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五例共同腔畸形儿童人工耳蜗植入的长期疗效

Long term outcome of cochlear implantation in five children with common cavity deformity.

作者信息

Pradhananga Rabindra Bhakta, Thomas John K, Natarajan Kiran, Kameswaran Mohan

机构信息

Department of Implantation Otology, Madras ENT Research Foundation (MERF), 1, I Cross Street, Off. II Main Road, R.A. Puram, Chennai 600 028, Tamil Nadu, India.

Department of Implantation Otology, Madras ENT Research Foundation (MERF), 1, I Cross Street, Off. II Main Road, R.A. Puram, Chennai 600 028, Tamil Nadu, India.

出版信息

Int J Pediatr Otorhinolaryngol. 2015 May;79(5):685-9. doi: 10.1016/j.ijporl.2015.02.015. Epub 2015 Feb 24.

Abstract

INTRODUCTION

A common cavity (CC) deformity is a deformed inner ear in which the cochlea and vestibule are confluent forming a common rudimentary cystic cavity. The outcome of cochlear implantation (CI) in this deformity is not expected as good as in other cochlear deformity. Categories of Auditory Performance (CAP) score, Speech Intelligibility Rating (SIR) scale, Meaningful Auditory-Integration Scale (MAIS) and Meaningful Use of Speech Scale (MUSS) are scales designed to assess benefit of functional device (hearing aid, Cochlear implant, ABI) in young children. The aim of the study was to observe and report the long-term audiological progress and speech development of children with CC deformity after CI by means of CAP, SIR, MAIS, MUSS scores and CI aided threshold.

METHODS AND MATERIALS

The retrospective and prospective study was carried out in five Indian children with CC deformity who underwent CI from 2004 to 2010. Demographic data of onset and/or duration of deafness, age at implantation, time with hearing aids before implantation, duration with CI and co-morbidity were retrieved from a local data base. Their outcome score in audition and speech development on the basis of their CAP and SIR score at the end of 1 year of habilitation were collected. All the patients were called to follow up to obtain latest CI aided audiogram, CAP, SIR, MAIS and MUSS scores.

RESULTS

One male and four female children were detected with common cavity deformity among 258 deaf children of age below 6 years operated during study period. The CAP and SIR Scores increased from average of 0.4 and 1 to 3.4 and 2.4, respectively, over one year of habilitation. The CAP score improved in subsequent follow up to average of 5.0 after more than 3 years of follow up but the SIR score hardly improved. We assessed the MAIS and MUSS at last visit after 3 years. The mean of MAIS and MUSS was 32.4 and 26.4, respectively.

CONCLUSION

Though the habilitation outcome was not up to the mark in children with CC deformity, CI provides excellent awareness of environment sound and development of few words.

摘要

引言

共同腔(CC)畸形是一种内耳畸形,其中耳蜗和前庭融合形成一个共同的原始囊性腔。预计这种畸形的人工耳蜗植入(CI)效果不如其他耳蜗畸形。听觉表现类别(CAP)评分、言语可懂度评级(SIR)量表、有意义听觉整合量表(MAIS)和言语有意义使用量表(MUSS)是用于评估功能性设备(助听器、人工耳蜗、听觉脑干植入)对幼儿益处的量表。本研究的目的是通过CAP、SIR、MAIS、MUSS评分和CI助听阈值观察并报告CC畸形儿童人工耳蜗植入后的长期听力学进展和言语发展情况。

方法和材料

对2004年至2010年接受人工耳蜗植入的5名患有CC畸形的印度儿童进行了回顾性和前瞻性研究。从当地数据库中检索耳聋发病和/或持续时间、植入时年龄、植入前使用助听器的时间、人工耳蜗使用时间和合并症等人口统计学数据。收集了他们在康复训练1年末基于CAP和SIR评分的听觉和言语发展结果评分。所有患者均被召回进行随访,以获得最新的CI助听听力图、CAP、SIR、MAIS和MUSS评分。

结果

在研究期间接受手术的258名6岁以下耳聋儿童中,发现1名男性和4名女性儿童患有共同腔畸形。经过一年的康复训练,CAP和SIR评分分别从平均0.4和1提高到3.4和2.4。在超过3年的随访后,后续随访中CAP评分提高到平均5.0,但SIR评分几乎没有改善。我们在3年后的最后一次随访中评估了MAIS和MUSS。MAIS和MUSS的平均值分别为32.4和26.4。

结论

虽然CC畸形儿童的康复效果未达预期,但人工耳蜗植入能使患儿对环境声音有良好的感知,并能发展出少量词汇。

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