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1.
Ear Hear ; 42(2): 364-372, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32769439

RESUMO

OBJECTIVES: Children with hearing loss (HL), in spite of early cochlear implantation, often struggle considerably with language acquisition. Previous research has shown a benefit of rhythmic training on linguistic skills in children with HL, suggesting that improving rhythmic capacities could help attenuating language difficulties. However, little is known about general rhythmic skills of children with HL and how they relate to speech perception. The aim of this study is twofold: (1) to assess the abilities of children with HL in different rhythmic sensorimotor synchronization tasks compared to a normal-hearing control group and (2) to investigate a possible relation between sensorimotor synchronization abilities and speech perception abilities in children with HL. DESIGN: A battery of sensorimotor synchronization tests with stimuli of varying acoustic and temporal complexity was used: a metronome, different musical excerpts, and complex rhythmic patterns. Synchronization abilities were assessed in 32 children (aged from 5 to 10 years) with a severe to profound HL mainly fitted with one or two cochlear implants (n = 28) or with hearing aids (n = 4). Working memory and sentence repetition abilities were also assessed. Performance was compared to an age-matched control group of 24 children with normal hearing. The comparison took into account variability in working memory capacities. For children with HL only, we computed linear regressions on speech, sensorimotor synchronization, and working memory abilities, including device-related variables such as onset of device use, type of device, and duration of use. RESULTS: Compared to the normal-hearing group, children with HL performed poorly in all sensorimotor synchronization tasks, but the effect size was greater for complex as compared to simple stimuli. Group differences in working memory did not explain this result. Linear regression analysis revealed that working memory, synchronization to complex rhythms performances, age, and duration of device use predicted the number of correct syllables produced in a sentence repetition task. CONCLUSION: Despite early cochlear implantation or hearing aid use, hearing impairment affects the quality of temporal processing of acoustic stimuli in congenitally deaf children. This deficit seems to be more severe with stimuli of increasing rhythmic complexity highlighting a difficulty in structuring sounds according to a temporal hierarchy.


Assuntos
Implante Coclear , Implantes Cocleares , Auxiliares de Audição , Perda Auditiva , Percepção da Fala , Criança , Pré-Escolar , Humanos
2.
J Acoust Soc Am ; 150(3): 1934, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34598651

RESUMO

Learning about new sounds is essential for cochlear-implant and normal-hearing listeners alike, with the additional challenge for implant listeners that spectral resolution is severely degraded. Here, a task measuring the rapid learning of slow or fast stochastic temporal sequences [Kang, Agus, and Pressnitzer (2017). J. Acoust. Soc. Am. 142, 2219-2232] was performed by cochlear-implant (N = 10) and normal-hearing (N = 9) listeners, using electric or acoustic pulse sequences, respectively. Rapid perceptual learning was observed for both groups, with highly similar characteristics. Moreover, for cochlear-implant listeners, an additional condition tested ultra-fast electric pulse sequences that would be impossible to represent temporally when presented acoustically. This condition also demonstrated learning. Overall, the results suggest that cochlear-implant listeners have access to the neural plasticity mechanisms needed for the rapid perceptual learning of complex temporal sequences.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Estimulação Acústica , Acústica , Testes Auditivos
3.
J Acoust Soc Am ; 139(4): 1578, 2016 04.
Artigo em Inglês | MEDLINE | ID: mdl-27106306

RESUMO

Temporal pitch perception in cochlear implantees remains weaker than in normal hearing listeners and is usually limited to rates below about 300 pulses per second (pps). Recent studies have suggested that stimulating the apical part of the cochlea may improve the temporal coding of pitch by cochlear implants (CIs), compared to stimulating other sites. The present study focuses on rate discrimination at low pulse rates (ranging from 20 to 104 pps). Two experiments measured and compared pulse rate difference limens (DLs) at four fundamental frequencies (ranging from 20 to 104 Hz) in both CI and normal-hearing (NH) listeners. Experiment 1 measured DLs in users of the (Med-El CI, Innsbruck, Austria) device for two electrodes (one apical and one basal). In experiment 2, DLs for NH listeners were compared for unresolved harmonic complex tones filtered in two frequency regions (lower cut-off frequencies of 1200 and 3600 Hz, respectively) and for different bandwidths. Pulse rate discrimination performance was significantly better when stimulation was provided by the apical electrode in CI users and by the lower-frequency tone complexes in NH listeners. This set of data appears consistent with better temporal coding when stimulation originates from apical regions of the cochlea.


