Oh Seung-Ha, Kim Chong-Sun, Kang Eun Joo, Lee Dong Soo, Lee Hyo Jeong, Chang Sun O, Ahn Soon-Hyun, Hwang Chan Ho, Park Hong Ju, Koo Ja Won
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea.
Acta Otolaryngol. 2003 Jan;123(2):148-53. doi: 10.1080/0036554021000028111.
To evaluate the long-term speech perception of cochlear implantees and to compare the developing auditory performance patterns of prelingual children and postlingual deaf adults.
Twenty-nine prelingually deaf children and 17 postlingually deaf adults who had been followed up for 4 years were included in the study. Speech perception ability was assessed by means of vowel and consonant confusion tests and the Korean version of the Central Institute of Deafness (K-CID) test (performed without visual cues). The test results were analyzed at 3 and 6 months after implantation and then annually.
In the prelingually deaf children, the average results continuously improved over the 4-year period. In the postlingually deaf adults, the average results did not improve further after the first 2 years. Individuals with < 5 years of deafness had a faster rate of recovery of speech perception than those who had been deaf for > 5 years. The K-CID scores were negatively correlated with age at implantation for the prelingually deaf group and with the duration of deafness in the postlingually deaf group. Children fitted with implants at a younger age showed better speech perception ability than those fitted with implants at an older age. Interestingly, prelingually deaf children aged 5-7 years at implantation showed the widest variation in individual outcomes. Amongst this group of children with highly variable outcomes, the metabolic status of brain cortices determined by means of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) was available for three patients. The individual with the widest hypometabolic area had the best speech perception ability.
The extent of hypometabolism as assessed by FDG-PET seemed to be one of the major factors predicting the outcome of cochlear implantation.
评估人工耳蜗植入者的长期言语感知能力，并比较语前聋儿童和语后聋成人的听觉性能发展模式。
本研究纳入了29名语前聋儿童和17名语后聋成人，他们均已接受了4年的随访。通过元音和辅音混淆测试以及韩国版聋人中央研究所测试（K-CID测试，无视觉提示）评估言语感知能力。在植入后3个月和6个月，然后每年对测试结果进行分析。
在语前聋儿童中，平均结果在4年期间持续改善。在语后聋成人中，平均结果在前2年后没有进一步改善。耳聋时间<5年的个体言语感知恢复速度比耳聋时间>5年的个体更快。K-CID得分与语前聋组的植入年龄以及语后聋组的耳聋持续时间呈负相关。较年幼时植入人工耳蜗的儿童比年长时植入的儿童表现出更好的言语感知能力。有趣的是，植入时年龄在5-7岁的语前聋儿童个体结果差异最大。在这组结果差异很大的儿童中，有三名患者可通过18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）确定脑皮质的代谢状态。代谢减低区域最广泛的个体言语感知能力最佳。
FDG-PET评估的代谢减低程度似乎是预测人工耳蜗植入结果的主要因素之一。
