse
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
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Bo D, Huang Y, Wang B, Lu P, Chen WX, Xu ZM. Auditory and Speech Outcomes of Cochlear Implantation in Children With Auditory Neuropathy Spectrum Disorder: A Systematic Review and Meta-Analysis. Ann Otol Rhinol Laryngol 2023; 132:371-380. [PMID: 35499129 DOI: 10.1177/00034894221092201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to critically assess the effect of cochlear implantation on auditory and speech performance outcomes of children with auditory neuropathy spectrum disorder (ANSD). MATERIAL AND METHODS A systematic literature search was conducted on PubMed, EMbase, and Web of Science. The outcomes included speech recognition score, Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR) score, and open-set speech perception. Results were expressed as standardized mean difference (SMD) or risk ratio (RR) with a 95% confidence interval (95% CI). RESULTS A total of 15 studies was included in this meta-analysis. Pooled data showed that, there were no significant differences between ANSD and sensorineural hearing loss (SNHL) groups in terms of speech recognition score (SMD = 0.01, 95% CI: -0.45, 0.47; P = .959),CAP (SMD = 0.71, 95% CI: -0.13, 1.54; P = .098), SIR score (SMD = -0.09, 95% CI: -0.49, 0.32; P = .667), and open-set speech perception (RR = 0.85, 95% CI: 0.69, 1.05; P = .142). Sensitivity analysis by removing individual studies one at a time showed that the overall estimate and level of heterogeneity did not change substantially. CONCLUSION The current evidence suggested that children with ANSD who underwent cochlear implants achieved comparable effects in auditory and speech performance as children with non-ANSD SNHL.
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Affiliation(s)
- Duan Bo
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Yue Huang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Bing Wang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Ping Lu
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Wen-Xia Chen
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Zheng-Min Xu
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
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Roman AN, Runge CL. Update on Auditory Neuropathy/Dyssynchrony in Children. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00297-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Tabibi S, Kegel A, Lai WK, Dillier N. A bio-inspired coding (BIC) strategy for cochlear implants. Hear Res 2020; 388:107885. [DOI: 10.1016/j.heares.2020.107885] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 12/24/2019] [Accepted: 12/31/2019] [Indexed: 11/26/2022]
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Tokat T, Çatlı T, Başaran Bozkurt E, Atsal G, Muderris T, Olgun L. Parents' View on Quality of Life after Cochlear Implantation in Children with Auditory Neuropathy. J Int Adv Otol 2019; 15:338-344. [PMID: 31846909 PMCID: PMC6937187 DOI: 10.5152/iao.2019.6103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/14/2018] [Accepted: 01/08/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The aim of this study is to evaluate the quality of life in pediatric patients with auditory neuropathy according to the perspective of their parents after cochlear implantation. MATERIALS AND METHODS The pediatric patients, who underwent cochlear implantation with the diagnosis of auditory neuropathy at İzmir Bozyaka Training and Research Hospital ENT Clinic between January 1997 and May 2017, were included to the study. "Parents' Perspective Questionnaire" developed by Nottingham Pediatric Cochlear Implant Programme was used in the study. The questionnaire was composed of 11 subscales and 58 questions in total. RESULTS The study included 26 pediatric patients (14 female, 12 male) who used cochlear implant for at least 1 year. The mean age of patients was 10.91±3.85 ( 4.3-17.3 years old) and implantation age varied between 14 months and 80 months. (median; 35.65±20.03 months). Patients who attended school had more self-confidence, and also those having implant use over 6 years had a better self confidence and social relationship. CONCLUSION Cochlear implantation not only improves the ability of hearing but also provides development of speech and language skills and therefore enhancing the patient's quality of life. From the perspective of parents, the use of cochlear implant in the children with auditory neuropathy improves the quality of life in many different ways. The perspective of parents can provide a multidimensional evaluation about the child's progress, therefore, ıt should be taken into consideration by the staff in implant centers.
