Retrospective analysis of auditory neuropathy patients after cochlear implantation / 中华耳鼻咽喉头颈外科杂志

Objectives@#To study an effects on hearing ability and speech performance of the patients with auditory neuropathy (AN) after cochlear implantation (CI).@*Methods@#Thirty-five AN patients (26 males and 9 females) after CI in our center since 2007 were chosen, including 5 postlingual patients (implanted age from 14.3 to 38.6 years old) and 30 prelingual patients (implanted age from 1.1 to 13.7 years old). Hearing sensitivity and speech performance were estimated via following methods: (1) implanted hearing thresholds by sound field audiometry; (2) speech audiometry, including monosyllable, disyllable and sentences recognition test by computer-controlled software and sentence recognition test under noise condition (signal to noise ratio=+ 10dB); (3) Mandarin Early Speech Perception test (MESP), Mandarin Pediatric Speech Intelligibility test (MPSI), MAIS, or IT-MAIS for prelingual AN implantees.@*Results@#The average implanted hearing threshold (250-4 000 Hz) was (41.1±11.7) dBHL in 22 AN implantees, while those prelingual implantees was (39.1±10.9) dBHL, and (44.9±12.3) dBHL in postlingual implantees. Speech audiometry were implemented in four of 5 postlingual AN implantees, the results showed increasing tendency in monosyllable recognition scores, dramatic individual variation in computer-controlled disyllable and sentences recognition test, and poor scores (<30%) in speech recognition test in noise condition. Four of 30 prelingual implantees reconstruct their speech recognition ability within 1-3 years after switch-on, characterized as recognition scores (>60%) in monosyllable, disyllable and sentences. The one of prelingual implantee gained recognition scores of speech in noise within 1 year after switch-on. MAIS or IT-MAIS were implemented in twenty-five prelingual implantees, the average score in these patients was 28.6±11.7.@*Conclusion@#Cochlear implant can improve the hearing thresholds of AN patients, however, the improvement in speech performance presented significant variations among the implanted individuals.

Study of auditory brainstem response to speech sounds in sex differences / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the electrophysiological characteristics of the Auditory Brainstem Response to Speech Sounds (s-ABR) in healthy adults, and then analyze its relationship between noise speech recognition ability and sex.@*METHOD@#We accessed the auditory brainstem response to a synthesized stop-consonant speech syllable / da/in 40 native-Chinese speech adults. Timing components of the response were compared between males and females to determine which aspects of the response are affected by sex. The relationship of the slope between the onset peak (V) and though (A) (V/A slope) and the noise speech recognition ability was analyzed.@*RESULT@#A dissimilarity between males and females was observed in the response to the component that change rapidly over time(P 0.05). Noise speech recognition and the V/A slope was negatively correlated (r = 0.478, P < 0.05), which indicated that the greater slope of V/A, the lower of the speech recognition threshold under noise.@*CONCLUSION@#The verbal components change rapidly over time, and high-frequency consonants evoked neural response obviously affected by gender. In the slower changing, lower frequency information in the stimulus was minimally affected by sex. The subjects with better abilities of processing transient and rapid information can show lower noise speech recognition threshold.

Development of early auditory and speech perception skills within one year after cochlear implantion in prelingual deaf children / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the development of early auditory capability and speech perception in the prelingual deaf children after cochlear implantation, and to study the feasibility of currently available Chinese assessment instruments for the evaluation of early auditory skill and speech perception in hearing-impaired children.</p><p><b>METHODS</b>A total of 83 children with severe-to-profound prelingual hearing impairment participated in this study. Participants were divided into four groups according to the age for surgery: A (1-2 years), B (2-3 years), C (3-4 years) and D (4-5 years). The auditory skill and speech perception ability of CI children were evaluated by trained audiologists using the infant-toddler/meaningful auditory integration scale (IT-MAIS/MAIS) questionnaire, the Mandarin Early Speech Perception (MESP) test and the Mandarin Pediatric Speech Intelligibility (MPSI) test. The questionnaires were used in face to face interviews with the parents or guardians. Each child was assessed before the operation and 3 months, 6 months, 12 months after switch-on.</p><p><b>RESULTS</b>After cochlear implantation, early postoperative auditory development and speech perception gradually improved. All MAIS/IT-MAIS scores showed a similar increasing trend with the rehabilitation duration (F=5.743, P=0.007). Preoperative and post operative MAIS/IT-MAIS scores of children in age group C (3-4 years) was higher than that of other groups. Children who had longer hearing aid experience before operation demonstrated higher MAIS/IT-MAIS scores than those with little or no hearing aid experience (F=4.947, P=0.000). The MESP test showed that, children were not able to perceive speech as well as detecting speech signals. However as the duration of CI use increased, speech perception ability also improved substantially. However, only about 40% of the subjects could be evaluated using the most difficult subtest on the MPSI in quiet at 12 months after switch-on. As MCR decreased, the proportion of children who could be tested using the MPSI reduced.</p><p><b>CONCLUSIONS</b>Within one year after CI, children develop early auditory and speech perception capabilities with time. Chinese versions of the IT-MAIS/MAIS, MESP and MPSI are useful instruments to document early auditory and speech perception skills in children after CI implantation.</p>