Assuntos
Cóclea/inervação , Implante Coclear/instrumentação , Implantes Cocleares , Pessoas com Deficiência Auditiva/reabilitação , Discriminação da Altura Tonal , Estimulação Acústica/métodos , Adulto , Idoso , Estudos de Casos e Controles , Implante Coclear/métodos , Discriminação Psicológica , Estimulação Elétrica , Feminino , Humanos , Percepção Sonora , Masculino , Pessoa de Meia-Idade , Pessoas com Deficiência Auditiva/psicologia , Fatores de Tempo
4.
Otol Neurotol ; 45(4): 419-425, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38437809

RESUMO

OBJECTIVE: This study aims to analyze the impact of age and other prognostic factors on the success of myringoplasty. STUDY DESIGN: A retrospective case series. SETTINGS: Pediatric ENT department of a tertiary academic center. PATIENTS: Two hundred forty-one children (318 ears) aged 3 to 17 years with tympanic perforation. INTERVENTION: Myringoplasty performed between 2009 and 2019. MAIN OUTCOMES MEASURES: The rate of tympanic closure, perforation recurrence, revision surgery, and audiometric gain were collected. The impact of age and anatomical and surgical factors was analyzed for each procedure. RESULTS: With a mean follow-up time of 1 year, the tympanic closure rate was 87.7%, the perforation recurrence rate was 18.6%, and 16.7% of ears required reoperation. The mean air-bone gap decreased from 21 dB preoperatively to 12 dB postoperatively ( p < 0.0001). We did not find different anatomical and audiometric results for our three groups of patients classified according to age. Audiometric results were associated with the location of the perforation, intraoperative inflammation of the middle ear mucosa, and the surgical technique performed. CONCLUSION: Myringoplasty in children is associated with excellent anatomical and functional results, even in the youngest patients. It can be proposed whatever the child's age if the patients are well selected before giving the indication.


Assuntos
Perfuração da Membrana Timpânica , Humanos , Criança , Estudos Retrospectivos , Resultado do Tratamento , Perfuração da Membrana Timpânica/cirurgia , Miringoplastia/métodos , Membrana Timpânica
5.
Geriatr Psychol Neuropsychiatr Vieil ; 21(1): 9-20, 2023 Mar 01.
Artigo em Francês | MEDLINE | ID: mdl-37115675

RESUMO

INTRODUCTION: Presbycusis is the physiological decrease in hearing due to advancing age and begins well before the sixth decade. These recommendations recall the principles of early diagnosis of presbycusis and the means of optimal rehabilitation as soon as the first symptoms appear. MATERIAL AND METHODS: The recommendations are based on a systematic analysis of the literature carried out by a multidisciplinary group of doctors and audioprosthetists from all over France. They are graded A, B, C or expert opinion according to decreasing level of scientific evidence. RESULTS: The diagnosis of presbycusis is more difficult at the beginning of its evolution but a certain number of tools are available for its early diagnosis and its management in face-to-face or even distance learning. CONCLUSION: In case of a clinical profile suggestive of presbycusis in a young subject, especially if there are several family cases, it is recommended to propose a genetic investigation. It is recommended to perform free-field speech audiometry in noise to measure intelligibility in an environment as close as possible to reality. Questionnaires can be used in addition to audiometry to best assess the patient's disability. It is recommended that hearing rehabilitation with a hearing aid or cochlear implant may slow or prevent cognitive decline. Combined auditory and cognitive rehabilitation should be offered regardless of the time elapsed since the fitting. It is recommended to integrate programs accessible via smartphones, tablets or the Internet, integrating different training domains in addition to face-to-face sessions.