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Affiliation(s)
- Taşkın Tokat
- Department of Otorhinolaryngology, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Tolgahan Çatlı
- Department of Otorhinolaryngology, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Ergün Başaran Bozkurt
- Department of Otorhinolaryngology, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Görkem Atsal
- Department of Otorhinolaryngology, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Togay Muderris
- Department of Otorhinolaryngology, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Levent Olgun
- Department of Otorhinolaryngology, Baskent University Hospital, İzmir, Turkey
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Measuring temporal response properties of auditory nerve fibers in cochlear implant recipients. Hear Res 2019; 380:187-196. [DOI: 10.1016/j.heares.2019.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/25/2019] [Accepted: 07/06/2019] [Indexed: 11/19/2022]
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Hosoya M, Minami SB, Enomoto C, Matsunaga T, Kaga K. Elongated EABR wave latencies observed in patients with auditory neuropathy caused by OTOF mutation. Laryngoscope Investig Otolaryngol 2018; 3:388-393. [PMID: 30410993 PMCID: PMC6209615 DOI: 10.1002/lio2.210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 07/30/2018] [Indexed: 11/06/2022] Open
Abstract
Objectives We sought to determine how the pathology altered electrically evoked auditory brainstem responses (EABRs) in patients with hearing loss by evaluating EABRs in auditory neuropathy patients with OTOF mutations comparing with various types of congenital deafness. Methods We included 15 patients with congenital hearing loss, grouped according to pathology: OTOF mutations (n = 4), GJB2 mutations (n = 4), SLC26A4 mutations (n = 4), or cytomegalovirus infections (n = 3). EABRs were recorded when patients underwent cochlear implantation surgery. We evaluated the latencies and amplitudes of the recorded EABRs and compared them statistically between four groups. Results The EABR latencies of Wave III and Wave V, and of the interval between them, were significantly longer in the OTOF mutation group than in the GJB2 and SLC26A4 mutation groups (Wave III) and in all three other groups (Wave V and Wave III-V latency); amplitudes were not significantly different between groups. Conclusions Our results suggest OTOF mutations cause delayed (or slowed) postsynaptic neurotransmission, although the presumed mechanism involved reduced presynaptic transmission between hair cells and spiral ganglion neurons. Level of Evidence Mainly a case report.
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Affiliation(s)
| | | | | | - Tatsuo Matsunaga
- Laboratory of Auditory Disorders and Division of Hearing and Balance Research Tokyo Japan.,Medical Genetics Center; National Institute of Sensory Organs, National Tokyo Medical Center Tokyo Japan
| | - Kimitaka Kaga
- National Institute of Sensory Organs Tokyo Japan.,Center for Speech and Hearing Disorders International University of Health and Welfare Tokyo Japan
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Daneshi A, Mirsalehi M, Hashemi SB, Ajalloueyan M, Rajati M, Ghasemi MM, Emamdjomeh H, Asghari A, Mohammadi S, Mohseni M, Mohebbi S, Farhadi M. Cochlear implantation in children with auditory neuropathy spectrum disorder: A multicenter study on auditory performance and speech production outcomes. Int J Pediatr Otorhinolaryngol 2018; 108:12-16. [PMID: 29605339 DOI: 10.1016/j.ijporl.2018.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/31/2018] [Accepted: 02/03/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To evaluate the auditory performance and speech production outcome in children with auditory neuropathy spectrum disorder (ANSD). The effect of age on the outcomes of the surgery at the time of implantation was also evaluated. METHODS Cochlear implantation was performed in 136 children with bilateral severe-to- profound hearing loss due to ANSD, at four tertiary academic centers. The patients were divided into two groups based on the age at the time of implantation; Group I: Children ≤24 months, and Group II: subjects >24 months. The categories of auditory performance (CAP) and speech intelligibility rating (SIR) scores were evaluated after the first and second years of implantation. The differences between the CAP and SIR scores in the two groups were assessed. RESULTS The median CAP scores improved significantly after the cochlear implantation in all the patients (p value < 0.001). The improvement in the CAP scores during the first year in Group II was greater than Group I (p value: 0.007), but the improvement in CAP scores tended to be significantly higher in patients who were implanted at ≤24 months (p value < 0.001). There was no significant difference between two groups in SIR scores at first-year and second-year follow-ups. The evaluation of the SIR improvement revealed significantly higher values for Group I during the second-year follow-up (p value: 0.003). CONCLUSION The auditory performance and speech production skills of the children with ANSD improved significantly after cochlear implantation, and this improvement was affected by age at the time of implantation.
