Frequency and intensity discrimination in children with cochlear implants

Nahed Mohamed Negm, Trandil Hassan Elmahalawy, Enaas Ahmad Kolkaila, Mona Ahmed Kotait
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Abstract

Frequency discrimination underlies more complicated auditory activities like speech comprehension and interpretation. However, intensity differences indicate how far apart noises are. This study aimed to evaluate and compare results of frequency modulation and difference limen for intensity in children with cochlear Implants (CI) as well as normal hearing children. This case–control work was performed on 40 children, aged from 5–18 years, divided into two equal groups: a study group with unilateral CI and a control group with normal peripheral hearing. All patients were subjected to otological examination, audiological evaluation, frequency modulation difference limen (FMDL) and difference limen for intensity (DLI) tests. Patients with CI, as compared to normal hearing (NH) subjects, required significantly higher frequencies to discriminate FMDL and DLI respectively (P value = 0.001). At 2000 and 4000 Hz: FMDL had a significant diagnostic power for patients with CI (AUC = 0.980, 0.998 respectively, P < 0.001), at cut off 1.5, with 100% sensitivity and 100% specificity. While, at 4000 Hz: DLI had a significant diagnostic power for patients with CI (AUC = 0.999, P < 0.001), at cut off 1.5, with 100% sensitivity and 100% specificity. A statistically substantial variation was observed among CI and NH children in FMDL and DLI at all frequencies tested. Patients with CI required significantly higher frequencies to discriminate as compared to NH subjects. Frequencies at 2000 Hz and 4000 Hz possess the best specificity and sensitivity of FMDL. While frequency 4000 Hz possess the best specificity and sensitivity of DLI.
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人工耳蜗儿童的频率和强度辨别能力
频率辨别是语音理解和解释等更复杂听觉活动的基础。然而,强度差异表明噪音之间的距离有多远。本研究旨在评估和比较人工耳蜗植入儿童和正常听力儿童的频率调制和强度差异极限的结果。这项病例对照研究的对象是 40 名 5-18 岁的儿童,分为两个相同的小组:单侧 CI 研究组和外周听力正常的对照组。所有患者都接受了耳科检查、听力评估、频率调制差限(FMDL)和强度差限(DLI)测试。与听力正常(NH)的受试者相比,CI 患者分别需要更高的频率来分辨 FMDL 和 DLI(P 值 = 0.001)。在 2000 和 4000 Hz 时:FMDL 对 CI 患者有明显的诊断能力(AUC 分别为 0.980 和 0.998,P < 0.001),截断点为 1.5,灵敏度为 100%,特异度为 100%。而在 4000 Hz 时DLI对CI患者有明显的诊断能力(AUC = 0.999,P < 0.001),在截断点为1.5时,灵敏度为100%,特异性为100%。在所有测试频率下,CI 和 NH 儿童的 FMDL 和 DLI 在统计学上都存在显著差异。与正常儿童相比,CI 患者需要更高的频率来进行分辨。2000赫兹和4000赫兹频率的FMDL特异性和灵敏度最高。而频率为 4000 Hz 的 DLI 具有最佳的特异性和灵敏度。
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