Assuntos
Audiologia , Geriatria , Otolaringologia , Presbiacusia , Humanos , Idoso , Presbiacusia/terapia , Presbiacusia/reabilitação , Cognição
6.
Artigo em Inglês | MEDLINE | ID: mdl-37170803

RESUMO

INTRODUCTION: Presbycusis is the physiological decrease in hearing due to advancing age and begins well before the sixth decade. These recommendations recall the principles of early diagnosis of presbycusis and the means of optimal rehabilitation as soon as the first symptoms appear. MATERIAL AND METHODS: The recommendations are based on a systematic analysis of the literature carried out by a multidisciplinary group of ENT physicians, audiologists, geriatricians and hearing specialists from all over France. They are classified as grade A, B, C or professional agreement according to a decreasing level of scientific evidence. RESULTS: The diagnosis of presbycusis is more difficult at the beginning of its evolution but a certain number of tools are available for its early diagnosis and its face-to-face or remote management. CONCLUSION: In the case of a clinical profile suggestive of presbycusis in a young subject, especially if there are several family cases, it is recommended to propose a genetic investigation. Free-field speech audiometry in noise is recommended to measure intelligibility in a realistic environment. Questionnaires in addition to audiometric tests would allow the best assessment of the patient's disability. Hearing rehabilitation with a hearing aid or cochlear implant may slow or prevent cognitive decline. Combined auditory and cognitive rehabilitation should be offered regardless of the time since the hearing was fitting. It is recommended to integrate programs accessible via smartphones, tablets or the Internet, that include different training domains to complement face-to-face sessions.

7.
Cognition ; 222: 105009, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34999437

RESUMO

Early sensory deprivation allows assessing the extent of reorganisation of cognitive functions, well beyond sensory processing. As such, it is a good model to explore the links between sensory experience and cognitive functions. One of these functions, statistical learning - the ability to extract and use regularities present in the environment - is suspected to be impaired in prelingually deaf children with a cochlear implant. However, empirical evidence supporting this claim is very scarce and studies have reported contradictory results. This might be because previous studies have tested statistical learning only in the visual modality and did not make clear distinctions between multiple types of statistical regularities. To overcome these problems, we designed a modified serial reaction time task where cochlear implanted children and normal hearing children had to react to auditory sequences that embed multiple statistical regularities, namely transition probabilities of 0th, 1st or 2nd order. We compared the reaction times of the children with the output of a simple computational model that learns transition probabilities. First, 6-12 years old children were able to learn 0th and 1st order transition probabilities but not 2nd order ones. Second, there were no differences between cochlear implanted children and their normal hearing peers. These results indicate that auditory statistical learning is preserved in congenitally deaf children with cochlear implants. This suggests in turn that early auditory deprivation might not be crucially detrimental for the normal development of statistical learning.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Criança , Implante Coclear/métodos , Cognição , Humanos , Aprendizagem
8.
Int J Pediatr Otorhinolaryngol ; 160: 111244, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35853402

RESUMO

OBJECTIVES: There is a lack of consensus regarding the definition, consequences, and management of mild bilateral hearing loss in children. The objective of this study is to analyze the benefit of hearing aids in children with mild bilateral hearing loss by evaluating their functional hearing. METHODS: This retrospective study included 57 children with mild bilateral hearing loss between 20 dB HL and 40 dB HL. Pure tone and speech audiometry thresholds were assessed with and without hearing aids. Two groups were subsequently formed: group E with an effective use of hearing aids (>10 h/day), and group IE whose use of hearing aids was deemed ineffective (<10 h/day). RESULTS: Without hearing aids, the initial median of hearing level was 35 dB HL and 36 dB HL in the right and left ears, respectively, compared to 23 dB HL and 25 dB HL with hearing aids. The Lafon test performed on 25 children at 55 dB HL and 65 dB HL showed results ranging from 0% to 100% without hearing aids and from 90% to 100% with hearing aids. Scores obtained with hearing aids were significantly higher than those without them at an average speech level. Median age at diagnosis and at prescription were found to significantly influence the daily use of hearing aids. CONCLUSIONS: Our results show that in the case of mild bilateral hearing loss, hearing aids have positive effects on the functional hearing of children and help them to no longer be disadvantaged. This study highlights the need to provide regular support to these children to ensure their optimal care in the event of hearing-related problems. Coordination between the different professionals working with these children is also necessary for their follow-up and appropriate management.


