le Roux Talita, Swanepoel De Wet, Louw Anel, Vinck Bart, Tshifularo Mashudu
Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa; Ear Sciences Centre, School of Surgery, University of Western Australia, Nedlands, Australia; Ear Science Institute Australia, Subiaco, Australia.
Int J Pediatr Otorhinolaryngol. 2015 Jan;79(1):8-14. doi: 10.1016/j.ijporl.2014.09.033. Epub 2014 Oct 28.
To describe profound childhood hearing loss in a South African population of pediatric cochlear implant recipients in terms of risk profile, and age of diagnosis and intervention.
A retrospective review of patient files for 264 pediatric cochlear implant recipients from five cochlear implant programs was conducted. Data was captured from 264 eligible subjects, of which all were implanted between 1996 and 2013 and PCEHL was confirmed under the age of 5 years old. Data collected included demographical information, risk factors from case histories, diagnostic test procedures conducted, diagnosis (type, onset and degree of hearing loss) and documented ages of caregiver suspicion, initial diagnosis and intervention.
Risk factors for permanent childhood hearing loss were present in 51.1% of cases, with the most prevalent risks being NICU admittance (28.1%), family history of childhood hearing loss (19.6%) and prematurity (15.1%). An associated syndrome was diagnosed in 10% of children and 23.5% presented with at least one additional developmental condition. Hearing loss for most (77.6%) children was confirmed as congenital/early onset, while 20.3% presented with postnatal onset of hearing loss. ANSD was diagnosed in 5% of children, with admittance to NICU (80%) and hyperbilirubinemia (50%) being the most prevalent risk factors for these cases. Hearing loss was typically diagnosed late (15.3 months), resulting in delayed initial hearing aid fitting (18.8 months), enrollment in early intervention services (19.5 months) and eventual cochlear implantation (43.6 months).
Most prevalent risk factors in profound childhood hearing loss were admittance to NICU, family history and prematurity. Diagnosis and intervention was typically delayed predisposing this population to poorer outcomes.
从风险概况、诊断年龄和干预年龄方面描述南非儿科人工耳蜗植入受者群体中的重度儿童听力损失情况。
对来自五个人工耳蜗植入项目的264名儿科人工耳蜗植入受者的病历进行回顾性研究。从264名符合条件的受试者中收集数据，所有受试者均在1996年至2013年间接受植入，且永久性儿童听力损失在5岁前得到确诊。收集的数据包括人口统计学信息、病史中的风险因素、进行的诊断测试程序、诊断结果（听力损失的类型、发病情况和程度）以及记录的照料者怀疑年龄、初次诊断年龄和干预年龄。
51.1%的病例存在永久性儿童听力损失的风险因素，最常见的风险是入住新生儿重症监护病房（28.1%）、儿童听力损失家族史（19.6%）和早产（15.1%）。10%的儿童被诊断出患有相关综合征，23.5%的儿童至少存在一种其他发育状况。大多数（77.6%）儿童的听力损失被确认为先天性/早发性，而20.3%的儿童表现为出生后发生听力损失。5%的儿童被诊断为听神经病谱系障碍，入住新生儿重症监护病房（80%）和高胆红素血症（50%）是这些病例中最常见的风险因素。听力损失通常诊断较晚（15.3个月），导致初次助听器适配延迟（18.8个月）、早期干预服务登记延迟（19.5个月）以及最终人工耳蜗植入延迟（43.6个月）。
重度儿童听力损失最常见的风险因素是入住新生儿重症监护病房、家族史和早产。诊断和干预通常延迟，这使得该群体的预后较差。
