title: Spatial hearing in a child with auditory neuropathy spectrum disorder and bilateral cochlear implants.
abstract: OBJECTIVE
  The neural dys-synchrony associated with auditory neuropathy spectrum disorder (ANSD) causes a temporal impairment that could degrade spatial hearing, particularly sound localization accuracy (SLA) and spatial release from masking (SRM). Unilateral cochlear implantation has become an accepted treatment for ANSD but treatment options for the contralateral ear remain controversial. We report spatial hearing measures in a child with ANSD before and after receiving a second cochlear implant (CI).
  
  
  METHODS
  An 11-year-7-month old boy with ANSD and expressive and receptive language delay received a second CI eight years after his first implant.
  
  
  METHODS
  The SLA and SRM were measured four months before sequential bilateral CIs (with the contralateral ear plugged and unplugged), and after nine months using both CIs.
  
  
  RESULTS
  Testing done before the second CI, with the first CI alone, suggested that residual hearing in the contralateral ear contributed to sound localization accuracy, but not word recognition in quiet or noise. Nine-months after receiving a second CI, SLA improved by 12.76° and SRM increased to 3.8-4.2 dB relative to pre-operative performance. Results were compared to published outcomes for children with bilateral CIs.
  
  
  CONCLUSIONS
  The addition of a second CI in this child with ANSD improved spatial hearing.
authors.affiliation: University of Tennessee Health Science Center, Department of Audiology and Speech Pathology, College of Allied Health Sciences, Knoxville, TN 37996-0740, USA. pjohnst1@uthsc.edu
authors.forename: Patti M
authors.initials: PM
authors.lastname: Johnstone
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Yeager
authors.forename: Emily
authors.initials: E
authors.lastname: Noss
mesh_terms: D000161:Acoustic Stimulation; D001299:Audiometry; D001306:Auditory Pathways / Q000503:physiopathology*; D001309:Auditory Threshold; D002648:Child; D002652:Child Behavior; D002663:Child Language; D019929:Cochlear Implantation / Q000295:instrumentation*; D003054:Cochlear Implants; D012048:Correction of Hearing Impairment / Q000295:instrumentation*; D006313:Hearing Loss, Central / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D007805:Language Development Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D008297:Male; D009622:Noise / Q000009:adverse effects; D010470:Perceptual Masking; D019986:Persons with Hearing Disabilities / Q000523:psychology / Q000534:rehabilitation*; D011474:Prosthesis Design; D020127:Recovery of Function; D013017:Sound Localization; D013067:Speech Perception; D013997:Time Factors; D016896:Treatment Outcome