Assuntos
Surdez , Auxiliares de Audição , Perda Auditiva Neurossensorial , Percepção da Fala , Audiometria de Tons Puros , Criança , Perda Auditiva Bilateral/diagnóstico , Perda Auditiva Bilateral/terapia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/terapia , Humanos , Estudos Retrospectivos
9.
Rev Prat ; 61(4): 491-4, 2011 Apr.
Artigo em Francês | MEDLINE | ID: mdl-21548227

RESUMO

The hearing disorders of the child between 3 and 12 years are dominated by the conductive hearing loss. The questioning, looking for risk factors, as well as the otoscopy are essential to detect and diagnose a hearing disorder. Screening tests help to identify the children with risk of hearing loss. Then, the child is sent for diagnosis towards an ENT specialist or a specialized structure. In spite of the frequency of the conductive hearing loss, in case of the slightest doubt, a sensorineural hearing loss must be always looked for by a puretone audiometry examination via the headphones.


Assuntos
Transtornos da Audição/diagnóstico , Criança , Pré-Escolar , Testes Auditivos , Humanos , Otoscopia
10.
Hear Res ; 403: 108176, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33524792

RESUMO

While electrically-evoked auditory brainstem response (eABR) thresholds for low-rate pulse trains correlate well with behavioral thresholds measured at the same rate, the correlation is much weaker with behavioral thresholds measured at high rates, such as used clinically. This implies that eABRs to low-rate stimuli cannot be reliably used for objective programming of threshold levels in cochlear implant (CI) users. Here, we investigate whether the use of bunched-up pulses (BUPS), consisting of groups of closely-spaced pulses may be used as an alternative stimulus. Experiment 1 measured psychophysical detection thresholds for several stimuli having a period of 32 ms in nine CI subjects implanted with a Med-EL device. The stimuli differed in the number of pulses present in each period (from 1 to 32), the pulse rate within period (1000 pps and as high as possible for BUPS) and the electrode location (apical or basal). The correlation between psychophysical thresholds obtained for a high-rate (1000 pps) clinical stimulus and for the BUPS stimuli increased as the number of pulses per period of BUPS increased from 1 to 32. This first psychophysical experiment suggests that the temporal processes affecting the threshold of clinical stimuli are also present for BUPS. Experiment 2 measured eABRs on the apical electrode of eight CI subjects for BUPS having 1, 2, 4, 8, 16 or 32 pulses per period. For most subjects, wave V was visible for BUPS having up to 16 pulses per period. The latency of wave V at threshold increased as a function of the number of pulses per period, suggesting that the eABR reflects the integration of multiple pulses at such low levels or that the neural response to each individual pulse increases along the sequence due to facilitation processes. There was also a strong within-subject correlation between electrophysiological and behavioral thresholds for the different BUPS stimuli. This demonstrates that the drop in behavioral threshold obtained when increasing the number of pulses per period of the BUPS can be measured electrophysiologically using eABRs. In contrast, the across-subject correlation between eABR thresholds for BUPS and clinical thresholds remained relatively weak and did not increase with the number of pulses per period. Implications of the use of BUPS for objective programming of CIs are discussed.


