Auditory neuropathy/auditory dyssynchrony in children with cochlear implants

Abstract

The electrical stimulation generated by the Cochlear Implant (CI) may improve the neural synchrony and hence contribute to the development of auditory skills in patients with Auditory Neuropathy / Auditory Dyssynchrony (AN/AD). Aim Prospective cohort cross-sectional study to evaluate the auditory performance and the characteristics of the electrically evoked compound action potential (ECAP) in 18 children with AN/AD and cochlear implants. Material and methods The auditory perception was evaluated by sound field thresholds and speech perception tests. To evaluate ECAP's characteristics, the threshold and amplitude of neural response were evaluated at 80Hz and 35Hz. Results No significant statistical difference was found concerning the development of auditory skills. The ECAP's characteristics differences at 80 and 35Hz stimulation rate were also not statistically significant. Conclusion The CI was seen as an efficient resource to develop auditory skills in 94% of the AN/ AD patients studied. The auditory perception benefits and the possibility to measure ECAP showed that the electrical stimulation could compensate for the neural dyssynchrony caused by the AN/AD. However, a unique clinical procedure cannot be proposed at this point. Therefore, a careful and complete evaluation of each AN/AD patient before recommending a Cochlear Implant is advised. Clinical Trials : NCT01023932

Ensino de comportamento verbal por múltiplos exemplares em uma criança com desordem do espectro da neuropatia auditiva: estudo de caso

“…Children with ANSD and CI also attain significant improvement in listening and speaking abilities, as shown in several studies 5,27 . Studies report improvement of auditory abilities in 94% of participants with the use of CI, and have shown that electrical stimulation was able to compensate for the characteristic dyssynchrony of ANSD 5 . Even so, the effectiveness of CI is influenced by several variables, such as age, time of use of CI, participation in a systematic therapeutic process and when the diagnosis was made 27 .…”

“…The cochlear implant (CI) is among the strategies indicated for auditory habilitation and rehabilitation especially for children in a critical period for developing linguistic skills as listeners or speakers. However, CIs are still a challenge for individuals with ANSD, since impairment of auditory perception, and speech comprehension and production, originate from alterations in neural functions 3,5 . The CI is an electronic device designed to promote auditory detection and, consequently, improve communication of people.…”

“…This apparatus stimulates the electrodes that are implanted in the cochlea 5,6 . The CI has been successful in developing cortical hearing and shown behavioral results from children with ANSD 3,7,8 .…”

“…This variability in results relates to extrinsic factors -such as motivation to use the CI, family support, rehabilitation methodand intrinsic factors -such as degree of impairment or changes in the auditory pathways 5 . Defining and standardizing clinical practices for a clinical group with ANSD is not yet possible considering its heterogeneity.…”

Effect of age at cochlear implantation on auditory and speech development of children with auditory neuropathy spectrum disorder

“…These good results may be attributed to the ability of cochlear implants to improve auditory temporal processing by stimulating the synchronous discharge of the auditory nerve [34,35], thereby preventing anterograde neural degeneration arising from the lack of afferent stimulation. In the 10 children enrolled in the current study, the lesion sites might have been pre-synaptic.…”