| Objective:Comparison of fractional anisotropy(FA)values of white matter fiber tracts between normal children and children with congenital sensorineural hearing loss(CSNHL)and analyze its influencing factors;Observe the correlation between FA values and the rehabilitation effect of preoperative language communication ability and explore the diagnostic and predictive role of FA value in the auditory speech rehabilitation effect after cochlear implantation.Methods:1.Patients with CSNHL who underwent cochlear implantation in the department of otorhinolaryngology and age-matched normal hearing patients from 2019.09 to2020.01 were collected,and according to the hearing condition of the subjects,they were divided into control group and CSNHL group.2.According to whether the patients were hearing aid or whether they were trained after hearing aid,the patients were divided into three groups in CSNHL group: non-hearing aid group,hearing aid group and hearing aid+language training group.3.The technology of diffusion tensor imaging(DTI)was used to scan the brain region structure images of each subjects.The cellulose microstructure of the standardized white matter was analyzed by using tract-based spatial statistics(TBSS),and the FA values of each white matter fiber tract were obtained.4.The preoperative language communication ability of CSNHL patients at 1,3,6,9 and 12 months after cochlear implantation was evaluated,and the scores of turn-taking,active communication,visual communication and auditory attention were calculated according to the video analysis.5.The critical value of the preoperative language communication ability was defined according to the hearing and speech rehabilitation of the patients after 1 year follow-up,to further explore the role of FA value in diagnosing and predicting the effect of auditory and speech rehabilitation after cochlear implantation by using the Receiver operating characteristic(ROC)curve.Results:1.Compared with the control group,the FA values of bilateral corticospinal tract,bilateral cingulum,forceps major,left superior longitudinal fasciculus,right uncinate fasciculus,bilateral inferior longitudinal fasciculus and bilateral inferior fronto-occipital fasciculus decreased in patientsc with CSNHL,the difference was statistically significant(P < 0.05),among them,the FA values of the right inferior fronto-occipital fasciculus and the right inferior longitudinal fasciculus decreased most significantly.2.The FA values of the right inferior fronto-occipital fasciculus and the right inferior longitudinal fasciculus in the hearing aid group were higher than those in the non-hearing aid group,the difference was statistically significant(P <0.05),while the FA values of the right inferior fronto-occipital fasciculus and the right inferior longitudinal fasciculus in hearing aid+language training group were higher than those in simple hearing aid group,the difference was statistically significant(P <0.05).3.There was a positive correlation between the evaluation scores of preoperative language communication ability and the FA values of right inferior fronto-occipital fasciculus and right inferior longitudinal fasciculus in patientsc with CSNHL at different periods after the start of the artificial cochlea,and the higher the preoperative FA value is,the higher the evaluation scores of indicators of preoperative language communication ability are.4.Diagnostic and prediction for the rehabilitation effect of the turn-taking ability: the minimum diagnostic critical value of FA in the right inferior fronto-occipital fasciculus is 0.232862,the minimum diagnostic critical value of FA in the right inferior longitudinal fasciculus is 0.232507;diagnostic and prediction for the rehabilitation effect of the auditory attention ability:the minimum diagnostic critical value of FA in the right inferior fronto-occipital fasciculus is 0.223798,the minimum diagnostic critical value of FA in the right inferior longitudinal fasciculus is 0.246516.there was no statistical difference in the area under ROC curve(AUC)between right inferior fronto-occipital fasciculus and the right inferior longitudinal fasciculus.That is,there is no significant difference between the right inferior fronto-occipital fasciculus and the right inferior longitudinal fasciculus in diagnosing and predicting the rehabilitation effect of preoperative language communication ability.Conclusions:1.FA values of white matter fiber bundles in patients with CSNHL are generally decreased,the FA value can be used as an index to quantify the changes of central microstructure and can be used to evaluate hearing deprivation.2.Early wearing of hearing aid or simultaneous language training after hearing aid may affect the development and integrity of the white matter microstructures in patients with CSNHL,and reduce the degree of auditory deprivation,to some extent,it may be beneficial to the rehabilitation effect of cochlear implant.3.The FA value may have diagnostic significance in predicting the curative effect of auditory speech rehabilitation after cochlear implantation and the FA value can also be used as a potential index for evaluating the degree of auditory deprivation,it is of certain significance to guide cochlear implant before operation. |
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