Assuntos
Implante Coclear , Implantes Cocleares , Limiar Auditivo , Estimulação Elétrica , Potenciais Evocados Auditivos do Tronco Encefálico , Frequência Cardíaca , Humanos
11.
Ann Otol Rhinol Laryngol ; 119(8): 501-5, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20860274

RESUMO

OBJECTIVES: We describe and evaluate the process of fixation of the Digisonic SP cochlear implant with two titanium screws. METHODS: The characteristics of this implant allow cochlear implantation using a minimal incision, a subperiosteal pocket, and fixation with two titanium screws, without drilling a custom-fitted seat or creating suture-retaining holes in the skull. The fixation system relies on two tailfins for use of osseo-integratable screws, incorporated into the cochlear implant housing. The first version of this fixation system was modified after a case of device migration: the size of the titanium insert inside the silicone tailfin was increased. Data on 156 patients (8 months to 86 years of age) from a 4-year period in 6 cochlear implantation centers were retrospectively evaluated. Ten patients have undergone bilateral implantation. RESULTS: Of 166 implantations, 4 postoperative infections and 1 device failure after head trauma were reported. No cerebrospinal fluid leaks or epidural hematomas were reported. One device migration was observed in the first series; no device migrations occurred in the second series. CONCLUSIONS: The fixation system with screws embedded in the Digisonic SP involves a fast and simple surgical technique that seems to efficiently prevent implant migration.


Assuntos
Parafusos Ósseos , Implante Coclear/instrumentação , Implantes Cocleares , Perda Auditiva/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Implante Coclear/efeitos adversos , Estudos de Coortes , Desenho de Equipamento , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/etiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Falha de Prótese , Estudos Retrospectivos , Fatores de Risco , Titânio , Resultado do Tratamento , Adulto Jovem
12.
J Speech Lang Hear Res ; 62(9): 3234-3247, 2019 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-31433722

RESUMO

Purpose In this study, we investigate temporal adaptation capacities of children with normal hearing and children with cochlear implants and/or hearing aids during verbal exchange. We also address the question of the efficiency of a rhythmic training on temporal adaptation during speech interaction in children with hearing loss. Method We recorded electroencephalogram data in children while they named pictures delivered on a screen, in alternation with a virtual partner. We manipulated the virtual partner's speech rate (fast vs. slow) and the regularity of alternation (regular vs. irregular). The group of children with normal hearing was tested once, and the group of children with hearing loss was tested twice: once after 30 min of auditory training and once after 30 min of rhythmic training. Results Both groups of children adjusted their speech rate to that of the virtual partner and were sensitive to the regularity of alternation with a less accurate performance following irregular turns. Moreover, irregular turns elicited a negative event-related potential in both groups, showing a detection of temporal deviancy. Notably, the amplitude of this negative component positively correlated with accuracy in the alternation task. In children with hearing loss, the effect was more pronounced and long-lasting following rhythmic training compared with auditory training. Conclusion These results are discussed in terms of temporal adaptation abilities in speech interaction and suggest the use of rhythmic training to improve these skills of children with hearing loss.


Assuntos
Adaptação Fisiológica , Implantes Cocleares , Auxiliares de Audição , Perda Auditiva/fisiopatologia , Perda Auditiva/terapia , Percepção da Fala , Criança , Feminino , Humanos , Masculino , Fatores de Tempo
13.
Int Tinnitus J ; 13(2): 157-8, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18229797

RESUMO

Palatal myoclonus is an uncommon, rhythmic, "shock-like" involuntary movement of the muscles of the soft palate, throat, and other structures derived from the branchial arcs. Objective tinnitus is frequently neglected in review articles about childhood tinnitus. Our aim was to present the case of a 7-year-old girl with bilateral objective tinnitus due to palatal myoclonus without hearing impairment (normal hearing thresholds between 250 Hz and 8 kHz) but with otherwise normal hearing thresholds (250 Hz-8 kHz) and no evidence of intracerebral or systemic disorders. No treatment was useful.