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Affiliation(s)
- Ahmad Daneshi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Marjan Mirsalehi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Seyed Basir Hashemi
- Department of Otorhinolaryngology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Ajalloueyan
- Department of Otorhinolaryngology, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Mohsen Rajati
- Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohammad Mahdi Ghasemi
- Sinus and Surgical Endoscopic Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hesamaldin Emamdjomeh
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Alimohamad Asghari
- Skull Base Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Shabahang Mohammadi
- Department of Otorhinolaryngology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Mohseni
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Saleh Mohebbi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Mohammad Farhadi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
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Walker E, McCreery R, Spratford M, Roush P. Children with Auditory Neuropathy Spectrum Disorder Fitted with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Current Practice and Outcomes. J Am Acad Audiol 2018; 27:204-218. [PMID: 26967362 DOI: 10.3766/jaaa.15050] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Up to 15% of children with permanent hearing loss (HL) have auditory neuropathy spectrum disorder (ANSD), which involves normal outer hair cell function and disordered afferent neural activity in the auditory nerve or brainstem. Given the varying presentations of ANSD in children, there is a need for more evidence-based research on appropriate clinical interventions for this population. PURPOSE This study compared the speech production, speech perception, and language outcomes of children with ANSD, who are hard of hearing, to children with similar degrees of mild-to-moderately severe sensorineural hearing loss (SNHL), all of whom were fitted with bilateral hearing aids (HAs) based on the American Academy of Audiology pediatric amplification guidelines. RESEARCH DESIGN Speech perception and communication outcomes data were gathered in a prospective accelerated longitudinal design, with entry into the study between six mo and seven yr of age. Three sites were involved in participant recruitment: Boys Town National Research Hospital, the University of North Carolina at Chapel Hill, and the University of Iowa. STUDY SAMPLE The sample consisted of 12 children with ANSD and 22 children with SNHL. The groups were matched based on better-ear pure-tone average, better-ear aided speech intelligibility index, gender, maternal education level, and newborn hearing screening result (i.e., pass or refer). DATA COLLECTION AND ANALYSIS Children and their families participated in an initial baseline visit, followed by visits twice a year for children <2 yr of age and once a yr for children >2 yr of age. Paired-sample t-tests were used to compare children with ANSD to children with SNHL. RESULTS Paired t-tests indicated no significant differences between the ANSD and SNHL groups on language and articulation measures. Children with ANSD displayed functional speech perception skills in quiet. Although the number of participants was too small to conduct statistical analyses for speech perception testing, there appeared to be a trend in which the ANSD group performed more poorly in background noise with HAs, compared to the SNHL group. CONCLUSIONS The American Academy of Audiology Pediatric Amplification Guidelines recommend that children with ANSD receive an HA trial if their behavioral thresholds are sufficiently high enough to impede speech perception at conversational levels. For children with ANSD in the mild-to-severe HL range, the current results support this recommendation, as children with ANSD can achieve functional outcomes similar to peers with SNHL.
