An Evoked Potential Study of the Developmental Time Course of the Auditory Nerve and Brainstem in Children Using Cochlear Implants

Gordon, Karen A.; Papsin, Blake C.; Harrison, Robert V.

doi:10.1159/000088851

Cited by 95 publications

(106 citation statements)

References 72 publications

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“…Brainstem responses rapidly change over the first year of unilateral CI use in children with early-onset deafness. 118,119 When the opposite (second) ear was implanted after this period (.1.5 years), the brainstem responses from this ear remained abnormally prolonged despite up to 3 years of bilateral implant use (Fig 3 120,121 ). By contrast, bilateral implantation with minimal or no delay in early development promoted symmetric maturation of the responses for both ears.…”

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confidence: 96%

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

2015

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Deafness affects ∼2 in 1000 children and is one of the most common congenital impairments. Permanent hearing loss can be treated by fitting hearing aids. More severe to profound deafness is an indication for cochlear implantation. Although newborn hearing screening programs have increased the identification of asymmetric hearing loss, parents and caregivers of children with single-sided deafness are often hesitant to pursue therapy for the deaf ear. Delayed intervention has consequences for recovery of hearing. It has long been reported that asymmetric hearing loss/single-sided deafness compromises speech and language development and educational outcomes in children. Recent studies in animal models of deafness and in children consistently show evidence of an "aural preference syndrome" in which singlesided deafness in early childhood reorganizes the developing auditory pathways toward the hearing ear, with weaker central representation of the deaf ear. Delayed therapy consequently compromises benefit for the deaf ear, with slow rates of improvement measured over time. Therefore, asymmetric hearing needs early identification and intervention. Providing early effective stimulation in both ears through appropriate fitting of auditory prostheses, including hearing aids and cochlear implants, within a sensitive period in development has a cardinal role for securing the function of the impaired ear and for restoring binaural/spatial hearing. The impacts of asymmetric hearing loss on the developing auditory system and on spoken language development have often been underestimated. Thus, the traditional minimalist approach to clinical management aimed at 1 functional ear should be modified on the basis of current evidence.Deafness is one of the most common congenital impairments. 1,2 Newborn hearing screening programs, implemented in many countries, have decreased the age at diagnosis of hearing loss. When hearing loss occurs in only 1 ear, the screening result may be overlooked or dismissed as unimportant, particularly when hearing in the opposite ear is normal (unilateral or single-sided deafness). The consequence will be a failure to intervene until long after major developmental effects have set in, which causes significant negative clinical implications. Screening programs will also miss children who acquire deafness in 1 ear from infection, trauma, or worsening of preexisting hearing loss. 3-6 Acquired unilateral deafness can go unidentified until educational, social, or other impairments push families and caregivers to seek medical consult. Because the prevalence of permanent unilateral hearing loss in neonates is reported to vary from 0.45 to 2.7 in 1000 7,8 In this State-of-the-Art Review, we present evidence from basic and applied neuroscience, audiology, and otology that points to the existence of an impairment of the central representation of the poorer hearing ear if developmental asymmetric hearing is left untreated for years. First, we review the current state of the problem as viewed in the clin...

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confidence: 96%

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

2015

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“…well as development of the auditory brainstem [Gordon et al, 2003[Gordon et al, , 2006[Gordon et al, , 2007a and cortex [Gordon et al, 2005a, b]. Although there are benefits to using one CI, it has become clear that the immature auditory system requires input from both ears.…”

mentioning

confidence: 99%

The Effects of Asymmetric Hearing on Bilateral Brainstem Function: Findings in Children with Bimodal (Electric and Acoustic) Hearing

Polonenko

Papsin²,

Gordon³

2015

Audiol Neurotol

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As implantation criteria are broadening to include children with asymmetric hearing loss, it is important to determine the degree of residual hearing needed to protect the bilateral auditory pathways for binaural hearing and whether there is a sensitive period in development for implantation in these children. We have been studying these questions in a growing cohort of children. In the present study, auditory brainstem responses were recorded in 21 children who had 2.2 ± 2.2 years of bimodal hearing. Responses were evoked by 11-Hz acoustic clicks presented to the non-implanted ear and with biphasic electric pulses presented to the implanted ear. Twelve of these children also completed a behavioural task in which they were asked to which side of their heads bilaterally presented clicks/pulses that varied in interaural level or timing lateralized. All children experienced a delay in the non-implanted ear that resulted in 2.0 ± 0.35 ms longer peak latencies. These were further prolonged in 7 children as measured by longer interwave latencies from this ear than from the implanted ear. Despite large asymmetries in timing of brainstem activity between the two ears, all children perceived changes in interaural level differences. They were unable to detect differences in interaural timing cues. Symmetric brainstem function suggests bilateral development was preserved in some children. Future work will explore whether these children have better potential for developing binaural hearing using bimodal input.

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“…23,24 Dees et al 25 and Gordon et al 21,12 have reported similar results. According to Haenggeli et al 26 and Miller et al, 27 direct stimulation of auditory neurons, by compensating synaptic mechanisms among cochlear hair cells and neural structures, partly explain the fact that ECAP latency is minimally affected by variations in the level of the current.…”

Section: N1 Peak Latencymentioning

confidence: 66%

“…[5][6][7] Studies in humans have shown different results in the stabilization of ECAP features, especially its amplitude, extrapolated threshold (p-NRT) and the amplitude growth curve slope. [8][9][10][11][12] Given the recent and significant technological developments in cochlear implant manufacturing, and continuous improvements in audiological diagnostic techniques, the indication criteria for cochlear implant have been extended to younger children. In the literature children with implants at age four months have already been reported.…”

Section: Introductionmentioning

confidence: 99%

Avaliação longitudinal do ECAP registrado em crianças usuárias de implante coclear

Tanamati¹,

Bevilácqua

Costa

2009

Rev. Bras. Otorrinolaringol.

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In children with cochlear implant (CI), the recording of the electrically evoked compound action potential (ECAP) of the auditory nerve represents an option to assess changes in auditory nerve responses and the interaction between the electrode bundle and the neural tissue over time. Aim: To study ECAP in children during the first year of CI use. Materials and methods: The ECAP characteristics have been analyzed in 13 children implanted younger than three years of age. Series study. Results: During the first year of CI use there was a significant statistical raise in the N1 peak amplitude, in basal electrodes, between the second and third return visits. There were not any significant differences obtained for N1 peak, latency, slope, p-NRT or recovery time, in the return visits. Conclusion: During the first year of CI use, the electrical stimulation provided by the intracochlear electrodes did not cause significant changes to ECAP characteristics, except for an increase in N1 peak amplitude.

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An Evoked Potential Study of the Developmental Time Course of the Auditory Nerve and Brainstem in Children Using Cochlear Implants

Cited by 95 publications

References 72 publications

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

The Effects of Asymmetric Hearing on Bilateral Brainstem Function: Findings in Children with Bimodal (Electric and Acoustic) Hearing

Avaliação longitudinal do ECAP registrado em crianças usuárias de implante coclear

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