Assuntos
Mioclonia/complicações , Mioclonia/diagnóstico , Zumbido/complicações , Zumbido/diagnóstico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Índice de Gravidade de Doença
14.
Rev Prat ; 57(16): 1796-800, 2007 Oct 31.
Artigo em Francês | MEDLINE | ID: mdl-18092723

RESUMO

The anatomical characteristic of the pediatric larynx allows physicians to better understand the incidence of symptomatic and severe presentations of acute laryngitis, which are frequent pediatric emergencies. Subglottis laryngitis and epiglottitis must be distinguished from each other. These two diseases are absolutely different: the first one is essentially viral and usually moderate, even though acute respiratory distress can occur. The other (epiglottitis) is bacterial, essentially caused by Haemophilus influenza B (Hi-B), and can be life threatening. The anti Hi-B vaccine leads to a decrease of frequency but does not make them disappear. Moreover, even if a child has a history of the Hi-B vaccine, diagnosis of epiglottitis can not to be ruled out. Lastly, in case of acute laryngeal dyspnea in a child, one must think about a foreign body.


Assuntos
Epiglotite/diagnóstico , Laringite/diagnóstico , Doença Aguda , Diagnóstico Diferencial , Dispneia/diagnóstico , Epiglotite/microbiologia , Corpos Estranhos/diagnóstico , Infecções por Haemophilus/diagnóstico , Vacinas Anti-Haemophilus , Haemophilus influenzae tipo b , Humanos , Laringite/virologia , Laringe/anatomia & histologia
15.
J Assoc Res Otolaryngol ; 18(3): 513-527, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28138791

RESUMO

Most cochlear implants (CIs) activate their electrodes non-simultaneously in order to eliminate electrical field interactions. However, the membrane of auditory nerve fibers needs time to return to its resting state, causing the probability of firing to a pulse to be affected by previous pulses. Here, we provide new evidence on the effect of pulse polarity and current level on these interactions. In experiment 1, detection thresholds and most comfortable levels (MCLs) were measured in CI users for 100-Hz pulse trains consisting of two consecutive biphasic pulses of the same or of opposite polarity. All combinations of polarities were studied: anodic-cathodic-anodic-cathodic (ACAC), CACA, ACCA, and CAAC. Thresholds were lower when the adjacent phases of the two pulses had the same polarity (ACCA and CAAC) than when they were different (ACAC and CACA). Some subjects showed a lower threshold for ACCA than for CAAC while others showed the opposite trend demonstrating that polarity sensitivity at threshold is genuine and subject- or electrode-dependent. In contrast, anodic (CAAC) pulses always showed a lower MCL than cathodic (ACCA) pulses, confirming previous reports. In experiments 2 and 3, the subjects compared the loudness of several pulse trains differing in current level separately for ACCA and CAAC. For 40 % of the electrodes tested, loudness grew non-monotonically as a function of current level for ACCA but never for CAAC. This finding may relate to a conduction block of the action potentials along the fibers induced by a strong hyperpolarization of their central processes. Further analysis showed that the electrodes showing a lower threshold for ACCA than for CAAC were more likely to yield a non-monotonic loudness growth. It is proposed that polarity sensitivity at threshold reflects the local neural health and that anodic asymmetric pulses should preferably be used to convey sound information while avoiding abnormal loudness percepts.


Assuntos
Limiar Auditivo , Implantes Cocleares , Percepção Sonora , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade
16.
J Assoc Res Otolaryngol ; 18(3): 495-512, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28224320

RESUMO

Electrical stimulation of auditory nerve fibers using cochlear implants (CI) shows psychophysical forward masking (pFM) up to several hundreds of milliseconds. By contrast, recovery of electrically evoked compound action potentials (eCAPs) from forward masking (eFM) was shown to be more rapid, with time constants no greater than a few milliseconds. These discrepancies suggested two main contributors to pFM: a rapid-recovery process due to refractory properties of the auditory nerve and a slow-recovery process arising from more central structures. In the present study, we investigate whether the use of different maskers between eCAP and psychophysical measures, specifically single-pulse versus pulse train maskers, may have been a source of confound.In experiment 1, we measured eFM using the following: a single-pulse masker, a 300-ms low-rate pulse train masker (LTM, 250 pps), and a 300-ms high-rate pulse train masker (HTM, 5000 pps). The maskers were presented either at same physical current (Φ) or at same perceptual (Ψ) level corresponding to comfortable loudness. Responses to a single-pulse probe were measured for masker-probe intervals ranging from 1 to 512 ms. Recovery from masking was much slower for pulse trains than for the single-pulse masker. When presented at Φ level, HTM produced more and longer-lasting masking than LTM. However, results were inconsistent when LTM and HTM were compared at Ψ level. In experiment 2, masked detection thresholds of single-pulse probes were measured using the same pulse train masker conditions. In line with our eFM findings, masked thresholds for HTM were higher than those for LTM at Φ level. However, the opposite result was found when the pulse trains were presented at Ψ level.Our results confirm the presence of slow-recovery phenomena at the level of the auditory nerve in CI users, as previously shown in animal studies. Inconsistencies between eFM and pFM results, despite using the same masking conditions, further underline the importance of comparing electrophysiological and psychophysical measures with identical stimulation paradigms.


