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Commercially available auditory steady state response (ASSR) systems are widely used to obtain hearing thresholds in the pediatric population objectively. Children are often examined during natural or induced sleep so that the recorded ASSRs are of subcortical origin, the inferior colliculus being often designated as the main ASSR contributor in these conditions. This report presents data from a battery of auditory neurophysiological objective tests obtained in 3 cases of severe brainstem dysfunction in sleeping children. In addition to ASSRs, envelope-following response (EFR) recordings designed to distinguish peripheral (cochlear nerve) from central (brainstem) were recorded to document the effect of brainstem dysfunction on the two types of phase-locked responses., SCOPUS: ar.j, info:eu-repo/semantics/published

Cochlear implant (CI) is the most effective solution for the restoration of hearing function in severe to profound sensorineural hearing loss. The main objective of this PhD thesis is to answer the question: « Does AI-assisted programming of a cochlear implant provide similar or better results than manual programming, with less time investment for the patient and the clinician? ». A first study that was conducted in 4 French-speaking centers in Belgium and in France showed a large variability of CI programming within and between centers. This context supports the use of a tool using artificial intelligence, such as the Fitting to Outcome eXpert® (FOX®). A pilot study on 2 subjects who had limited results with their manually programmed CI showed encouraging benefits. Secondly, FOX® was used on a larger scale in 2 prospective interventional studies. The first study evaluated the benefits of using FOX® in former patients who had been implanted and formerly manually programmed for several years. 89% of the subjects showed better auditory performances (psychoacoustic battery A§E®) with the FOX® map than with the manual map. This significant but not systematic gain is discussed, considering the impact of FOX® as a novelty among other factors. The second study compared the manual and FOX® types of programming in a randomised longitudinal study with a crossover design in newly implanted "naïve" subjects. The crossover design involved each group changing programming type at one year post-activation. The FOX® group achieved better speech test results more rapidly than the manual group and maintained these results at one year post-activation. Due to the crossover, FOX® improved the results of 81% of the patients initially programmed manually. In terms of time gain, the number of programming sessions decreased by 55% over one year in patients initially programmed with FOX® compared to those initially programmed manually. A general discussion and a conclusion nuance the results., L’implant cochléaire (IC) est la solution la plus efficace, en termes de restauration de la fonction auditive, dans le cadre d’une surdité neurosensorielle sévère à profonde. L’objectif principal de cette thèse de doctorat est de répondre à la question : « La programmation d’un implant cochléaire assistée par l’intelligence artificielle donne-t-elle des résultats semblables voire meilleurs que ceux obtenus par la programmation manuelle, avec moins d’investissement en temps pour le patient et le clinicien ? ». Une première étude réalisée auprès de 4 centres francophones en Belgique et en France rend compte de la grande variabilité des programmations d’ICs intra et inter-centres. Ce contexte justifie l’apport d’un outil utilisant l’intelligence artificielle, comme le Fitting to Outcome eXpert® (FOX®). Une étude pilote sur 2 sujets présentant des résultats limités avec leur IC programmé manuellement relève des bénéfices encourageants. Ensuite, FOX® est utilisé à plus grande échelle dans 2 études prospectives interventionnelles. La première évalue son apport chez d’anciens patients implantés et programmés manuellement depuis des années. 89% des sujets présentent de meilleures performances auditives (batterie psychoacoustique A§E®) avec la map FOX® qu’avec la map manuelle. Ce gain significatif mais non systématique se discute, en tenant compte, entre autres, de l’impact du FOX® en tant que nouveauté. La deuxième compare chez de nouveaux sujets implantés « naïfs » les types de programmation, manuelle et FOX®, dans une étude longitudinale randomisée avec un cross-over. Le design cross-over implique que chaque groupe change de type de programmation à un an post-activation. Le groupe FOX® obtient plus rapidement de meilleurs résultats aux tests vocaux que le groupe manuel, résultats qu’il maintient à un an post-activation. Suite au cross-over, FOX® améliore les résultats de 81% patients initialement programmés manuellement. Au niveau du gain de temps, le nombre de sessions d, (BIFA - Sciences biomédicales et pharmaceutiques) -- UCL, 2022