Byun Hayoung, Moon Il Joon, Kim Eun Yeon, Park Junoh, Kwon See Youn, Han Hyo Dam, Chung Won-Ho, Cho Yang-Sun, Hong Sung Hwa
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
Int J Pediatr Otorhinolaryngol. 2013 Jun;77(6):1013-8. doi: 10.1016/j.ijporl.2013.03.034. Epub 2013 Apr 29.
To investigate auditory perception, speech production, and language ability of prelingually deaf toddlers with cerebral palsy (CP) who were implanted within a sensitive period and who received proper speech therapy. Comparison of their outcomes with age- and sex-matched CI recipients without additional disabilities was also performed.
We retrospectively reviewed a cohort of pediatric CI in Samsung Medical Center. Eight CP subjects who received CI before 3 years of age and age-sex matched control recipients who had no additional disabilities except idiopathic sensorineural hearing loss (SNHL) were included for the analysis. Preoperative evaluation included the Categories of Auditory Performance (CAP) score, Korean Version of the Ling's Stage (K-Ling), Sequenced Language Scale for Infants (SELSI), Bailey Scales of Infant Development II assessment, Social Maturity Scale test, and grading of CP severity using severity level and Gross Motor Function Classification System for CP (GMFCS). To measure the outcome, the CAP scores, K-Ling, and SELSI were performed at 3, 6, 12, and 24 months after implantation.
Four CP children with outstanding performances showed comparable achievement with matched control recipients. These patients had less severe motor disabilities (mild-moderate severity, GMFCS level 1-3), better social quotient, and better cognitive abilities. Although the others showed poor language abilities and hardly produced meaningful speech, their CAP scores reached 1 or 2 in 24 months after implantation.
Deaf children with CP could have various ranges of benefits up to the levels of normal peers whose only disability was hearing loss, when CI was performed within a critical period. Especially, children with mild or moderate CP had a favorable outcome after CI, equivalent to that of normal peers.
研究在敏感期内接受人工耳蜗植入并接受适当言语治疗的语前聋脑瘫幼儿的听觉感知、言语产生和语言能力。还将他们的结果与年龄和性别匹配的无其他残疾的人工耳蜗接受者进行比较。
我们回顾性分析了三星医疗中心的一组儿科人工耳蜗植入病例。纳入分析的有8名3岁前接受人工耳蜗植入的脑瘫患儿以及年龄和性别匹配的对照组接受者，后者除特发性感音神经性听力损失（SNHL）外无其他残疾。术前评估包括听觉表现类别（CAP）评分、韩语版林氏阶段（K-Ling）、婴儿序列语言量表（SELSI）、贝利婴儿发育量表第二版评估、社会成熟度量表测试，以及使用脑瘫严重程度分级和脑瘫粗大运动功能分类系统（GMFCS）对脑瘫严重程度进行分级。为了测量结果，在植入后3、6、12和24个月进行CAP评分、K-Ling和SELSI评估。
4名表现出色的脑瘫患儿与匹配的对照组接受者取得了相当的成绩。这些患者的运动残疾较轻（轻度至中度严重程度，GMFCS 1-3级），社交商数更高，认知能力更好。虽然其他患儿语言能力较差，几乎无法产生有意义的言语，但他们在植入后24个月的CAP评分达到了1或2。
当在关键期内进行人工耳蜗植入时，脑瘫聋儿可获得各种程度的益处，直至达到仅患有听力损失的正常同龄人的水平。特别是，轻度或中度脑瘫患儿在人工耳蜗植入后有良好的结果，与正常同龄人相当。