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Auditory Performance and Electrical Stimulation Measures in Cochlear Implant Recipients With Auditory Neuropathy Compared With Severe to Profound Sensorineural Hearing Loss. Ear Hear 2018; 38:184-193. [PMID: 28225734 DOI: 10.1097/aud.0000000000000384] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of the study was to compare auditory and speech outcomes and electrical parameters on average 8 years after cochlear implantation between children with isolated auditory neuropathy (AN) and children with sensorineural hearing loss (SNHL). DESIGN The study was conducted at a tertiary, university-affiliated pediatric medical center. The cohort included 16 patients with isolated AN with current age of 5 to 12.2 years who had been using a cochlear implant for at least 3.4 years and 16 control patients with SNHL matched for duration of deafness, age at implantation, type of implant, and unilateral/bilateral implant placement. All participants had had extensive auditory rehabilitation before and after implantation, including the use of conventional hearing aids. Most patients received Cochlear Nucleus devices, and the remainder either Med-El or Advanced Bionics devices. Unaided pure-tone audiograms were evaluated before and after implantation. Implantation outcomes were assessed by auditory and speech recognition tests in quiet and in noise. Data were also collected on the educational setting at 1 year after implantation and at school age. The electrical stimulation measures were evaluated only in the Cochlear Nucleus implant recipients in the two groups. Similar mapping and electrical measurement techniques were used in the two groups. Electrical thresholds, comfortable level, dynamic range, and objective neural response telemetry threshold were measured across the 22-electrode array in each patient. Main outcome measures were between-group differences in the following parameters: (1) Auditory and speech tests. (2) Residual hearing. (3) Electrical stimulation parameters. (4) Correlations of residual hearing at low frequencies with electrical thresholds at the basal, middle, and apical electrodes. RESULTS The children with isolated AN performed equally well to the children with SNHL on auditory and speech recognition tests in both quiet and noise. More children in the AN group than the SNHL group were attending mainstream educational settings at school age, but the difference was not statistically significant. Significant between-group differences were noted in electrical measurements: the AN group was characterized by a lower current charge to reach subjective electrical thresholds, lower comfortable level and dynamic range, and lower telemetric neural response threshold. Based on pure-tone audiograms, the children with AN also had more residual hearing before and after implantation. Highly positive coefficients were found on correlation analysis between T levels across the basal and midcochlear electrodes and low-frequency acoustic thresholds. CONCLUSIONS Prelingual children with isolated AN who fail to show expected oral and auditory progress after extensive rehabilitation with conventional hearing aids should be considered for cochlear implantation. Children with isolated AN had similar pattern as children with SNHL on auditory performance tests after cochlear implantation. The lower current charge required to evoke subjective and objective electrical thresholds in children with AN compared with children with SNHL may be attributed to the contribution to electrophonic hearing from the remaining neurons and hair cells. In addition, it is also possible that mechanical stimulation of the basilar membrane, as in acoustic stimulation, is added to the electrical stimulation of the cochlear implant.
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Fontenot TE, Giardina CK, Teagle HF, Park LR, Adunka OF, Buchman CA, Brown KD, Fitzpatrick DC. Clinical role of electrocochleography in children with auditory neuropathy spectrum disorder. Int J Pediatr Otorhinolaryngol 2017; 99:120-127. [PMID: 28688553 PMCID: PMC5538887 DOI: 10.1016/j.ijporl.2017.05.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/26/2017] [Accepted: 05/31/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To assess electrocochleography (ECochG) to tones as an instrument to account for CI speech perception outcomes in children with auditory neuropathy spectrum disorder (ANSD). MATERIALS & METHODS Children (<18 years) receiving CIs for ANSD (n = 30) and non-ANSD (n = 74) etiologies of hearing loss were evaluated with ECochG using tone bursts (0.25-4 kHz). The total response (TR) is the sum of spectral peaks of responses across frequencies. The compound action potential (CAP) and the auditory nerve neurophonic (ANN) in ECochG waveforms were used to estimate nerve activity and calculate nerve score. Performance on open-set monosyllabic word tests was the outcome measure. Standard statistical methods were applied. RESULTS On average, TR was larger in ANSD than in non-ANSD subjects. Most ANSD (73.3%) and non-ANSD (87.8%) subjects achieved open-set speech perception; TR accounted for 33% and 20% of variability in the outcomes, respectively. In the ANSD group, the PTA accounted for 69.3% of the variability, but there was no relationship with outcomes in the non-ANSD group. In both populations, nerve score was sensitive in identifying subjects at risk for not acquiring open-set speech perception, while the CAP and the ANN were more specific. CONCLUSION In both subject groups, the TRs correlated with outcomes but these measures were notably larger in the ANSD group. There was also strong correlation between PTA and speech perception outcome in ANSD group. In both subject populations, weaker evidence of neural activity was related to failure to achieve open-set speech perception.
