低龄语前聋患儿双侧人工耳蜗植入与双模式干预早期效果分析

Early Outcomes of Bilateral Cochlear Implantation and Bimodal Stimulation in Children with Bilateral Server to Profound Sensorineural Hearing Loss

徐卓;周敏;林颖;张鑫雨;张域开;任寸寸;樊小勤;乔燕;邱建华;查定军;

1:空军军医大学西京医院耳鼻咽喉头颈外科

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摘要

目的探讨语前聋患儿双模式(一侧人工耳蜗植入，对侧配戴助听器)干预与双侧人工耳蜗植入(cochlear implantation, CI)后早期听觉言语康复效果以及生活质量，为语前聋患儿双侧干预模式的选择提供参考。方法回顾性分析2016～2019年行双侧CI 28例(双侧CI组)和双模式干预28例(双模式组)语前聋患儿的临床资料，双侧CI组的平均植入年龄和术前助听器使用时长低于双模式组。所有患儿均于开机时、开机1、3、6和12个月时完成听觉行为分级标准(CAP)、婴幼儿有意义听觉整合量表(IT-MAIS)、言语可懂度分级标准(SIR)、有意义使用言语量表(MUSS)问卷填写，并于术后2±0.76年完成中文版CI儿童家长观点调查问卷(MPP),比较两组结果。结果双模式组IT-MAIS得分在开机时(F=16.52,P<0.001)、开机1个月(F=12.02,P=0.001)、开机3个月(F=4.27,P=0.043)高于双侧CI组，之后两组间IT-MAIS得分无统计学差异(P>0.05)。双模式组CAP分级在开机时(F=9.50,P=0.003)、开机1个月(F=8.70,P=0.005)高于双侧CI组，随后两组间CAP分级无统计学差异(P>0.05)。双模式组术后MUSS得分高于双侧CI组(F=5.46,P=0.023)。在开机时、开机1个月两组间SIR分级无统计学差异(P>0.05),在开机3个月(F=4.50,P=0.039)、6个月(F=10.89,P=0.002)和12个月时(F=5.46,P=0.023)双模式组SIR分级高于双侧CI组。MPP问卷的幸福感(F=9.15,P=0.004)、社会关系(F=5.03,P=0.029)和教育(F=7.97,P=0.007)维度得分双模式组高于双侧CI组，在交流、基本功能、自立能力、CI的效果和影响以及对患儿的支持维度两组间得分无统计学差异(P>0.05)。结论双侧CI与双模式干预患儿术后听觉言语能力均能取得较大进步；尽管术后早期双模式干预患儿的听觉言语能力进步更明显，但考虑到植入年龄、术前助听器使用时间等因素的影响，尚不能认为双模式干预的效果优于双侧CI。

关键词

双侧人工耳蜗植入;双模式;听觉言语康复;生活质量

基金项目(Foundation):

国家自然科学基金面上项目(81870732);; 陕西省科技创新基地科技资源开放共享平台(2018PT-01);; 空军军医大学第一附属医院学科助推计划-卫勤专项研究项目(XJZT15D02)

作者

徐卓;周敏;林颖;张鑫雨;张域开;任寸寸;樊小勤;乔燕;邱建华;查定军;

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