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Yuan D, Tournis E, Ryan ME, Lai CM, Geng X, Young NM, Wong PCM. Early-stage use of hearing aids preserves auditory cortical structure in children with sensorineural hearing loss. Cereb Cortex 2024; 34:bhae145. [PMID: 38610087 PMCID: PMC11021813 DOI: 10.1093/cercor/bhae145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Hearing is critical to spoken language, cognitive, and social development. Little is known about how early auditory experiences impact the brain structure of children with bilateral sensorineural hearing loss. This study examined the influence of hearing aid use and residual hearing on the auditory cortex of children with severe to profound congenital sensorineural hearing loss. We evaluated cortical preservation in 103 young pediatric cochlear implant candidates (55 females and 48 males) by comparing their multivoxel pattern similarity of auditory cortical structure with that of 78 age-matched children with typical hearing. The results demonstrated that early-stage hearing aid use preserved the auditory cortex of children with bilateral congenital sensorineural hearing loss. Children with less residual hearing experienced a more pronounced advantage from hearing aid use. However, this beneficial effect gradually diminished after 17 months of hearing aid use. These findings support timely fitting of hearing aids in conjunction with early implantation to take advantage of neural preservation to maximize auditory and spoken language development.
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Affiliation(s)
- Di Yuan
- Brain and Mind Institute, The Chinese University of Hong Kong, 4F, Hui Yeung Shing Building, Shatin, N.T., Hong Kong SAR, China
- Department of Psychology, The Chinese University of Hong Kong, 3F, Sino Building Shatin, N.T., Hong Kong SAR, China
| | - Elizabeth Tournis
- Department of Audiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL 60611, United States
| | - Maura E Ryan
- Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL 60611, United States
- Department of Medical Imaging, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St,Chicago, IL 60611, United States
| | - Ching Man Lai
- Brain and Mind Institute, The Chinese University of Hong Kong, 4F, Hui Yeung Shing Building, Shatin, N.T., Hong Kong SAR, China
| | - Xiujuan Geng
- Brain and Mind Institute, The Chinese University of Hong Kong, 4F, Hui Yeung Shing Building, Shatin, N.T., Hong Kong SAR, China
| | - Nancy M Young
- Division of Otolaryngology, Ann and Robert H Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL 60611, United States
- Department of Otolaryngology–Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, 676 N St. Clair St, Chicago, IL 60611, United States
- Knowles Hearing Center, Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, Evanston, IL 60208-3540, United States
| | - Patrick C M Wong
- Brain and Mind Institute, The Chinese University of Hong Kong, 4F, Hui Yeung Shing Building, Shatin, N.T., Hong Kong SAR, China
- Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, G/F, Leung Kau Kui Building, Shatin, N.T., Hong Kong SAR, China
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Jenks CM, Hoff SR, Haney J, Tournis E, Thomas D, Young NM. Cochlear Implantation Can Improve Auditory Skills, Language and Social Engagement of Children With Autism Spectrum Disorder. Otol Neurotol 2022; 43:313-319. [PMID: 34935761 PMCID: PMC8843363 DOI: 10.1097/mao.0000000000003463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To review outcomes of cochlear implantation (CI) in children diagnosed with autism spectrum disorder (ASD). STUDY DESIGN Retrospective case review and parent survey. SETTING Tertiary care children's hospital. PATIENTS Thirty children with ASD who underwent CI between 1991 and 2018. Mean age at CI = 3.5 years (0.8-11.8), mean age at diagnosis of ASD = 5.1 years (2.0-15.0) (22/30 diagnosed after CI), mean follow-up = 10.5 years (1.4-21.6). Parents of 7 children returned a survey. INTERVENTION Unilateral or bilateral cochlear implantation. MAIN OUTCOME MEASURES Speech perception; expressive communication mode; educational placement; social engagement; consistency of CI use; parent survey of child behavior change. RESULTS Thirty-three percent of all and 45% of the 22 consistent device users developed measurable open-set speech perception by an average of 4.5 years of device use. Educational placement at last follow-up included 13% mainstreamed without interpreter, 50% Special Education programs, 10% therapeutic residential or day programs, 23% total communication programs, and one home schooled. Spoken language alone was used by 31% and spoken plus sign by 14%, with the remainder using sign alone, augmentative communication devices or no mode of communication. By parent report, 86% showed improvement in social engagement compared to pre-CI. Survey results showed the behaviors most frequently ranked as most affected by CI were communication and attention, while awareness of environment had the lowest (most affected) mean ranking. CONCLUSIONS Findings support a growing body of literature that cochlear implantation has the potential to improve auditory skills, language, and enhance social engagement in some deaf children with autism spectrum disorder.