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Affiliation(s)
- Tatyana E Fontenot
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States.
| | - Christopher K Giardina
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States; University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Holly F Teagle
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States
| | - Lisa R Park
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States
| | - Oliver F Adunka
- The Ohio State University, Department of Otolaryngology, Columbus, OH, United States
| | - Craig A Buchman
- Washington University in St. Louis, Department of Otolaryngology, St. Louis, MO, United States
| | - Kevin D Brown
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States
| | - Douglas C Fitzpatrick
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States; University of North Carolina School of Medicine, Chapel Hill, NC, United States
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Prabhu P, Barman A. Effectiveness of low-cut modified amplification strategy and channel-free hearing aid in individuals with auditory neuropathy spectrum disorder. Int J Audiol 2017; 56:759-766. [DOI: 10.1080/14992027.2017.1323123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
| | - Animesh Barman
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
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16
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Rance G, Starr A. Pathophysiological mechanisms and functional hearing consequences of auditory neuropathy. Brain 2015; 138:3141-58. [PMID: 26463676 DOI: 10.1093/brain/awv270] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/05/2015] [Indexed: 01/19/2023] Open
Abstract
The effects of inner ear abnormality on audibility have been explored since the early 20th century when sound detection measures were first used to define and quantify 'hearing loss'. The development in the 1970s of objective measures of cochlear hair cell function (cochlear microphonics, otoacoustic emissions, summating potentials) and auditory nerve/brainstem activity (auditory brainstem responses) have made it possible to distinguish both synaptic and auditory nerve disorders from sensory receptor loss. This distinction is critically important when considering aetiology and management. In this review we address the clinical and pathophysiological features of auditory neuropathy that distinguish site(s) of dysfunction. We describe the diagnostic criteria for: (i) presynaptic disorders affecting inner hair cells and ribbon synapses; (ii) postsynaptic disorders affecting unmyelinated auditory nerve dendrites; (iii) postsynaptic disorders affecting auditory ganglion cells and their myelinated axons and dendrites; and (iv) central neural pathway disorders affecting the auditory brainstem. We review data and principles to identify treatment options for affected patients and explore their benefits as a function of site of lesion.
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Affiliation(s)
- Gary Rance
- 1 Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Parkville 3010 Australia
| | - Arnold Starr
- 2 Department of Neurology, The University of California (Irvine), 200 S. Manchester Ave., Suite 206, Orange, CA 92868-4280, USA
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Ji F, Li J, Hong M, Chen A, Jiao Q, Sun L, Liang S, Yang S. Determination of benefits of cochlear implantation in children with auditory neuropathy. PLoS One 2015; 10:e0127566. [PMID: 26010832 PMCID: PMC4443975 DOI: 10.1371/journal.pone.0127566] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 04/16/2015] [Indexed: 11/19/2022] Open
Abstract
Background Auditory neuropathy (AN) is a recently recognized hearing disorder characterized by intact outer hair cell function, disrupted auditory nerve synchronization and poor speech perception and recognition. Cochlear implants (CIs) are currently the most promising intervention for improving hearing and speech in individuals with AN. Although previous studies have shown optimistic results, there was large variability concerning benefits of CIs among individuals with AN. The data indicate that different criteria are needed to evaluate the benefit of CIs in these children compared to those with sensorineural hearing loss. We hypothesized that a hierarchic assessment would be more appropriate to evaluate the benefits of cochlear implantation in AN individuals. Methods Eight prelingual children with AN who received unilateral CIs were included in this study. Hearing sensitivity and speech recognition were evaluated pre- and postoperatively within each subject. The efficacy of cochlear implantation was assessed using a stepwise hierarchic evaluation for achieving: (1) effective audibility, (2) improved speech recognition, (3) effective speech, and (4) effective communication. Results The postoperative hearing and speech performance varied among the subjects. According to the hierarchic assessment, all eight subjects approached the primary level of effective audibility, with an average implanted hearing threshold of 43.8 ± 10.2 dB HL. Five subjects (62.5%) attained the level of improved speech recognition, one (12.5%) reached the level of effective speech, and none of the subjects (0.0%) achieved effective communication. Conclusion CIs benefit prelingual children with AN to varying extents. A hierarchic evaluation provides a more suitable method to determine the benefits that AN individuals will likely receive from cochlear implantation.
