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语前聋且耳蜗骨化儿童的人工耳蜗植入

Cochlear implantation in prelingually deaf children with ossified cochleae.

作者信息

El-Kashlan Hussam K, Ashbaugh Carissa, Zwolan Teresa, Telian Steven A

机构信息

Department of Otolaryngology, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0312, USA.

出版信息

Otol Neurotol. 2003 Jul;24(4):596-600. doi: 10.1097/00129492-200307000-00011.

Abstract

OBJECTIVE

To evaluate the effects that degree of cochlear ossification has on performance of prelingually deafened children who receive cochlear implants.

STUDY DESIGN

A matched-pairs analysis comparing speech perception results obtained 6 and 24 months after implant by children with ossified and nonossified cochleae. Additionally, long-term performance was evaluated in patients with follow-up periods longer than 24 months. Comparisons were also performed within the ossified cochleae group to determine if degree of cochlear ossification and surgical technique affected outcome with the cochlear implant. SETTING Large cochlear implant program in an academic tertiary care medical center.

PATIENTS

Twenty-one pairs of prelingually deaf children with and without cochlear ossification. Meningitis was the etiology of hearing loss in children with ossified cochleae. The control group had nonmeningitic etiology for the hearing loss.

INTERVENTIONS

Multichannel cochlear implantation and routine postoperative auditory rehabilitation and performance evaluation.

MAIN OUTCOME MEASURES

Speech perception category ratings based on scores obtained on a battery of closed- and open-set speech recognition tests 6 and 24 months after implant. Longer follow-up period is also reported.

RESULTS

As a group, children with cochlear ossification showed significant improvement in their speech perception abilities 6 and 24 months after implant. Children with cochlear ossification performed at a significantly lower speech perception category than a group of matched controls with nonossified cochleae at both the 6- and 24-month postimplant intervals. With longer implant use, open-set speech recognition was possible in some children with ossification. Within-group analysis of the children with ossified cochleae revealed that degree of ossification and surgical procedure used for implantation did not significantly affect outcome.

CONCLUSIONS

Prelingually deafened children with postmeningitic hearing loss and ossified cochleae receive significant benefit from cochlear implants. Their performance is frequently poorer, however, than children with nonossified cochleae.

摘要

目的

评估耳蜗骨化程度对接受人工耳蜗植入的语前聋儿童效果的影响。

研究设计

采用配对分析,比较耳蜗骨化和未骨化儿童在植入后6个月和24个月时获得的言语感知结果。此外,对随访期超过24个月的患者进行长期效果评估。在骨化耳蜗组内也进行了比较,以确定耳蜗骨化程度和手术技术是否会影响人工耳蜗植入的结果。地点:一所学术性三级医疗中心的大型人工耳蜗植入项目。

患者

21对语前聋儿童,其中部分儿童存在耳蜗骨化。脑膜炎是耳蜗骨化儿童听力损失的病因。对照组儿童听力损失的病因是非脑膜炎性的。

干预措施

多通道人工耳蜗植入及常规术后听觉康复和效果评估。

主要观察指标

基于植入后6个月和24个月时一系列闭集和开集言语识别测试得分的言语感知类别评分。还报告了更长的随访期。

结果

总体而言,耳蜗骨化儿童在植入后6个月和24个月时言语感知能力有显著改善。在植入后6个月和24个月时,耳蜗骨化儿童的言语感知类别表现显著低于一组匹配的未骨化耳蜗对照组。随着植入时间延长,一些骨化儿童能够进行开集言语识别。对耳蜗骨化儿童的组内分析显示,骨化程度和植入手术方法对结果没有显著影响。

结论

患有脑膜炎后听力损失且耳蜗骨化的语前聋儿童从人工耳蜗植入中获益显著。然而,他们的表现通常比未骨化耳蜗的儿童差。

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