Cochlear implant and autism spectrum disorder: a case report / Implante coclear e transtorno do espectro autista: relato de caso

ABSTRACT Autism Spectrum Disorder is not an adverse condition for cochlear implantation, but the goals and expectations about the effects on hearing and language outcomes are different from the group of children without other impairments. The objective of this study was to analyze the development of auditory and oral language skills of a child with autism who underwent early cochlear implantation surgery and was included in an auditory (re)habilitation program using the aural-oral method. There was no benefit from the device for the development of oral language, and the child was referred to another communicative method. After 2 years and 9 months using the cochlear implants, there was little benefit from the use of the device for the development of auditory skills, with the child evolving to recognize only his own name. The patient quit using the device after three years of its activation.

RESUMO O transtorno do espectro autista não é uma contraindicação para o implante coclear, mas as metas e expectativas sobre os efeitos nos resultados da audição e da linguagem são diferentes em relação ao grupo de crianças sem outros comprometimentos. O objetivo deste estudo foi analisar o desenvolvimento das habilidades auditivas e de linguagem falada de uma criança com transtorno do espectro autista submetida precocemente à cirurgia de implante coclear e inserida em um programa de (re)habilitação auditiva no método aurioral. Observou-se que não houve benefício do dispositivo para o desenvolvimento da linguagem falada, tendo a criança sido encaminhada para outro método comunicativo. Em 2 anos e 9 meses de uso do implante coclear, observou-se pouco benefício do uso do dispositivo para o desenvolvimento das habilidades auditivas, havendo a evolução para o reconhecimento somente do próprio nome. A criança deixou de fazer uso dos dispositivos após três anos da ativação.

Hearing Rehabilitation through Bone-Conducted Sound Stimulation: Preliminary Results

Abstract Introduction The bone-anchored hearing aid (BAHA) is a bone conduction system that transmits the sound directly to the inner ear by surpassing the skin impedance and the subcutaneous tissue. It is indicated for patients with mixed, conductive and unilateral sensorineural hearing loss who did not benefit from conventional hearing aids (HAs). Although the benefits from BAHA are well demonstrated internationally, this field still lacks studies in Brazil. Objective To assess the auditory rehabilitation process in BAHA users through audiological, speech perception and tinnitus aspects. Methods Individuals with hearing loss were assessed before and after the implantation. The participants were subjected to pure tone audiometry in free field, functional gain audiometry, speech perception tests, tinnitus handicap inventory (THI) in open format, and to the visual analog scale (VAS). Results It was found that the participants benefited from the use of BAHA. The difference in the performance of the participants before and after the BAHA surgery was significant in terms of hearing acuity. There was no statistically significant difference in the speech perception tests. The tinnitus assessment showed that 80% of the participants scored slight tinnitus severity in THI after using a BAHA. Eighty percent of the participants classified their tinnitus as absent tomild in the VAS after the surgery. Conclusion Based on the results of the current study, we can conclude that the participants improved both the auditory perception and the tinnitus handicap. (AU)

Hearing Rehabilitation through Bone-Conducted Sound Stimulation: Preliminary Results.

Introduction The bone-anchored hearing aid (BAHA) is a bone conduction system that transmits the sound directly to the inner ear by surpassing the skin impedance and the subcutaneous tissue. It is indicated for patients with mixed, conductive and unilateral sensorineural hearing loss who did not benefit from conventional hearing aids (HAs). Although the benefits from BAHA are well demonstrated internationally, this field still lacks studies in Brazil. Objective To assess the auditory rehabilitation process in BAHA users through audiological, speech perception and tinnitus aspects. Methods Individuals with hearing loss were assessed before and after the implantation. The participants were subjected to pure tone audiometry in free field, functional gain audiometry, speech perception tests, tinnitus handicap inventory (THI) in open format, and to the visual analog scale (VAS). Results It was found that the participants benefited from the use of BAHA. The difference in the performance of the participants before and after the BAHA surgery was significant in terms of hearing acuity. There was no statistically significant difference in the speech perception tests. The tinnitus assessment showed that 80% of the participants scored slight tinnitus severity in THI after using a BAHA. Eighty percent of the participants classified their tinnitus as absent to mild in the VAS after the surgery. Conclusion Based on the results of the current study, we can conclude that the participants improved both the auditory perception and the tinnitus handicap.

