伴脑白质发育异常语前聋患儿人工耳蜗植入后听觉言语康复效果评估

Effect of Leukodystrophy on Hearing and Speech Ability of Children with Prelingual Hearing Loss after Cochlear Implantation

朱悦汀;郭玉玺;刘申;沈蓓;

1:天津市儿童医院(天津大学儿童医院)耳鼻咽喉头颈外科

2:天津市残联聋儿康复中心

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摘要

目的探讨脑白质发育异常对语前聋患儿人工耳蜗植入术后听觉言语康复效果的影响。方法以2014年1月至2019年12月行人工耳蜗植入术的语前聋患儿105例为研究对象,根据术前头颅核磁共振成像(MRI)结果,分为脑白质发育异常组(A组,31例)和脑白质正常组(B组,74例),选择30例伴脑白质异常佩戴助听器的语前聋患儿作为对照组(C组),比较A、B两组患儿人工耳蜗植入术后6、12、18个月的听觉言语康复效果,并与同时间段C组患儿相比较。结果术前A、C两组患儿MRI的Scheltens评分(脑白质病变评分)无明显差异(P>0.05),但均明显高于B组(P<0.05);A、B两组患儿术后行为听阈均较术前明显改善(P<0.05),CI术前、术后6个月的平均听觉行为分级(CAP)、言语可懂度分级(SIR)评分无明显差异(P>0.05),A组患儿CI术后12、18个月的平均CAP、SIR评分均明显低于B组(P<0.05);与C组患儿同时期相比较,A组患儿的平均CAP、SIR评分均明显较高(P<0.05)。Pearson相关性分析发现,Scheltens评分与术后6个月的平均CAP、SIR评分无明显相关性,但与术后12、18个月的平均CAP、SIR评分呈明显负相关(r=-0.461～-0.431,P<0.05)。A、B两组4岁以前CI者术后6、12个月的平均CAP、SIR评分无明显差异(P>0.05)。结论伴脑白质发育异常语前聋患儿越早行人工耳蜗植入,术后听觉言语康复效果越好,且随着术后康复时间的延长,其听觉能力逐渐提高。

关键词

脑白质发育异常;语前聋;人工耳蜗植入;听觉能力;言语能力

基金项目(Foundation):

作者

朱悦汀;郭玉玺;刘申;沈蓓;

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脑白质发育异常语前聋人工耳蜗植入听觉能力言语能力

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朱悦汀郭玉玺刘申沈蓓