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postgraduate thesis: Central auditory impairment in children with nonsyndromic cleft lip and/or palate

TitleCentral auditory impairment in children with nonsyndromic cleft lip and/or palate
Authors
Advisors
Advisor(s):McPherson, DB
Issue Date2011
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Abstract
Auditory impairment in patients with craniofacial clefts has been well studied for decades. However, most previous research has only focused on middle ear disorders and related auditory consequences in this group. Studies of higher level auditory status and central auditory processing abilities of this group—particularly in children—have been unsystematic and have significant limitations, while the potentially negative impact of central auditory impairment on children should not be ignored. One important area which needs further research is the status of the central auditory nervous system (CANS) in children with non-syndromic cleft lip and/or palate (NSCLP). In order to objectively investigate possible central auditory impairment in children with NSCLP, the present research programme was initiated. Firstly, two major studies aimed to provide anatomical structural analysis and functional evaluation of the auditory structures of CANS in a group of infants with NSCLP, and compare the results to those of normal controls (Studies 1 and 2). Secondly, a pilot study (Study 3) was conducted to provide preliminary data and suggest methodology to support a major, future research programme to comprehensively investigate central auditory processing abilities in children with NSCLP. A multi-disciplinary approach that included brain magnetic resonance image (MRI) scanning, auditory evoked potentials (AEP) recording, and a central behavioural auditory test battery assessment protocol, was applied in the present research programme. Based on the results of the studies and data analysis, it was concluded that: (1) Structural abnormalities of CANS in infants with NSCLP may be primarily located in the left cerebral hemisphere and cortical abnormalities were more marked compared with those in other subcortical locations. The development and maturation of the auditory cortex in infants with NSCLP may be abnormal, compared with that in normal children; (2) Infants with NSCLP might have normal auditory sensory function at brain stem and subcortical levels, yet this group may have significant impaired auditory discriminatory function at cortical level; (3) Children with NSCLP may show normal auditory processing abilities in a quiet listening environment. However, they may be more vulnerable to background noise and have impaired auditory processing abilities in areas such as monaural low redundancy and temporal resolution ability. In summary, combining the results of MRI, AEP and behavioural measurements in the present research programme, it is suggested that children with NSCLP are at potential risk of both structural abnormalities and functional disorders of the CANS, particularly at auditory cortical level. In addition, this group might also be at risk of auditory processing impairments to some degree, particularly in noisy environments. The present research programme has made a contribution to our understanding of the central auditory status of children with NSCLP, which was not systematically investigated in previous studies, and provided information on which to base further research. The research findings should draw the attention of researchers and clinicians to improving auditory assessment and intervention for patients with craniofacial cleft disorders. Further efforts in this field in the long-term may help to develop a more sophisticated audiological evaluation and intervention approach for this population.
DegreeDoctor of Philosophy
SubjectSpeech disorders in children.
Hearing disorders in children.
Cleft lip.
Cleft palate children.
Dept/ProgramSpeech and Hearing Sciences

 

DC FieldValueLanguage
dc.contributor.advisorMcPherson, DB-
dc.contributor.authorYang, Feng, Frank.-
dc.contributor.author杨峰.-
dc.date.issued2011-
dc.description.abstractAuditory impairment in patients with craniofacial clefts has been well studied for decades. However, most previous research has only focused on middle ear disorders and related auditory consequences in this group. Studies of higher level auditory status and central auditory processing abilities of this group—particularly in children—have been unsystematic and have significant limitations, while the potentially negative impact of central auditory impairment on children should not be ignored. One important area which needs further research is the status of the central auditory nervous system (CANS) in children with non-syndromic cleft lip and/or palate (NSCLP). In order to objectively investigate possible central auditory impairment in children with NSCLP, the present research programme was initiated. Firstly, two major studies aimed to provide anatomical structural analysis and functional evaluation of the auditory structures of CANS in a group of infants with NSCLP, and compare the results to those of normal controls (Studies 1 and 2). Secondly, a pilot study (Study 3) was conducted to provide preliminary data and suggest methodology to support a major, future research programme to comprehensively investigate central auditory processing abilities in children with NSCLP. A multi-disciplinary approach that included brain magnetic resonance image (MRI) scanning, auditory evoked potentials (AEP) recording, and a central behavioural auditory test battery assessment protocol, was applied in the present research programme. Based on the results of the studies and data analysis, it was concluded that: (1) Structural abnormalities of CANS in infants with NSCLP may be primarily located in the left cerebral hemisphere and cortical abnormalities were more marked compared with those in other subcortical locations. The development and maturation of the auditory cortex in infants with NSCLP may be abnormal, compared with that in normal children; (2) Infants with NSCLP might have normal auditory sensory function at brain stem and subcortical levels, yet this group may have significant impaired auditory discriminatory function at cortical level; (3) Children with NSCLP may show normal auditory processing abilities in a quiet listening environment. However, they may be more vulnerable to background noise and have impaired auditory processing abilities in areas such as monaural low redundancy and temporal resolution ability. In summary, combining the results of MRI, AEP and behavioural measurements in the present research programme, it is suggested that children with NSCLP are at potential risk of both structural abnormalities and functional disorders of the CANS, particularly at auditory cortical level. In addition, this group might also be at risk of auditory processing impairments to some degree, particularly in noisy environments. The present research programme has made a contribution to our understanding of the central auditory status of children with NSCLP, which was not systematically investigated in previous studies, and provided information on which to base further research. The research findings should draw the attention of researchers and clinicians to improving auditory assessment and intervention for patients with craniofacial cleft disorders. Further efforts in this field in the long-term may help to develop a more sophisticated audiological evaluation and intervention approach for this population.-
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.source.urihttp://hub.hku.hk/bib/B47231841-
dc.subject.lcshSpeech disorders in children.-
dc.subject.lcshHearing disorders in children.-
dc.subject.lcshCleft lip.-
dc.subject.lcshCleft palate children.-
dc.titleCentral auditory impairment in children with nonsyndromic cleft lip and/or palate-
dc.typePG_Thesis-
dc.identifier.hkulb4723184-
dc.description.thesisnameDoctor of Philosophy-
dc.description.thesisleveldoctoral-
dc.description.thesisdisciplineSpeech and Hearing Sciences-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.5353/th_b4723184-
dc.date.hkucongregation2011-

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