The Application In The Assessment Of Children With Cochlear Implantion By Cortical Auditory Evoked Potential P1-N1-P2

Objectives1. Research of the development of auditory cortical evoked potential latency and peak of P1wave compared normal children with cochlear implants children.2. Analysis of the correlation between the development of P1-N1-P2and speech test point in children after cochlear implants.3. Evaluation of the value of use P1-N1-P2to assessment auditory perception in children after cochlear implant.4. Evaluation of the clinical value of application of P1-N1-P2to assessment the effect of speech rehabilitation in children after cochlear implantation.Methods1. Research objectsNormal children:Xicheng District, Beijing City.10children, among them there were six male and four female, the minimum age is24months, the maximal age is74months, and the mean age is50months.Children with cochlear implant:cochlear implant rehabilitation center, Tongzhou District, Beijing City. There were39children,24male and15female, the minimum age is25months, the maximal age is248months, and the average age is46months. Because7children did not have integrated data, they were excluded from this research. There still were32children,20male and12female, the minimum age is25months, the maximal age is121months, and the average age is59months. They were all paralanguage deafness and did not use the hearing aids before cochlear implantation, the minimums CI age is5months, the maximal CI age is72months, and the average density of speech training is1h/d.2. Experimental and environmental requirementsThe CAEP record by the Australian Hearlab test system, the insulation chamber requires less than30dB SPL,the subjects remain in a vigilant and quiet state.3. Experimental procedure (1)Children wear parietal recording electrode, the ground electrode, the non-surgery ear reference electrode. It was important by watching a silent cartoon to keep alert and quiet state. Open Hearlab test system, selected sound field hearing aid under stimulus intensity of65dB SPL, play stimulus and record the P1wave at the same time observe the status of the children. Each waveform records twice.(2) Questionnaire gets by trained professional audiologistsAsk their parents or guardians to the four kinds of speech audiometry scale, according to the detailed answers of the parents to score. Those including infants and young children meaningful auditory integration of the order of testing (IT-MAIS), Auditory Integration Scale (MAIS) Auditory behavior classification standard (CAP), the parent questionnaire forms of meaningful verbal Scale (MUSS), speech intelligibility grading standards (SIR).4. Statistical analysisThe experimental data were statistical analysis by SPSS17.0.(1) Analysis of the rate of P1derivation under the different stimuli.Application of chi-square and Bonferroni test for statistical analysis for PI derivation under the different stimuli of the CI children, P<0.05was considered statistically.(2) Analysis the correlation of the wearing time and P1latency and amplitude under different stimuli.Application two variables relevance analysis, the children wearing time and P1latency and the amplitude of the correlation analysis, P<0.05was statistically significant.(3) Analysis the correlation of the score of speech test and P1latency and amplitude under different stimuli.Application two variables relevance analysis, the score of speech test and P1latency and the amplitude of the correlation analysis, P<0.05was statistically significant.(4) Analysis of the influence between CI age and P1latency.Application of rank-sum test for statistical analysis for normal children,<42months of CI age and>42months of CI age, P<0.05was statistically significant. The results were show in a simple linear regression analysis.Results1. Analysis of the rate of P1derivation under the different stimuli.When the stimulus for the/M/,/T/,/G/, it application of chi-square and Bonferroni test for statistical analysis for P1derivation of the CI children. P1and N1, P1and P2two groups, P<0.05was statistically significant. It indicates that P1has the most rate of derivation under the different stimuli of the CI children. The P1is the robust wave in CAEP of CI children.2. Analysis the correlation of the wearing time and P1latency and amplitude under different stimuli.When the stimulus for the/M/,/T/,/G/, analysis the correlation of the wearing time and P1latency and amplitude under different stimuli the normal children and cochlear implantation. When the stimulus for the/M/, the correlation coefficient is-0.363,P<0.05was statistically significant; but when the stimulus for the/T/,/G/, P>0.05was not statistically significant, it indicates that the wearing time and P1latency and amplitude has no correlation.3. Analysis the correlation of the score of speech test and P1latency and amplitude under different stimuli.When the stimulus for the/M/,/T/,/G/, it analysis the correlation of the score of speech test and P1latency and amplitude under different stimuli. The amplitude has strong correlation of the score of speech test. The P1latency just has correlation of MUSS、 CAP, has no correlation with MAIS, SIR.4. Analysis of the influence between CI age and P1latency.4.1. When the stimulus for the/M/,the normal children and cochlear implantation in42months children P1latency were112.20±14.57,122.29±13.60, P=0.079; when the stimulus for the/T/, the normal children and cochlear implantation in42months children P1latency were113.30±14.61,119.70±15.44, P=0.421; When the stimulus for the/G/, the normal children with cochlear implantation in42months children P1latency were110.40±12.45,118.71±12.94, P=0.091.4.2. When the stimulus for the/M/, the normal children and cochlear implantation42months in children P1latency were112.20±14.57,133.00±14.55, P=0.006; when the stimulus for the/T/, the normal children and cochlear implantation42months in children P1latency were113.30±14.61,135.20±13.76, P=0.002; When the stimulus for the/G/, the normal children with cochlear implantation in42months children P1latency were110.40±12.45,136.07±14.33, P=0.000.4.3.When the stimulus for the/M/, cochlear implantation in<42months children and>42months in children P1latency were122.29±13.60,133.00±14.55, P=0.006; When the stimulus for the/T/, aged<42months children with aged>42months children P1latency of cochlear implantation were119.70±15.44,135.20±13.76, P=0.002; When the stimulus for the/G/, cochlear implantation in<42months children and>42months in children P1latency were118.71±12.94,136.07±14.33,P=0.000.Conclusions1. In CI children CAEP can be observed three main waves, including P1, N1and P2. ALL of the CI children have P1. The latency and peak of the P1were main measures of Cl-after children.2. Cochlear implant aged<42months’children, the latency of P1close to the normal children.3. To CI children with high speech audiometry results, CAEP was in a prompt development.4. Aged<42months was the best time of cochlear implantation by observing the P1wave latency.5. Test results showed that use of P1for the determination of the effect of rehabilitation and speech perception in children after cochlear implantation has important application value.