Analysis of electrically evoked compound action potential of the auditory nerve in children with bilateral cochlear implants / Análise do potencial de ação composto do nervo auditivo evocado eletricamente em crianças usuárias de implante coclear bilateral

ABSTRACT INTRODUCTION: The cochlear implant device has the capacity to measure the electrically evoked compound action potential of the auditory nerve. The neural response telemetry is used in order to measure the electrically evoked compound action potential of the auditory nerve. OBJECTIVE: To analyze the electrically evoked compound action potential, through the neural response telemetry, in children with bilateral cochlear implants. METHODS: This is an analytical, prospective, longitudinal, historical cohort study. Six children, aged 1-4 years, with bilateral cochlear implant were assessed at five different intervals during their first year of cochlear implant use. RESULTS: There were significant differences in follow-up time (p = 0.0082) and electrode position (p = 0.0019) in the T-NRT measure. There was a significant difference in the interaction between time of follow-up and electrode position (p = 0.0143) when measuring the N1-P1 wave amplitude between the three electrodes at each time of follow-up. CONCLUSION: The electrically evoked compound action potential measurement using neural response telemetry in children with bilateral cochlear implants during the first year of follow-up was effective in demonstrating the synchronized bilateral development of the peripheral auditory pathways in the studied population.

RESUMO INTRODUÇÃO: O implante coclear tem a capacidade de medir o potencial de ação composto eletricamente evocado do nervo auditivo (ECAP). Para esta verificação utiliza-se uma medida chamada telemetria de respostas neurais. OBJETIVO: Analisar o potencial de ação composto evocado eletricamente, por meio da neurotelemetria de respostas neurais, em crianças usuárias de implante coclear bilateral. MÉTODO: Trata-se de um estudo analítico, prospectivo, de coorte histórica longitudinal. Foram recrutadas seis crianças, com idades entre de 1-4 anos, usuárias de implante coclear bilateral. Estas crianças foram avaliadas em cinco momentos durante o primeiro ano de uso do implante coclear. RESULTADOS: Houve diferença significativa no tempo de acompanhamento (p = 0,0082) e posição do eletrodo (p = 0,0019) na medida de T-NRT. Houve diferença significativa na interação entre tempo de acompanhamento e posição do eletrodo (p = 0,0143) na medida da amplitude das ondas N1-P1 entre os três eletrodos a cada tempo de acompanhamento. CONCLUSÃO: A mensuração do ECAP por meio da NRT nas crianças com implante coclear bilateral durante o primeiro ano de acompanhamento foi uma medida importante para apresentar o desenvolvimento bilateral da via auditiva periférica de forma sincronizada nesta população estudada.

Analysis of electrically evoked compound action potential of the auditory nerve in children with bilateral cochlear implants.

INTRODUCTION: The cochlear implant device has the capacity to measure the electrically evoked compound action potential of the auditory nerve. The neural response telemetry is used in order to measure the electrically evoked compound action potential of the auditory nerve. OBJECTIVE: To analyze the electrically evoked compound action potential, through the neural response telemetry, in children with bilateral cochlear implants. METHODS: This is an analytical, prospective, longitudinal, historical cohort study. Six children, aged 1-4 years, with bilateral cochlear implant were assessed at five different intervals during their first year of cochlear implant use. RESULTS: There were significant differences in follow-up time (p=0.0082) and electrode position (p=0.0019) in the T-NRT measure. There was a significant difference in the interaction between time of follow-up and electrode position (p=0.0143) when measuring the N1-P1 wave amplitude between the three electrodes at each time of follow-up. CONCLUSION: The electrically evoked compound action potential measurement using neural response telemetry in children with bilateral cochlear implants during the first year of follow-up was effective in demonstrating the synchronized bilateral development of the peripheral auditory pathways in the studied population.