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Affiliation(s)
- Fei Ji
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Jianan Li
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Mengdi Hong
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Aiting Chen
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Qingshan Jiao
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Li Sun
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Sichao Liang
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Shiming Yang
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
- * E-mail:
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Fernandes NF, Morettin M, Yamaguti EH, Costa OA, Bevilacqua MC. Performance of hearing skills in children with auditory neuropathy spectrum disorder using cochlear implant: a systematic review. Braz J Otorhinolaryngol 2015; 81:85-96. [PMID: 25458263 PMCID: PMC9452214 DOI: 10.1016/j.bjorl.2014.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 03/03/2014] [Indexed: 11/25/2022] Open
Abstract
Introduction Currently, there are no doubts about the benefits of cochlear implants for the development of children with severe or profound hearing loss. However, there is still no consensus among researchers and professionals regarding the benefits for the improvement of hearing skills in children with auditory neuropathy spectrum disorder using cochlear implants. Objective Review the available evidence in the literature to answer the following: “What is the performance of hearing skills in children with auditory neuropathy spectrum disorder using cochlear implants?” Methods Systematic review of the literature through electronic database consultation, considering publications in the period 2002–2013. Results Twenty-two studies met the criteria and were included in the systematic review. Conclusion The analyzed studies demonstrated that after cochlear implant surgery, individuals with auditory neuropathy spectrum disorder improved their performance of hearing skills and had similar performance to that of children with sensorineural hearing loss using cochlear implant.
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Affiliation(s)
- Nayara Freitas Fernandes
- Department of Sciences, Faculdade de Odontologia de Bauru, Universidade de São Paulo (FOB - USP), Bauru, SP, Brazil; Department of Phonoaudiology, Universidade de São Paulo (USP), Bauru, SP, Brazil.
| | - Marina Morettin
- Department of Sciences, Faculdade de Odontologia de Bauru, Universidade de São Paulo (FOB - USP), Bauru, SP, Brazil; Department of Phonoaudiology, Universidade de São Paulo (USP), Bauru, SP, Brazil
| | - Elisabete Honda Yamaguti
- Department of Sciences, Faculdade de Odontologia de Bauru, Universidade de São Paulo (FOB - USP), Bauru, SP, Brazil; Department of Phonoaudiology, Hospital for Rehabilitation of Craniofacial Anomalies, Universidade de São Paulo (HRAC - USP), Bauru, SP, Brazil
| | - Orozimbo Alves Costa
- Department of Phonoaudiology, Universidade de São Paulo (USP), Bauru, SP, Brazil; Division of Otology, Hospital for Rehabilitation of Craniofacial Anomalies, Universidade de São Paulo (HRAC - USP), Bauru, SP, Brazil
| | - Maria Cecilia Bevilacqua
- Department of Phonoaudiology, Universidade de São Paulo (USP), Bauru, SP, Brazil; Department of Phonoaudiology, Hospital for Rehabilitation of Craniofacial Anomalies, Universidade de São Paulo (HRAC - USP), Bauru, SP, Brazil; Division of Audiology, Hospital for Rehabilitation of Craniofacial Anomalies, Universidade de São Paulo (HRAC - USP), Bauru, SP, Brazil
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Liu Y, Dong R, Li Y, Xu T, Li Y, Chen X, Gong S. Effect of age at cochlear implantation on auditory and speech development of children with auditory neuropathy spectrum disorder. Auris Nasus Larynx 2014; 41:502-6. [DOI: 10.1016/j.anl.2014.06.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 04/28/2014] [Accepted: 06/09/2014] [Indexed: 11/25/2022]
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Norrix LW, Velenovsky DS. Auditory neuropathy spectrum disorder: a review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2014; 57:1564-1576. [PMID: 24686491 DOI: 10.1044/2014_jslhr-h-13-0213] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Auditory neuropathy spectrum disorder, or ANSD, can be a confusing diagnosis to physicians, clinicians, those diagnosed, and parents of children diagnosed with the condition. The purpose of this review is to provide the reader with an understanding of the disorder, the limitations in current tools to determine site(s) of lesion, and management techniques. METHOD This article is a review of what is known about ANSD. It includes descriptions of assessment tools, causes of ANSD, and patient management techniques. CONCLUSIONS This review is a guide to audiologists, speech-language pathologists, and early interventionists who work with individuals diagnosed with ANSD and/or their families. It highlights the need for more precise tools to describe the disorder in order to facilitate decisions about interventions and lead to better predictions of outcome.
