单侧人工耳蜗植入学龄前耳聋儿童听觉言语康复效果影响因素分析

The Infulence of Factors on Auditory and Speech Performances in Preschool Children with Unilateral Cochlear Implantation

陈默;王朝燕;张智雯;伍伟景;谢鼎华;肖自安;

1:中南大学湘雅二医院耳鼻咽喉头颈外科

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摘要

目的探讨学龄前耳聋儿童单侧人工耳蜗植入(cochlear implantation,CI)后早期康复效果的影响因素。方法对行单侧人工耳蜗植入术且在听觉言语康复机构按照中国残联聋康中心标准进行听觉言语康复1年以上的165例双耳极重度感音神经性聋患儿进行听觉行为分级(categories of auditory performance,CAP)、言语可懂度分级(speech intelligibility rating,SIR)评估,分析性别、植入年龄、基因突变类型、助听器佩戴经验以及内耳畸形与康复效果的关系。结果经过多因素回归分析,植入年龄、基因突变与CI儿童的CAP、SIR得分增长相关(P<0.05),而性别、助听器佩戴史及内耳畸形(大前庭水管综合症)与CAP、SIR得分增长无关(P<0.05)。13岁组CAP提高速度最快,2、3、4岁组SIR增长速度最快;GJB2基因突变致聋的CI儿童康复12个月后的CAP、SIR得分均高于非GIB2突变者。结论植入年龄为13岁组CAP提高速度最快,2、3、4岁组SIR增长速度最快;GJB2基因突变致聋的CI儿童康复12个月后的CAP、SIR得分均高于非GIB2突变者。结论植入年龄为13岁者早期听觉康复速度较快,植入年龄为23岁者早期听觉康复速度较快,植入年龄为24岁者早期言语能力发育速度较快;GJB2突变致聋的儿童人工耳蜗植入后听觉言语康复效果更优;大前庭水管综合症患儿人工耳蜗植入效果与非大前庭水管患儿相同。

关键词

人工耳蜗植入;学龄前儿童;康复

基金项目(Foundation):

作者

陈默;王朝燕;张智雯;伍伟景;谢鼎华;肖自安;

参考文献

1刘军.人工耳蜗植入的效果评估[J].中华耳科学杂志,2007,5:21.

2 Archbold S,Lutman ME,Marshall DH.Categories of auditory performance[J].Ann Otol Rhinol Laryngo,1995,166(Suppl):312.

3 Allen MC,Nikolopoulos TP,O’Donoghue GM.Speech intelligibility in children after cochear implantation[J].Am J Otol,1998,19:742.

4 McConkey Robbins A,Koch DB,Osberger MJ,et al.Effect of age at cochlear implantation on auditory skill development in infants and toddlers[J].Arch Otolaryngol Head Neck Surg,2004:130:570.

5 Anderson I,Weichbold V,D'Haese PS,et al.Cochlear implantation in children under the age of two--what do the outcomes show us[J]?Int J Pediatr Otorhinolaryngol,2004,68:425.

6 Myung-Whan S,Eung KC,Bong JK,et al.Long term outcomes of early cochlear implantation in Korea[J].Clinical and Experimental Otorhinolaryngology,2009,2:120.

7 颜玉君,李蕴,杨涛,等.GJB2及SLC26A4基因突变患儿耳蜗植入效果分析[J].中华耳科学杂志,2011,9:163.

8 Ko HC,Liu TC,Lee LA,et al.Timing of surgical intervention with cochlear implant in patients with large vestibular aqueduct syndrome[J].PLoS One,2013,8:e81568.

9 Martines F,Martines E,Ballacchino A,et al.Speech perception outcomes after cochlear implantation in prelingually deaf infants:the Western Sicily experience[J].Int J Pediatr Otorhinolaryngol,2013,77:707.

10 Janeschik S,Teschendorf M,Bagus H,et al.Influence of etiologic factors on speech perception of cochlear-implanted children[J].Cochlear Implants Int,2013,14:190.

11 Varga L,KabátováZ,MaindováI,et al.Is deafness etiology important for prediction of functional outcomes in pediatric cochlear implantation[J].Acta Otolaryngol,2014,134:571.

12 Connell SS,Angeli SI,Suarez H,et al.Performance after cochlear implantation in DFNB1 patients[J].Otolaryngol Head Neck Surg,2007,137:596.

13 Bauer PW,Geers AE,Brenner C,et al.The effect of GJB2allele variants on performance after cochlear implantation[J].Laryngoscope,2003,113:2135.

14 Propst EJ,Papsin BC,Stockley TL,et al.Auditory responses in cochlear implant users with and without GJB2deafness[J].Laryngoscope,2006,116:317.

15 Bille J,Fink-Jensen V,Ovesen T.Outcome of cochlear implantation in children with cochlear malformations[J].Eur Arch Otorhinolaryngol,2015,272:583.

16 刘辉,董玉云,莫玲燕,等.大前庭水管综合征患者的听力学特点[J].听力学及言语疾病杂志,2006,14:31.

17 Chen X,Liu B,Liu S.The development of auditory skills in infants with isolated Large Vestibular Aqueduct Syndrome after cochlear implantation[J].Int J Pediatr Otorhinolaryngol,2011,75:943.

18 Wu CM,Sun YS,Liu TC.Long-term speech perception of cochlear implantation in children with large vestibular aqueduct syndrome:how we do it[J].Clin Otolarygol,2008,33:472.

19 Vincent C,Arndt S,Firszt JB,et al.Identification and evaluation of cochlear implant candidates with asymmetrical hearing loss[J].Audiol Neurootol,2015,20:87.

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