Cortical reorganization in children with unilateral sensorineural hearing loss

Schmithorst, Vincent J.; Holland, Scott K.; Ret, Jennifer; Duggins, Angie; Arjmand, Ellis M.; Greinwald, John H.

doi:10.1097/00001756-200504040-00009

Cited by 50 publications

(31 citation statements)

References 23 publications

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“…Similar conclusions were reached by Propst et al (2010), who used fMRI to compare activation of auditory association areas and attention networks in children with severe-profound UHL with those in NH children. They also found significant differences between the effects of left and right UHL, supporting similar earlier findings by Schmithorst et al (2005).…”

Section: Developmental and Physiological Consequences Of Uhlsupporting

confidence: 86%

Potential benefits from cochlear implantation of children with unilateral hearing loss

Boyd

2014

Cochlear Implants International

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Children with acquired UHL are likely to gain similar positive benefits from cochlear implantation as those recently reported in adults (improved localization and better speech understanding in specific noise conditions). However, implantation of children with prelingual UHL is currently problematic as the impact of UHL may not become apparent until the child enters full-time education, by which time outcomes from cochlear implantation may be sub-optimal due to auditory deprivation. Development of appropriate candidacy criteria is important but challenging as criteria may need to be based on real-world hearing difficulties as well as audiological measures.

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Section: Developmental and Physiological Consequences Of Uhlsupporting

confidence: 86%

Potential benefits from cochlear implantation of children with unilateral hearing loss

Boyd

2014

Cochlear Implants International

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“…Pathway reorganization in the brainstem is likely to affect more central areas of the auditory system. Indeed differences in cortical responses, reflecting altered patterns of response, have been shown in both adults and children with unilateral hearing loss (Ponton et al, 2001;Schmithorst et al, 2005). It is possible then that unilateral stimulation from a cochlear implant promotes reorganization of the auditory pathways during a sensitive period in development and that these changes might be difficult to reverse once the sensitive period is over.…”

Section: Introductionmentioning

confidence: 99%

Auditory brainstem activity in children with 9–30 months of bilateral cochlear implant use

2007

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“…[101][102][103][104][105][106][107] The differences from normal were larger when the loss occurred in the right ear compared with the left ear. 103,104,108 More extensive effects, including recruitment of additional cortical areas/networks, were observed in children with unilateral hearing loss, [109][110][111][112][113] in line with the increasing effects found in younger cats 90,91 and the language, cognitive, and educational challenges these children are reported to have (discussed in "Current State of the Problem" section above).Further support for abnormal aural preference comes from children who receive bilateral CIs sequentially. Although expected cortical electrophysiologic responses were measured from the first implanted ear, responses from the second, laterimplanted ear remained abnormal.…”

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confidence: 99%

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

2015

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Deafness affects ∼2 in 1000 children and is one of the most common congenital impairments. Permanent hearing loss can be treated by fitting hearing aids. More severe to profound deafness is an indication for cochlear implantation. Although newborn hearing screening programs have increased the identification of asymmetric hearing loss, parents and caregivers of children with single-sided deafness are often hesitant to pursue therapy for the deaf ear. Delayed intervention has consequences for recovery of hearing. It has long been reported that asymmetric hearing loss/single-sided deafness compromises speech and language development and educational outcomes in children. Recent studies in animal models of deafness and in children consistently show evidence of an "aural preference syndrome" in which singlesided deafness in early childhood reorganizes the developing auditory pathways toward the hearing ear, with weaker central representation of the deaf ear. Delayed therapy consequently compromises benefit for the deaf ear, with slow rates of improvement measured over time. Therefore, asymmetric hearing needs early identification and intervention. Providing early effective stimulation in both ears through appropriate fitting of auditory prostheses, including hearing aids and cochlear implants, within a sensitive period in development has a cardinal role for securing the function of the impaired ear and for restoring binaural/spatial hearing. The impacts of asymmetric hearing loss on the developing auditory system and on spoken language development have often been underestimated. Thus, the traditional minimalist approach to clinical management aimed at 1 functional ear should be modified on the basis of current evidence.Deafness is one of the most common congenital impairments. 1,2 Newborn hearing screening programs, implemented in many countries, have decreased the age at diagnosis of hearing loss. When hearing loss occurs in only 1 ear, the screening result may be overlooked or dismissed as unimportant, particularly when hearing in the opposite ear is normal (unilateral or single-sided deafness). The consequence will be a failure to intervene until long after major developmental effects have set in, which causes significant negative clinical implications. Screening programs will also miss children who acquire deafness in 1 ear from infection, trauma, or worsening of preexisting hearing loss. 3-6 Acquired unilateral deafness can go unidentified until educational, social, or other impairments push families and caregivers to seek medical consult. Because the prevalence of permanent unilateral hearing loss in neonates is reported to vary from 0.45 to 2.7 in 1000 7,8 In this State-of-the-Art Review, we present evidence from basic and applied neuroscience, audiology, and otology that points to the existence of an impairment of the central representation of the poorer hearing ear if developmental asymmetric hearing is left untreated for years. First, we review the current state of the problem as viewed in the clin...

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Cortical reorganization in children with unilateral sensorineural hearing loss

Cited by 50 publications

References 23 publications

Potential benefits from cochlear implantation of children with unilateral hearing loss

Potential benefits from cochlear implantation of children with unilateral hearing loss

Auditory brainstem activity in children with 9–30 months of bilateral cochlear implant use

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

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