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Affiliation(s)
- Carolyn M. Jenks
- Department Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine, Northwestern University Feinberg School of Medicine
- Division of Otolaryngology – Head and Neck Surgery, Section of Otology and Ann & Robert H Lurie Children's Hospital of Chicago
| | - Stephen R. Hoff
- Department Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine, Northwestern University Feinberg School of Medicine
- Division of Otolaryngology – Head and Neck Surgery, Section of Otology and Ann & Robert H Lurie Children's Hospital of Chicago
| | - Jennifer Haney
- Department of Children's Services, Ann & Robert H Lurie Children's Hospital of Chicago
| | - Elizabeth Tournis
- Department of Audiology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Denise Thomas
- Department of Audiology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Nancy M. Young
- Department Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine, Northwestern University Feinberg School of Medicine
- Division of Otolaryngology – Head and Neck Surgery, Section of Otology and Ann & Robert H Lurie Children's Hospital of Chicago
- Knowles Hearing Center, Northwestern University School of Communication, Evanston, Illinois
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Hoff S, Ryan M, Thomas D, Tournis E, Kenny H, Hajduk J, Young NM. Safety and Effectiveness of Cochlear Implantation of Young Children, Including Those With Complicating Conditions. Otol Neurotol 2020; 40:454-463. [PMID: 30870355 PMCID: PMC6426352 DOI: 10.1097/mao.0000000000002156] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Determine safety and effectiveness of cochlear implantation of children under age 37 months, including below age 12 months. STUDY DESIGN Retrospective review. SETTING Tertiary care children's medical center. PATIENTS 219 children implanted before age 37 mos; 39 implanted below age 12 mos and 180 ages 12-36 mos. Mean age CI = 20.9 mos overall; 9.4 mos (5.9-11.8) and 23.4 mos (12.1-36.8) for the two age groups, respectively. All but two ≤12 mos (94.9%) received bilateral implants as did 70.5% of older group. Mean follow-up = 5.8 yrs; age last follow-up = 7.5 yrs, with no difference between groups. INTERVENTIONS Cochlear implantation. MAIN OUTCOME MEASURES Surgical and anesthesia complications, measurable open-set speech discrimination, primary communication mode(s). RESULTS Few surgical complications occurred, with no difference by age group. No major anesthetic morbidity occurred, with no critical events requiring intervention in the younger group while 4 older children experienced desaturations or bradycardia/hypotension. Children implanted under 12 mos developed open-set earlier (3.3 yrs vs 4.3 yrs, p ≤ 0.001) and were more likely to develop oral-only communication (88.2% vs 48.8%, p ≤ 0.001). A significant decline in rate of oral-only communication was present if implanted over 24 months, especially when comparing children with and without additional conditions associated with language delay (8.3% and 35%, respectively). CONCLUSIONS Implantation of children under 37 months of age can be done safely, including those below age 12 mos. Implantation below 12 mos is positively associated with earlier open-set ability and oral-only communication. Children implanted after age 24 months were much less likely to use oral communication exclusively, especially those with complex medical history or additional conditions associated with language delay.
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Affiliation(s)
- Stephen Hoff
- Department Otolaryngology-Head & Neck Surgery.,Division of Otolaryngology-Head & Neck Surgery
| | - Maura Ryan
- Department of Medical Imaging.,Department of Medical Imaging, Northwestern University Feinberg School of Medicine
| | | | | | | | - John Hajduk
- Department of Anesthesiology, Ann & Robert H Lurie Children's Hospital of Chicago
| | - Nancy M Young
- Department Otolaryngology-Head & Neck Surgery.,Division of Otolaryngology-Head & Neck Surgery.,Knowles Hearing Center, Northwestern University School of Communication, Chicago, Illinois
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Young NM, Kim FM, Ryan ME, Tournis E, Yaras S. Pediatric cochlear implantation of children with eighth nerve deficiency. Int J Pediatr Otorhinolaryngol 2012; 76:1442-8. [PMID: 22921779 DOI: 10.1016/j.ijporl.2012.06.019] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 06/18/2012] [Accepted: 06/20/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the auditory outcomes of children implanted in an ear with eighth nerve hypoplasia or aplasia and to determine whether preoperative characteristics are predictive of auditory performance achieved. STUDY DESIGN retrospective case review. SETTING tertiary care medical center. PATIENTS ten children implanted in an ear with eighth nerve hypoplasia or aplasia, as determined by high resolution magnetic resonance imaging. MAIN OUTCOME MEASURES Neural response test measurements, detection and speech awareness thresholds, Meaningful Auditory Integration Scale scores, as well as speech perception level achieved. RESULTS Post-implantation, three children demonstrated little to no detection of sound, three had improved detection and awareness of environmental sounds, one developed closed-set speech perception and spoken language, and three developed open-set speech perception and spoken language. No imaging findings appeared related to outcomes. Significantly better implant detection thresholds and Meaningful Auditory Integration Scale scores were found in children who had preoperative aided auditory detection (p's ≤ 0.02-0.05). CONCLUSION Some children with eighth nerve hypoplasia or aplasia may derive significant benefit from a cochlear implant. In our study high resolution magnetic resonance imaging was more sensitive than high resolution computer tomography in detecting neural deficiency. However, no imaging findings were predictive of auditory performance level achieved post-implantation.
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Affiliation(s)
- Nancy M Young
- Section of Otology and Neurotology, Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, United States.
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