Kuo S C, Gibson W P
University of Sydney and Royal North Shore Hospital, Australia.
Am J Otol. 2000 Sep;21(5):657-62.
To show that congenitally deaf children who receive a cochlear implant between 10 and 15 years of age find it significantly more difficult to learn the new signal, and that a history of sound detection at high frequencies with hearing aids is predictive of better outcomes in these children.
A retrospective study using a within-subjects design.
Children's Cochlear Implant Centre, Sydney (CCIC), Royal Prince Alfred Hospital, and the New Children's Hospital in Westmead are tertiary referral centers.
Forty-five congenitally deaf patients were grouped according to their age (in years) at implantation into group 1 (aged 10-15), group 2 (aged <10), group 2a (aged 6-9), and group 2b (aged 3-5). Within each group, individuals with previous hearing between 2 and 4 kHz before receiving a cochlear implant were identified, and their mean results were compared with those in their respective age-matched groups.
Surgical implantation, intensive weekly habilitation at the CCIC.
Speech perception, speech production, and language measures were compared. Questionnaires and telephone interviews were conducted.
Group 2 (age <10 years) consistently outperformed group 1 (10-15 years) on all outcome measures, and most of them learned to converse without lipreading. In group 1, children with previous aided hearing at high frequencies displayed exceptional gains in speech perception and speech production, with reduced dependence on lipreading. Previous high-frequency hearing does not benefit group 2.
Implant recipients aged 10 to 15 years experience more difficulty than younger children during the initial periods of device use. A history of high-frequency hearing before implantation in these individuals correlates with more rapid improvement.
证明10至15岁接受人工耳蜗植入的先天性失聪儿童学习新信号的难度显著更高，并且使用助听器进行高频声音检测的经历可预测这些儿童会有更好的结果。
采用受试者内设计的回顾性研究。
悉尼儿童人工耳蜗中心（CCIC）、皇家阿尔弗雷德王子医院以及韦斯特米德新儿童医院均为三级转诊中心。
45名先天性失聪患者按植入时的年龄（岁）分组，分为第1组（10 - 15岁）、第2组（年龄<10岁）、第2a组（6 - 9岁）和第2b组（3 - 5岁）。在每组中，确定了在接受人工耳蜗植入前2至4千赫兹有过听力的个体，并将他们的平均结果与各自年龄匹配组的结果进行比较。
手术植入，在CCIC每周进行强化康复训练。
比较语音感知、语音产生和语言指标。进行问卷调查和电话访谈。
在所有观察指标上，第2组（年龄<10岁）始终优于第1组（10 - 15岁），并且他们中的大多数人学会了无需唇读就能交谈。在第1组中，之前有高频助听经历的儿童在语音感知和语音产生方面有显著进步，对唇读的依赖减少。之前的高频听力对第2组没有益处。
10至15岁的人工耳蜗植入接受者在设备使用的初始阶段比年幼儿童面临更多困难。这些个体植入前的高频听力史与更快的改善相关。
