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脑的认知功能依赖于外周神经系统的感觉输入 ,在听觉系统中 ,外周听器损伤可以立即导致与损伤程度密切相关的听觉功能障碍 ,从而严重影响言语识别能力。本文所讨论迟发性听觉剥夺效应 (Late onsetanditorydeprivation)与听力损失程度无关。例如 ,对称性听力损失患者如果单耳佩戴助听器 ,一段时间以后 ,助听耳的言语识别能力将得以改善 ,但这种改善并非在佩戴助听器后立即发生 ,因此不能简单归因于听觉放大本身 ,相反 ,非助听耳的言语识别能力却发生与听力损失无关的进一步下降。这种迟发性听觉剥夺效应源于外周信号输入改变后听觉中枢功能的改变 ,是使用依赖性认知功能重塑的结果。但迟发性听觉剥夺效应不会发生在双耳佩戴助听器的患者。本文对多种迟发性听觉剥夺效应的认识发展过程、可逆性以及可能的机制进行了系统回顾分析 ,并对迟发性听觉剥夺效应对助听器佩戴的影响、今后的研究发展方向以及其临床应用价值进行了探讨。
The cognitive function of the brain relies on the sensory input of the peripheral nervous system. In the auditory system, the damage of the peripheral hearing aids can immediately lead to hearing impairment, which is closely related to the degree of injury, thus seriously affecting speech recognition ability. The late on-stage auditory deprivation effect discussed in this article is independent of the degree of hearing loss. For example, hearing loss patients with symmetrical hearing aids wear hearing aids on one ear, hearing aural speech recognition will be improved over time, but this improvement does not occur immediately after wearing hearing aids, and therefore can not simply be attributed to the auditory amplification itself, In contrast, non-auditory aural recognition of speech occurs without any further reduction in hearing loss. This late-onset auditory deprivation is due to changes in auditory central function following changes in peripheral signaling and is a consequence of the use of cognitive-functional remodeling. However, the delayed onset of hearing loss does not occur in patients wearing hearing aids on both ears. This article systematically reviews and analyzes the cognitive development, reversibility and possible mechanisms of various delayed-onset auditory deprivation effects. It also studies the effects of delayed-onset auditory-deprivation on hearing aid wear, future research directions and their clinical applications Value is discussed.