Philips Birgit, Corthals Paul, De Raeve Leo, D'haenens Wendy, Maes Leen, Bockstael Annelies, Keppler Hannah, Swinnen Freya, De Vel Eddy, Vinck Bart, Dhooge Ingeborg
ENT Department, Ghent University, Ghent, Belgium.
Laryngoscope. 2009 May;119(5):974-9. doi: 10.1002/lary.20188.
OBJECTIVES/HYPOTHESIS: To evaluate the impact of a newborn hearing screening program on the management and outcome of deaf children and to identify underlying factors that may be responsible for the differences between high and low performing implanted children.
Retrospective cohort study of 391 implanted children in Flanders (Belgium).
First, implanted children were sorted into two groups on account of screening age (early screened, n = 195 vs. late screened, n = 196). Both groups were compared with respect to several variables. Second, outcome of cochlear implantation was measured in terms of the child's speech perception and production skills (n = 355). A subgroup of high performing cochlear implant (CI) users was compared with low performing CI users with regard to several variables.
Early screened children differ significantly from late screened children with respect to age of hearing loss detection and age at cochlear implantation. Furthermore, early screening and implantation is associated with better auditory receptive skills and speech intelligibility. Additional impairments negatively influence both receptive and productive skills. In addition, children who communicate orally and wear bilateral cochlear implants perform better on speech production, whereas a better speech perception was found in children who became progressively deaf as opposed to congenitally deaf children.
The results of this extensive study of profoundly deaf children with CIs in Flanders indicate that a newborn hearing screening program results in earlier intervention in deaf children, which beneficially influences the auditory receptive skills and speech intelligibility.
目的/假设:评估新生儿听力筛查项目对聋儿管理及预后的影响,并确定可能导致植入效果较好和较差儿童之间差异的潜在因素。
对比利时弗拉芒地区391名植入人工耳蜗儿童的回顾性队列研究。
首先,根据筛查年龄将植入人工耳蜗的儿童分为两组(早期筛查组,n = 195;晚期筛查组,n = 196)。对两组在多个变量方面进行比较。其次,根据儿童的言语感知和表达能力(n = 355)来衡量人工耳蜗植入的效果。将人工耳蜗植入效果较好的使用者亚组与效果较差的使用者亚组在多个变量方面进行比较。
早期筛查儿童与晚期筛查儿童在听力损失检测年龄和人工耳蜗植入年龄方面存在显著差异。此外,早期筛查和植入与更好的听觉接受能力和言语清晰度相关。其他障碍会对接受能力和表达能力产生负面影响。此外,采用口语交流且佩戴双侧人工耳蜗的儿童在言语表达方面表现更好,而渐进性耳聋儿童的言语感知能力优于先天性耳聋儿童。
这项对弗拉芒地区重度聋儿人工耳蜗植入的广泛研究结果表明,新生儿听力筛查项目能使聋儿得到更早干预,这对听觉接受能力和言语清晰度有积极影响。