Auditory Development in the Fetus and Infant
Auditory Development in the Fetus and Infant
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DOI：
10.1053/j.nainr.2008.10.010
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发表时间：
2008-12-01
期刊：
影响因子：
--
通讯作者：
Browne, Joy V.
中科院分区：
文献类型：
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作者：
Graven, Stanley N.;Browne, Joy V.
胎儿和婴儿的听觉发育需要在妊娠前20周发育的耳朵结构部分，而听觉系统的神经感觉部分主要在妊娠20周后发育。听觉系统在怀孕25周左右开始发挥作用。中耳的耳蜗和颞叶的听觉皮层在听觉系统的发育中起着至关重要的作用。它们都很容易受到新生儿重症监护病房（NICU）环境和护理实践的影响。从怀孕25周到5 - 6个月是听觉系统神经感觉部分发育的关键时期。此时，耳蜗的毛细胞、听神经的轴突和颞叶听觉皮层的神经元被调谐以接收特定频率和强度的信号。与视觉系统不同，听觉系统需要外界的听觉刺激。这需要包含来自环境的演讲、音乐和有意义的声音。早产儿和足月婴儿不能识别或区分背景噪音水平大于60分贝的有意义的声音。背景噪音越强，尤其是低频噪音，能被听到并用来调节耳蜗毛细胞的特定频率（音高）就越少。在新生儿重症监护室或家中持续暴露在嘈杂的背景噪音中会干扰听觉发育，尤其是频率识别。听觉系统（言语和音乐）的初始刺激需要发生在子宫内或新生儿重症监护室，以形成听觉皮层的张力异位柱，并使耳蜗毛细胞发生关键的调谐。控制外界噪音，接触有意义的语音和音乐，保护睡眠和睡眠周期，特别是快速眼动睡眠，对健康的听觉发育至关重要。胎儿在子宫内或新生儿重症监护室的环境和护理实践是听觉系统发育的关键因素。
Auditory development in the fetus and infant entails the structural parts of the ears that develop in the first 20 weeks of gestation, and the neurosensory part of the auditory system develops primarily after 20 weeks' gestational age. The auditory system becomes functional at around 25 weeks' gestation. The cochlea of the middle ear and the auditory cortex in the temporal lobe are most important in the development of the auditory system. They are both easily affected by the environment and care practices in the newborn intensive care unit (NICU). The period from 25 weeks' gestation to 5 to 6 months of age is most critical to the development of the neurosensory part of the auditory system. This is the time when the hair cells of the cochlea, the axons of the auditory nerve, and the neurons of the temporal lobe auditory cortex are tuned to receive signals of specific frequencies and intensities. Unlike the visual system, the auditory system requires outside auditory stimulation. This needs to include speech, music, and meaningful sounds from the environment. The preterm as well as the term infant cannot recognize or discriminate meaningful sounds with background noise levels greater than 60 dB. The more intense the background noise, especially low frequency, the fewer specific frequencies ( pitch) can be heard and used to tune the hair cells of the cochlea. Continuous exposure to loud background noise in the NICU or home will interfere with auditory development and especially frequency discrimination. The initial stimulation of the auditory system (speech and music) needs to occur in utero or in the NICU to develop tonotopic columns in the auditory cortex and to have the critical tuning of the hair cells of the cochlea occur. The control of outside noise, the exposure to meaningful speech sounds and music, and the protection of sleep and sleep cycles, especially rapid eye movement sleep, are essential for healthy auditory development. The environment and care practices for the fetus in utero or the infant in the NICU are critical factors in the development of the auditory system.