Assuntos
Potenciais de Ação , Adaptação Fisiológica , Implantes Cocleares , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Hear Res ; 353: 8-16, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28759745

RESUMO

Hearing loss is known to impact brain function. The aim of this study was to characterize cerebral metabolic Positron Emission Tomography (PET) changes in elderly patients fulfilling criteria for cochlear implant and investigate the impact of hearing loss on functional connectivity. Statistical Parametric Mapping-T-scores-maps comparisons of 18F-FDG-PET of 27 elderly patients fulfilling criteria for cochlear implant for hearing loss (best-aided speech intelligibility lower or equal to 50%) and 27 matched healthy subjects (p < 0.005, corrected for volume extent) were performed. Metabolic connectivity was evaluated through interregional correlation analysis. Patients were found to have decreased metabolism within the right associative auditory cortex, while increased metabolism was found in prefrontal areas, pre- and post-central areas, the cingulum and the left inferior parietal gyrus. The right associative auditory cortex was integrated into a network of increased metabolic connectivity that included pre- and post-central areas, the cingulum, the right inferior parietal gyrus, as well as the striatum on both sides. Metabolic values of the right associative auditory cortex and left inferior parietal gyrus were positively correlated with performance on neuropsychological test scores. These findings provide further insight into the reorganization of the connectome through sensory loss and compensatory mechanisms in elderly patients with severe hearing loss.


Assuntos
Vias Auditivas/diagnóstico por imagem , Mapeamento Encefálico/métodos , Córtex Cerebral/diagnóstico por imagem , Surdez/diagnóstico por imagem , Metabolismo Energético , Fluordesoxiglucose F18/administração & dosagem , Audição , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos/administração & dosagem , Percepção da Fala , Adaptação Fisiológica , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/metabolismo , Envelhecimento/psicologia , Vias Auditivas/metabolismo , Vias Auditivas/fisiopatologia , Estudos de Casos e Controles , Córtex Cerebral/metabolismo , Córtex Cerebral/fisiopatologia , Surdez/metabolismo , Surdez/fisiopatologia , Surdez/psicologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Inteligibilidade da Fala
18.
Ann Otol Rhinol Laryngol ; 115(5): 346-9, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16739665

RESUMO

We report a technique for surgical repair of laryngotracheoesophageal clefts from type II to IV through an anterior approach that involves performing a tracheoesophagoplasty with two overlapping flaps (TEP-TOF). We offer a technical description, a retrospective study, and a review of the literature. Ten children were operated on for laryngotracheoesophageal clefts of types II, III, or IV of the Benjamin and Inglis classification by the TEP-TOF procedure. After a median follow-up of 58 months (2 months to 12 years), neither complications nor recurrences were observed. All surgical details of the TEP-TOF procedure, including the approach, the kind of sutures, the method of creating the flaps, and the preoperative and postoperative management, are discussed and compared with the data found in the literature.