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Jeong SW, Kim LS. Auditory neuropathy spectrum disorder: predictive value of radiologic studies and electrophysiologic tests on cochlear implant outcomes and its radiologic classification. Acta Otolaryngol 2013; 133:714-21. [PMID: 23768056 DOI: 10.3109/00016489.2013.776176] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The width of the bony cochlear nerve canal (BCNC) and the size of the cochlear nerve are reliable predictors of long-term speech perception abilities for children with auditory neuropathy spectrum disorder (ANSD) after cochlear implantation (CI). In addition, electrical stapedial reflex (ESR) and electrical compound action potential (ECAP) also have considerable value in predicting postoperative speech perception abilities in these children. OBJECTIVES To assess whether speech perception abilities after CI in children with ANSD can be predicted from the results of radiologic studies and electrophysiologic tests. METHODS Fifteen children with ANSD underwent CI. The width of the BCNC and the size of the cochlear nerve were measured using preoperative CT and MRI. The results of early postoperative ESR, ECAP, and implant evoked electrical auditory brainstem response were reviewed. The latest speech perception test scores were also reviewed. RESULTS Radiologic findings of normal BCNC and normal cochlear nerve correlated with excellent speech perception abilities after CI. A narrow or obliterated BCNC and a deficient cochlear nerve correlated with poor speech perception abilities. Children with good speech perception abilities showed robust responses on ESR and ECAP, but there were no responses from any of the children with poor speech perception abilities.
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Affiliation(s)
- Sung-Wook Jeong
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Dong-A University, Busan, Korea
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Humphriss R, Hall A, Maddocks J, Macleod J, Sawaya K, Midgley E. Does cochlear implantation improve speech recognition in children with auditory neuropathy spectrum disorder? A systematic review. Int J Audiol 2013; 52:442-54. [DOI: 10.3109/14992027.2013.786190] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Costa NTDO, Martinho-Carvalho AC, Cunha MC, Lewis DR. Auditory and communicative abilities in the auditory neuropathy spectrum disorder and mutation in the Otoferlin gene: clinical cases study. ACTA ACUST UNITED AC 2012; 24:181-7. [PMID: 22832688 DOI: 10.1590/s2179-64912012000200016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 01/12/2012] [Indexed: 11/22/2022]
Abstract
This study had the aim to investigate the auditory and communicative abilities of children diagnosed with Auditory Neuropathy Spectrum Disorder due to mutation in the Otoferlin gene. It is a descriptive and qualitative study in which two siblings with this diagnosis were assessed. The procedures conducted were: speech perception tests for children with profound hearing loss, and assessment of communication abilities using the Behavioral Observation Protocol. Because they were siblings, the subjects in the study shared family and communicative context. However, they developed different communication abilities, especially regarding the use of oral language. The study showed that the Auditory Neuropathy Spectrum Disorder is a heterogeneous condition in all its aspects, and it is not possible to make generalizations or assume that cases with similar clinical features will develop similar auditory and communicative abilities, even when they are siblings. It is concluded that the acquisition of communicative abilities involves subjective factors, which should be investigated based on the uniqueness of each case.
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Affiliation(s)
- Nayara Thais de Oliveira Costa
- Graduate Program in Speech-Language Pathology and Audiology, Pontifícia Universidade Católica de São Paulo, São Paulo, SP, Brazil.
