le Roux Talita, Vinck Bart, Butler Iain, Cass Nicolize, Louw Liebie, Nauta Leone, Schlesinger Dani, Soer Maggi, Tshifularo Mashudu, Swanepoel De Wet
Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa; Speech-Language Audiology Department, Ghent University, Belgium.
Int J Pediatr Otorhinolaryngol. 2016 May;84:61-70. doi: 10.1016/j.ijporl.2016.02.025. Epub 2016 Mar 3.
To identify and describe predictors of pediatric cochlear implantation outcomes in a South African population.
A retrospective study of 301 pediatric cochlear implant (CI) recipients from five CI programs was conducted and cross-sectional outcome data were added at the time of data collection. Twenty potential prognostic factors were identified from the retrospective dataset, including demographical, CI, risk and family factors. Multiple regression analyses were performed to identify predictor variables that influence outcomes in terms of auditory performance (CAP scores), speech production (SIR scores), communication mode and educational placement.
Although implanted children within this sample did not have equal opportunity to access a second implant, bilateral implantation was strongly predictive of better auditory performance and speech production scores, an oral mode of communication and mainstream education. NICU admittance/prematurity were associated with poorer auditory performance and speech production scores, together with a higher probability for non-oral communication and non-mainstream education. The presence of one or more additional developmental condition was predictive of poorer outcomes in terms of speech production and educational placement, while a delay between diagnosis and implantation of more than one year was also related to non-mainstream education. Ethnicities other than Caucasian were predictive of poorer auditory performance scores and a lower probability for mainstream education.
An extensive range of prognostic indicators were identified for pediatric CI outcomes in South Africa. These predictive factors of better and poorer outcomes should guide pediatric CI services to promote optimal outcomes and assist professionals in providing evidence-based informational counseling.
确定并描述南非人群中儿童人工耳蜗植入结果的预测因素。
对来自五个人工耳蜗植入项目的301名儿童人工耳蜗植入受者进行了一项回顾性研究，并在数据收集时添加了横断面结果数据。从回顾性数据集中确定了20个潜在的预后因素，包括人口统计学、人工耳蜗植入、风险和家庭因素。进行了多元回归分析，以确定在听觉表现（听觉能力分级[CAP]评分）、言语产生（言语可懂度分级[SIR]评分）、交流方式和教育安置方面影响结果的预测变量。
尽管该样本中的植入儿童没有平等的机会接受二次植入，但双侧植入强烈预示着更好的听觉表现和言语产生评分、口语交流方式和主流教育。新生儿重症监护病房（NICU）入院/早产与较差的听觉表现和言语产生评分相关，同时非口语交流和非主流教育的可能性更高。存在一种或多种其他发育状况预示着在言语产生和教育安置方面的结果较差，而诊断与植入之间超过一年的延迟也与非主流教育有关。非白种人的种族预示着较差的听觉表现评分和主流教育的较低可能性。
确定了南非儿童人工耳蜗植入结果的广泛预后指标。这些关于较好和较差结果的预测因素应指导儿童人工耳蜗植入服务，以促进最佳结果，并协助专业人员提供基于证据的信息咨询。
