胼胝体部分发育不全的个案研究:听力学意义

L. Skinner, L. Hickson
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引用次数: 3

摘要

本案例研究提出了四年半的听力学观察,测试和听力康复的一个女孩的胼胝体部分发育(ACC)。在6个月大时通过MRI扫描诊断ACC,以消除导致发育迟缓的神经学原因。这个孩子出生时也患有腭裂,并在3岁零3个月时被诊断出患有罗比诺综合征。听力学结果显示,在4年期间,听力阈值有所改善。孩子的眼科医生也报告说,随着时间的推移,孩子的视觉技能有所改善。孩子听力最有趣的方面是单耳听力和双耳听力结果之间的差异。也就是说,当双耳评估时,她经常表现为轻度至中度混合性听力损失,而当单耳评估时,她表现为右耳中度至重度混合性听力损失,左耳重度混合性听力损失。随着时间的推移,单耳和双耳结果之间的差异发生了变化。当双耳听力评估时,听力损失从正常的低频听力下降到轻微的高频听力损失。当单侧评估时,最近的结果显示右耳轻度丧失,左耳中度丧失。这种双耳和单耳结果之间的差异在辅助和非辅助测试中都很明显。对于最近的阈值,双耳结果在四年半中首次与正确的单耳阈值一致。家长报告的儿童听力与双耳临床结果一致。本病例提示听力学家需要(1)仔细监测ACC患儿的听力,(2)获得单耳和双耳听力和辅助阈值结果,(3)将这些患儿的功能能力与客观测试结果进行比较。这个病例确实质疑助听器是否适合ACC患儿。如果认为助听器是合适的,那么应该考虑使用具有压缩特性的助听器。
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A case study of partial agenesis of the corpus callosum: Audiological implications
This case study presents four and a half years of audiological observations, testing and aural habilitation of a female child with a partial agenesis of the corpus callosum (ACC). The ACC was diagnosed by MRI scan performed at 6 months of age to eliminate neurological causes for the developmental delay. This child was also born with a cleft palate and was diagnosed with Robinow Syndrome at 3 years and 3 months of age. The audiological results showed an improvement in hearing thresholds over the 4-year period. The child’s ophthalmologist also reported an improvement in visual skills over time. The most interesting aspect of the child’s hearing was the discrepancy between the monaural and the binaural results. That is, when assessed binaurally she often presented with a mild to moderate mixed loss and, when assessed monaurally, she showed a moderate to severe mixed loss for the right ear and a severe mixed loss for the left ear. Over time, the discrepancy between the monaural and binaural results changed. When assessed binaurally, the loss decreased to normal low frequency hearing sloping to a mild high frequency loss. When assessed monaurally, the most recent results showed a mild loss for the right ear and a moderate loss for the left ear. This discrepancy between binaural and monaural results was evident for both aided and unaided tests. For the most recent thresholds, the binaural results were consistent with the right monaural thresholds for the first time over the four and a half years. Parental reports of the child’s hearing were consistent with the binaural clinical results. This case indicates the need for audiologists to (1) carefully monitor the hearing of children with ACC, (2) obtain monaural and binaural hearing and aided thresholds results, and (3) compare these children’s functional abilities with the objective test results obtained. This case does question whether hearing aids are appropriate for children with ACC. If hearing aids are deemed to be appropriate, then hearing aids with compression characteristics should be considered.
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