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Roush P, Frymark T, Venediktov R, Wang B. Audiologic management of auditory neuropathy spectrum disorder in children: a systematic review of the literature. Am J Audiol 2011; 20:159-70. [PMID: 21940978 DOI: 10.1044/1059-0889(2011/10-0032)] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This review summarizes current evidence related to the audiologic management of children with auditory neuropathy spectrum disorder (ANSD). METHOD A systematic search of the literature was conducted in 25 electronic databases (e.g., PubMed, CINAHL, and ERIC) using key words such as auditory neuropathy, auditory neuropathy spectrum disorder, auditory neuropathy/dyssynchrony, and hearing loss. Eighteen studies met the inclusion criteria by addressing 1 or more of 8 clinical questions. Studies were evaluated for methodological quality, and data regarding participant, intervention, and outcome variables are reported. RESULTS Fifteen of the 18 studies addressed the use of cochlear implantation, and 4 addressed conventional acoustic amplification. All participants demonstrated improved auditory performance; however, all 18 studies were considered exploratory, and many had methodological limitations. CONCLUSION The clinical evidence related to intervention for ANSD is at a very preliminary stage. Additional research is needed to address the efficacy of acoustic amplification and cochlear implantation in children with ANSD and the impact of this disorder on developmental outcomes.
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Affiliation(s)
| | - Tobi Frymark
- American Speech-Language-Hearing Association, Rockville, MD
| | | | - Beverly Wang
- American Speech-Language-Hearing Association, Rockville, MD
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Kim JR, Kim LS, Jeong SW, Kim JS, Chung SH. Recovery function of electrically evoked compound action potential in implanted children with auditory neuropathy: preliminary results. Acta Otolaryngol 2011; 131:796-801. [PMID: 21466261 DOI: 10.3109/00016489.2011.560187] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The results of this study show that the temporal processing ability in children with auditory neuropathy (AN) can be restored to some degree by electrical stimulation through a cochlear implant. In addition, the electrically evoked compound action potential (ECAP) may be a useful index to predict outcomes in implanted children with AN. OBJECTIVES The purpose of this study was to evaluate restoration of the temporal processing abilities in implanted children with AN using ECAP recovery function and speech perception. METHODS Ten children who had received cochlear implantations participated in this study, including six with AN and four with sensorineural hearing loss (SNHL). ECAP recovery functions were measured, and the slopes of ECAP recovery functions in implanted children with AN were compared with those of implanted children with SNHL. Open-set speech perception test scores of implanted children with AN were compared with those of 78 implanted children with SNHL. RESULTS The slopes of the ECAP recovery function in children with AN did not differ significantly from those in children with SNHL. The group of children with robust ECAPs showed good postoperative performance. However, the group with no ECAPs showed poor performance.
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Affiliation(s)
- Jae-Ryong Kim
- Department of Otolaryngology-Head and Neck Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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Shapiro SM, Popelka GR. Auditory impairment in infants at risk for bilirubin-induced neurologic dysfunction. Semin Perinatol 2011; 35:162-70. [PMID: 21641490 DOI: 10.1053/j.semperi.2011.02.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Classical and subtypes of kernicterus associated with bilirubin toxicity can be differentiated in part with physiological auditory measures that include auditory-evoked potentials and measures of cochlear integrity. The combination of these auditory measures suggests that bilirubin exposure results in auditory system damage initially at the level of the brainstem, progressing to the level of the VIII cranial nerve and then to greater neural centers. There is no evidence of neural damage at the level of the cochlea. Auditory neural damage from bilirubin toxicity ranges from neural timing deficits, including neural firing delays and dyssynchrony, to neural response reduction and even elimination of auditory neural responses. This condition is comprehensively described as auditory neuropathy spectrum disorder. Independent measures of cochlear function and auditory neural function up to the level of the brainstem can effectively diagnose auditory neural damage resulting from bilirubin neurotoxicity. Intervention, including cochlear implants can be effective.
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Affiliation(s)
- Steven M Shapiro
- Division of Child Neurology, Department of Neurology, Medical College of Virginia Campus, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0211, USA.
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Kim LS, Jeong SW, Lee YM, Kim JS. Cochlear implantation in children. Auris Nasus Larynx 2010; 37:6-17. [DOI: 10.1016/j.anl.2009.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 09/10/2009] [Accepted: 09/22/2009] [Indexed: 10/20/2022]
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