Assuntos
Anormalidades Múltiplas/cirurgia , Esôfago/anormalidades , Cartilagens Laríngeas/anormalidades , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Traqueia/anormalidades , Pré-Escolar , Esôfago/cirurgia , Feminino , Seguimentos , Humanos , Lactente , Cartilagens Laríngeas/cirurgia , Masculino , Traqueia/cirurgia , Resultado do Tratamento
19.
Hear Res ; 337: 89-95, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27240480

RESUMO

UNLABELLED: While the positive benefits of pediatric cochlear implantation on language perception skills are now proven, the heterogeneity of outcomes remains high. The understanding of this heterogeneity and possible strategies to minimize it is of utmost importance. Our scope here is to test the effects of an auditory training strategy, "sound in Hands", using playful tasks grounded on the theoretical and empirical findings of cognitive sciences. Indeed, several basic auditory operations, such as auditory scene analysis (ASA) are not trained in the usual therapeutic interventions in deaf children. However, as they constitute a fundamental basis in auditory cognition, their development should imply general benefit in auditory processing and in turn enhance speech perception. The purpose of the present study was to determine whether cochlear implanted children could improve auditory performances in trained tasks and whether they could develop a transfer of learning to a phonetic discrimination test. MATERIAL AND METHODS: Nineteen prelingually unilateral cochlear implanted children without additional handicap (4-10 year-olds) were recruited. The four main auditory cognitive processing (identification, discrimination, ASA and auditory memory) were stimulated and trained in the Experimental Group (EG) using Sound in Hands. The EG followed 20 training weekly sessions of 30 min and the untrained group was the control group (CG). Two measures were taken for both groups: before training (T1) and after training (T2). RESULTS: EG showed a significant improvement in the identification, discrimination and auditory memory tasks. The improvement in the ASA task did not reach significance. CG did not show any significant improvement in any of the tasks assessed. Most importantly, improvement was visible in the phonetic discrimination test for EG only. Moreover, younger children benefited more from the auditory training program to develop their phonetic abilities compared to older children, supporting the idea that rehabilitative care is most efficient when it takes place early on during childhood. These results are important to pinpoint the auditory deficits in CI children, to gather a better understanding of the links between basic auditory skills and speech perception which will in turn allow more efficient rehabilitative programs.


Assuntos
Percepção Auditiva , Implantes Cocleares , Surdez/reabilitação , Surdez/cirurgia , Percepção da Fala , Adolescente , Adulto , Criança , Pré-Escolar , Implante Coclear , Cognição , Feminino , Humanos , Desenvolvimento da Linguagem , Aprendizagem , Masculino , Pessoa de Meia-Idade
20.
Neuropsychologia ; 89: 57-65, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27263123

RESUMO

The development of the phoneme inventory is driven by the acoustic-phonetic properties of one's native language. Neural representation of speech is known to be shaped by language experience, as indexed by cortical responses, and recent studies suggest that subcortical processing also exhibits this attunement to native language. However, most work to date has focused on the differences between tonal and non-tonal languages that use pitch variations to convey phonemic categories. The aim of this cross-language study is to determine whether subcortical encoding of speech sounds is sensitive to language experience by comparing native speakers of two non-tonal languages (French and English). We hypothesized that neural representations would be more robust and fine-grained for speech sounds that belong to the native phonemic inventory of the listener, and especially for the dimensions that are phonetically relevant to the listener such as high frequency components. We recorded neural responses of American English and French native speakers, listening to natural syllables of both languages. Results showed that, independently of the stimulus, American participants exhibited greater neural representation of the fundamental frequency compared to French participants, consistent with the importance of the fundamental frequency to convey stress patterns in English. Furthermore, participants showed more robust encoding and more precise spectral representations of the first formant when listening to the syllable of their native language as compared to non-native language. These results align with the hypothesis that language experience shapes sensory processing of speech and that this plasticity occurs as a function of what is meaningful to a listener.


Assuntos
Mapeamento Encefálico , Encéfalo/fisiologia , Idioma , Percepção da Fala/fisiologia , Fala/fisiologia , Estimulação Acústica , Adolescente , Adulto , Análise de Variância , Estudos de Casos e Controles , Comparação Transcultural , Eletroencefalografia , Feminino , Análise de Fourier , Humanos , Masculino , Adulto Jovem
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