The development of vocabulary capability at 2-year follow-up in the prelingual deaf children with cochlear implants / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the development of early vocabulary capability in the prelingual deaf children after cochlear implantation (CI) , and to study the feasibility of current Chinese assessment procedures about language development for hearing-impaired children.@*METHOD@#A total of 56 cases with severe-to-profound prelingual deaf children were participated in this study. The vocabulary development of CI children were evaluated by trained audiologists using the vocabulary assessment tools: Chinese communicative development inventory (CCDI) and mandarin expressive and receptive vocabulary test (MERVT). The questionnaire assessed by parents or guardians answered the questionnaire; vocabulary tests were evaluated by children accompanied with audiologists. Patients were assessed before operation and in 2 years after switch-on.@*RESULT@#With the rehabilitation, early post-operative vocabulary development gradually improved. The vocabulary increased with an increase in the duration of CI use, and the receptive vocabulary developed earlier than the expressive ones.@*CONCLUSION@#After 2 years of CI use, the child partly developed the vocabulary capability. Children's vocabulary test, CCDI and MERVT test, is an important index to evaluate the development of children's language ability after cochlear implantation. Vocabulary test, together with auditory and speech perception assessment procedures, constitute a more complete auditory-speech-language evaluation system for Chinese children after cochlear implants.

Speech and pitch perception with the new fine structure speech coding strategy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the performance of the new fine structure processing strategy(FS4) compared to the previous generation coding strategy HDCIS.@*METHOD@#Twelve post-lingual hearing-impaired cochlear implant users were included. FS4 and HDCIS were compared in music pitch perception and speech perception test.@*RESULT@#Acute comparison between FS4 and HDCIS showed that FS4 performed as well as HDCIS in speech perception tests, and outperformed HDCIS in music pitch perception.@*CONCLUSION@#Results indicate that FS4 performs better than HDCIS in music perception. Differences between the two strategies were not significant for speech test.

Study of aural rehabilitation in post-lingual deafened patients with multi-channel cochlear implant / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To seek a convenient and effective method through subjective psychophysical measurements and CAP/SIR assessment. To compare the discrimination of rehabilitation between post-lingual and pre-lingual deafened patients.@*METHOD@#Thirty-one post-lingual cochlear implantees and 59 pre-lingual cochlear implantees, the warble tone and CAP/SIR were assessed. The discrimination of threshold levels, comfortable levels and dynamic range between post-lingual and pre-lingual deafened patients in same electrodes were compared.@*RESULT@#There was no statistic difference in warble tone, T-levels, C-levels and dynamic range in same electrodes implant after 6 months implant (P>0.05). The score of CAP and SIR in post-lingual deafened patients were more prominent.@*CONCLUSION@#CAP and SIR is a kind of convenient and effective method to assess the ability of aural and oral. There was no discrimination in warble tone, T-levels, C-levels and dynamic range in same electrodes implant, but the ability of aural and oral in post-lingual deafened patients were more prominent.

Standardized Mandarin Sentence Perception in Babble Noise Test Materials for Children / 听力学及言语疾病杂志

Objective To examine among preschool children the validity, reliability and sensitivity of a new assessment tool of Mandarin sentence recognition in babble noise, consisting of twenty-seven equivalent lists, as well as to investigate the effect of age and gender on children's speech recognition. Methods Fifty-four normalhearing children aged 4 to 6 years were recruited from Beijing and were divided into three age groups (4～, 4.5～,and 5.0～6.0 years) containing 18 children each, half boys and half girls. According to randomized split-plot design, we examined their speech recognition ability with 27 sentence-in-babble-noise lists in a sound-treated booth in a kindergarten (ambient noise ＜40 dB). The sentences were presented at fixed intensity of 65 dB SPL, paired with competing babble noise at three different signal to noise ratios (SNR= +1, -2, -5 dB) by the same loudspeaker with 0° azimuth. Speech recognition score were calculated based on the children's repetition of keySNR functions exhibited that the threshold was -1.96±0. 19 dB SNR and the slope was 15.8%±1.1%/dB for of variance and Post- Hoc Scheffe test indicated that significant differences in performance were most pronounced between the 4～ year group and the other two groups (P＜0.001), while there was no significant difference between 4.5～ year group and 5.0～6. 0 year group (P=0. 90). The girls' performance was also significantly better than boys' (P＜0. 001). Conclusion The 27 lists of Mandarin speech recognition in babble noise were equivalent among children, and the sensitivity of performance versus SNR was 15.8%/dB. Both of them were below the adult averchildren aged 4.5～ up years. Even though the performance differed between boys and girls, the difference was relatively small compared to 24.6%, the critical difference as the reliability indicator.