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儿童重度至极重度感音神经性听力损失的神经发育障碍:一项临床研究。

Neurodevelopmental disorders in children with severe to profound sensorineural hearing loss: a clinical study.

机构信息

Department of Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy.

出版信息

Dev Med Child Neurol. 2010 Sep;52(9):856-62. doi: 10.1111/j.1469-8749.2010.03621.x. Epub 2010 Mar 19.

Abstract

AIM

The effects of sensorineural hearing loss (SNHL) are often complicated by additional disabilities, but the epidemiology of associated disorders is not clearly defined. The aim of this study was to evaluate the frequency and type of additional neurodevelopmental disabilities in a sample of children with SNHL and to investigate the relation between these additional disabilities and the aetiology of deafness.

METHOD

One hundred children with severe/profound SNHL (60 males, 40 females; mean age 5 y 7 mo, SD 3 y 6 mo, range 8 mo-16 y) were investigated using a diagnostic protocol including neurodevelopmental, genetic, neurometabolic, and brain magnetic resonance imaging (MRI) assessment.

RESULTS

Forty-eight per cent of the sample exhibited one or more additional disabilities, with cognitive, behavioural-emotional, and motor disorders being the most frequent. The risk of additional disabilities varied according to the type of aetiology. Thirty-seven out of 80 individuals with available MRIs showed signal abnormalities, in particular brain malformations (46%) and white matter abnormalities (54%). Frequency and type of disability were associated with aetiology (p=0.015) and MRI data (p<0.001).

INTERPRETATION

A multidimensional evaluation, including aetiological, neurodevelopmental, and MRI investigation, is needed for planning therapeutic intervention, such as cochlear implantation in children with severe to profound hearing impairment. The aetiology of deafness is a relevant risk indicator for the presence of an associated disorder.

摘要

目的

感音神经性听力损失(SNHL)的影响通常因其他残疾而变得复杂,但相关疾病的流行病学尚未明确界定。本研究旨在评估一组 SNHL 儿童中额外神经发育障碍的频率和类型,并探讨这些额外残疾与耳聋病因之间的关系。

方法

采用包括神经发育、遗传、神经代谢和脑磁共振成像(MRI)评估在内的诊断方案,对 100 名重度/极重度 SNHL 儿童(60 名男性,40 名女性;平均年龄 5 岁 7 个月,标准差 3 岁 6 个月,范围 8 个月-16 岁)进行了研究。

结果

48%的样本存在一种或多种额外残疾,以认知、行为-情绪和运动障碍最为常见。残疾的风险因病因类型而异。80 名可获得 MRI 的患者中有 37 人存在信号异常,特别是脑畸形(46%)和白质异常(54%)。残疾的频率和类型与病因(p=0.015)和 MRI 数据(p<0.001)相关。

结论

需要进行多维评估,包括病因、神经发育和 MRI 检查,以便为严重至极重度听力障碍的儿童规划治疗干预措施,如人工耳蜗植入。耳聋的病因是存在相关障碍的一个重要风险指标。

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