Hearing rehabilitation in cerebral palsy: development of language and hearing after cochlear implantation / Reabilitação auditiva na paralisia cerebral: desenvolvimento da audição e linguagem após implante coclear

INTRODUCTION: Auditory rehabilitation in children with bilateral severe-to-profound sensorineural hearing loss with cochlear implant has been developed in recent decades; however, the rehabilitation of children with cerebral palsy still remains a challenge to otolaryngology and speech therapy professionals. OBJECTIVE: To verify the effectiveness of cochlear implants in the development of auditory and language skills in children with cerebral palsy. METHODS: A prospective analytical study. The evaluation of auditory responses to speech test was applied to the children in this study at regular intervals following implantation. Standardized tests that assess and quantify the development of auditory and language skills were administered and speech therapy video records and speech therapy files were analyzed. All children went through individually tailored intensive audiological rehabilitation programs following cochlear implantation. RESULTS: Two participants had gradual auditory and language development when compared to other participants who reached advanced levels in hearing and oral language classifications. CONCLUSION: The use of the Cochlear implant enabled participants to reach advanced stages of hearing and language skills in three of the five participants with cerebral palsy in this study. This electronic device is a viable therapeutic option for children with cerebral palsy to help them achieve complex levels of auditory and language skills. .

INTRODUÇÃO: A reabilitação auditiva em crianças com deficiência auditiva neurossensorial severa a profunda bilateral com o Implante Coclear foi consagrado nas últimas décadas, contudo, ainda permanece um desafio para a otorrinolaringologia e a fonoaudiologia a reabilitação do portador de paralisia cerebral. OBJETIVO: Verificar a efetividade do Implante Coclear no desenvolvimento das habilidades auditivas e de linguagem em crianças com paralisia cerebral. MÉTODO: Estudo analítico prospectivo. Foram aplicados testes padronizados que avaliam e quantificam o desenvolvimento das habilidades auditivas e de linguagem. Foram analisadas as filmagens das terapias fonoaudiológicas e os registros descritos ao término de cada sessão de terapia. RESULTADOS: As crianças analisadas apresentaram desenvolvimento auditivo e de linguagem satisfatório quando comparado às demais crianças que alcançaram níveis mais complexos nas categorias de audição e evolução significativa no desenvolvimento da linguagem oral. CONCLUSÃO: O uso do Implante Coclear favoreceu o alcance de etapas avançadas das habilidades de audição e linguagem em três das cinco crianças com paralisia cerebral desse estudo. Esse dispositivo eletrônico tem sido uma opção terapêutica viável para que crianças com paralisia cerebral alcancem etapas complexas no que se refere às habilidades auditivas e de linguagem. .

Hearing rehabilitation in cerebral palsy: development of language and hearing after cochlear implantation.

INTRODUCTION: Auditory rehabilitation in children with bilateral severe-to-profound sensorineural hearing loss with cochlear implant has been developed in recent decades; however, the rehabilitation of children with cerebral palsy still remains a challenge to otolaryngology and speech therapy professionals. OBJECTIVE: To verify the effectiveness of cochlear implants in the development of auditory and language skills in children with cerebral palsy. METHODS: A prospective analytical study. The evaluation of auditory responses to speech test was applied to the children in this study at regular intervals following implantation. Standardized tests that assess and quantify the development of auditory and language skills were administered and speech therapy video records and speech therapy files were analyzed. All children went through individually tailored intensive audiological rehabilitation programs following cochlear implantation. RESULTS: Two participants had gradual auditory and language development when compared to other participants who reached advanced levels in hearing and oral language classifications. CONCLUSION: The use of the Cochlear implant enabled participants to reach advanced stages of hearing and language skills in three of the five participants with cerebral palsy in this study. This electronic device is a viable therapeutic option for children with cerebral palsy to help them achieve complex levels of auditory and language skills.