Publication: Koklear implantlı çocuklarda P1 latansının incelenmesi
Abstract
1.ÖZET Bu tezin amacı, koklear implantasyon uygulanan çocuklarda santral işitsel sistemin matürasyonunun P1 latansı ile incelenmesi ve erken dönemde uygulanan implantasyon ile normal işiten yaşıtlarının santral işitsel sistemine benzer gelişimler gösterip göstermediğini araştırmaktır. Çalışmaya normal işiten, 9 ay-7 yaş arası (ortalama 4,2 yaş) 19 çocuk ile 1-7 yaş arası implante edilmiş olan 16 çok ileri derecede sensorı-neural işitme kayıplı çocuk dahil edilmiştir. Normal işiten çocuklarda herhangi bir nörolojik, lisan ve otolojik problemin olmaması gözönüne alınmıştır. Koklear implantlı çocuklar 2-11 yaş arasındadır. Koklear implantlı çocuklarda doğuştan işitme kaybı olma ve en az dört aydır implant kullanmış olma şartı aranmıştır. Bilgisayarda işlemlenen / da/ konuşma hecesi kullanılarak verilen uyarana P1 kortikal işitsel uyarılmış cevap kaydedilmiştir. / da/ konuşma hecesinin süresi 200 msn ve uyaranın tekrar sayısı 1.1/ sn olarak ayarlanmıştır. Konuşma uyaranı bir hoparlör ile normal işitenlerin sağ tarafından, implantlıların, implantın olduğu taraftan 45 derece açı ile verilmiştir. Verteks (Cz) noninverting elektrot, alın (Fpz) toprak elektrot, M1/ 2 veya inion (Oz) inverting elektrot olarak belirlenmiştir. Normal işiten çocukların yaşları ve P1 komponentinin latansı arasında anlamlı bir korelasyon olduğu, yaş ilerledikçe P1 latans değerinde kısalma olduğu saptanmıştır. Koklear implantlı çocuklarda yaş ile P1 latansı arasında anlamlı bir ilişki bulunmamıştır. Ancak koklear implant kullanım süresi arttıkça P1 latansında kısalma olduğu belirlenmiştir. Özellikle erken dönemde implante edilmiş çocukların, kısa süreli koklear implant kullanıcısı olmalarına rağmen normal işiten yaşıtlarının latans değerlerine daha hızlı ulaştıkları gözlenmiştir. Elde edilen bulgular, işitsel deprivasyon sonucu santral işitsel sistemde dejenerasyonlar olduğunu, erken dönemde koklear implant uygulamasından sonra kısa sürede P1 latansının normal işiten çocuklarınkine benzer sürede oluştuğunu göstermiştir. 2.
Investigation of P1 Latency in Cochlear Implanted Children The goal of this study was to evaluate central auditory system maturation of the cochlear implanted children and also to determine whether there were similarities in P1 latency between the early implanted children and normal hearing children . Our measure of central auditory function was the latency of the P1 auditory evoked potential, whose generators included auditory thalamocortical areas. 19 normal hearing children, ranging between 9 months - 7 years and 16 implanted children, ranging between 2-11 years were included . The implant age was between 1-7 years.There were no neurological, language and otological problems in normal hearing children. All implanted children had congenital hearing loss and used their implants at least for 4 months. / da/ speech stimuli, was used in measuring P1 latency. Repetition rate was 1.1/ sec and the duration of stimulus was 200 msec. The stimulus was given via loudspeaker with 45 degree angle from the right side of the normal hearing children, and from the implanted side of the implanted children. Cz (Vertex) was non-inverting electrode, Fpz (forehead) was ground electrode and mastoid of the nonimplanted side or Oz (inion) were used for inverting electrode. A significant relationship was found between the age of normal hearing children and P1 latency, as the age increased, P1 latency decreased. There was no significant relationship between the age and the P1 latency in the cochlear implanted children. But there was a relationship between the duration of the implantation and P1 latency, as the duration of implantation increased P1 latency decreased. Our data suggest that the P1 latency showed similarities in the children received implant at an early age as normal hearing children.
Investigation of P1 Latency in Cochlear Implanted Children The goal of this study was to evaluate central auditory system maturation of the cochlear implanted children and also to determine whether there were similarities in P1 latency between the early implanted children and normal hearing children . Our measure of central auditory function was the latency of the P1 auditory evoked potential, whose generators included auditory thalamocortical areas. 19 normal hearing children, ranging between 9 months - 7 years and 16 implanted children, ranging between 2-11 years were included . The implant age was between 1-7 years.There were no neurological, language and otological problems in normal hearing children. All implanted children had congenital hearing loss and used their implants at least for 4 months. / da/ speech stimuli, was used in measuring P1 latency. Repetition rate was 1.1/ sec and the duration of stimulus was 200 msec. The stimulus was given via loudspeaker with 45 degree angle from the right side of the normal hearing children, and from the implanted side of the implanted children. Cz (Vertex) was non-inverting electrode, Fpz (forehead) was ground electrode and mastoid of the nonimplanted side or Oz (inion) were used for inverting electrode. A significant relationship was found between the age of normal hearing children and P1 latency, as the age increased, P1 latency decreased. There was no significant relationship between the age and the P1 latency in the cochlear implanted children. But there was a relationship between the duration of the implantation and P1 latency, as the duration of implantation increased P1 latency decreased. Our data suggest that the P1 latency showed similarities in the children received implant at an early age as normal hearing children.