First Implant-Induced Changes in Rostral Brainstem Impair Second Implant Outcomes in Sequential Bilateral Cochlear Implant Children With Long Inter-Implant Delay
First Implant-Induced Changes in Rostral Brainstem Impair Second Implant Outcomes in Sequential Bilateral Cochlear Implant Children With Long Inter-Implant Delay
复制标题
首次植入引起的头端脑干变化会损害连续双侧人工耳蜗植入儿童的植入效果
DOI：
10.1097/mao.0000000000002130
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发表时间：
2019
期刊：
影响因子：
2.1
通讯作者：
Yamazaki T
中科院分区：
文献类型：
--
作者：
Kishimoto I;Yamazaki H;Naito Y;Moroto S;Yamazaki T
方法：15例双侧脑梗死患儿（平均值±SD，28.7±12.1 mo）在第二次植入后即刻分别进行第一次和第二次脑梗死（CI 1和CI 2）的电诱发听性脑干反应（EABR）测试。CI 1和CI 2分别在23.7±9.6和53.1±12.1个月（平均值±SD）时植入。比较了CI 1和CI 2侧之间随着植入物使用而降低的电诱发波间III-V潜伏期（eIII-eV斜率）的顶-底差异。结果：CI 2诱发的eIII-eV斜率表现出较CI 1更不成熟的模式。然而，随着植入物间延迟的延长，这一CI 2与CI 1在eIII-eV斜率上的差异降低，表明在第二次植入前，CI 1诱导的支配第二耳的头端脑干成熟。第二次植入时CI 2与CI 1在eIII-eV斜率上的差异较小，与使用CI 2的结果比使用CI 1的结果差相关。结论：在该人群中，长期单侧CI使用诱导了支配第二耳的头端脑干的重组，这影响了使用CI 2的听力结果。在第二次植入时评估eIII-eV斜率可能有助于预测CI 2的听力结果。
Background:In sequential bilateral CI children with long inter-implant delay, both sides of auditory cortices were dominantly activated by the first CI, but mechanisms of this abnormal development of the auditory system remain unclear.Methods:Fifteen sequential bilateral CI children with long delay (mean±SD, 28.7±12.1 mo) underwent electrically evoked auditory brainstem response (EABR) testing using each of the first and second CI (CI1 and CI2, respectively), immediately after the second implantation. CI1 and CI2 were implanted at age of 23.7±9.6 and 53.1±12.1 months (mean±SD), respectively. Apical-to-basal difference in electrically evoked interwave III-V latencies (eIII-eV slope) which decreases with implant use was compared between the CI1 and CI2 sides. Their speech perception scores were evaluated 3 years after the second implantation.Results:eIII-eV slopes evoked by the CI2 showed less mature pattern than those by the CI1. This CI2 versus CI1 difference in eIII-eV slopes, however, reduced as the inter-implant delay was prolonged, suggesting CI1-induced maturation of the rostral brainstem innervating the second ear before the second implantation. The smaller CI2 versus CI1 difference in eIII-eV slopes at the second implantation was correlated to poorer outcomes using the CI2 than the CI1.Conclusions:In this population, long-term unilateral CI use induced re-organization of the rostral brainstem innervating the second ear, which affected hearing outcomes using the CI2. Evaluation of eIII-eV slopes at the second implantation may be useful to predict hearing outcomes with CI2.