Kocdor Pelin, Iseli Claire E, Teagle Holly F, Woodard Jennifer, Park Lisa, Zdanski Carlton J, Brown Kevin D, Adunka Oliver F, Buchman Craig A
Department of Otolaryngology Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
Department of Otolaryngology Head and Neck Surgery, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Laryngoscope. 2016 Oct;126(10):2389-94. doi: 10.1002/lary.26012. Epub 2016 Apr 21.
OBJECTIVES/HYPOTHESIS: To determine if prolongation of the interdevice interval in children receiving bilateral cochlear implants adversely affects speech perception outcomes.
Retrospective chart review.
Retrospective review of our pediatric cochlear implant database was performed. Children who had undergone revision surgery or had less than 12 months listening experience with either the first or second implant were excluded. The interdevice interval, best Phonetically Balanced Kindergarten word lists (PBK) score from each ear, and demographic data about each patient were collected. A ratio of PBK was generated (PBK second side/PBK first side) to minimize potential confounding from other individual patient factors that affect speech outcomes.
Two hundred forty children met the study criteria. Mean age at first cochlear implantation (CI) was 3.2 years (0.6-17.9), and the second was 6.6 years (0.8-22.4). Mean best PBK score from the first CI side was 83.8% (0-100), and the second was 67.5% (0-100) (P < .001). When the PBK ratio was plotted against interdevice interval, R(2) was 0.47 (P < .001). When analyzed for hearing stability, those with a progressive loss history demonstrated less influence of prolonged interdevice interval on performance. Multivariate analysis did not identify other factors influencing the ratio. A line of best fit for those with stable hearing loss suggested best outcomes were with an interdevice interval less than 3 to 4 years. Beyond 7 to 8 years, very few achieved useful speech recognition from the second CI.
Where possible, the second implant should be received within 3 to 4 years of the first to maximize outcome in those with stable, severe to profound sensorineural hearing loss.
目的/假设：确定接受双侧人工耳蜗植入的儿童中，设备间隔时间延长是否会对言语感知结果产生不利影响。
回顾性病历审查。
对我们的儿科人工耳蜗植入数据库进行回顾性审查。排除接受过翻修手术或首次或第二次植入后听力经验少于12个月的儿童。收集设备间隔时间、每只耳朵的最佳语音平衡幼儿园单词列表（PBK）得分以及每位患者的人口统计学数据。生成PBK比率（PBK第二侧/PBK第一侧），以尽量减少其他影响言语结果的个体患者因素的潜在混杂影响。
240名儿童符合研究标准。首次人工耳蜗植入（CI）时的平均年龄为3.2岁（0.6 - 17.9岁），第二次为6.6岁（0.8 - 22.4岁）。首次CI侧的平均最佳PBK得分为83.8%（0 - 100），第二次为67.5%（0 - 100）（P <.001）。当将PBK比率与设备间隔时间作图时，R²为0.47（P <.001）。在分析听力稳定性时，有渐进性听力损失病史的患者显示设备间隔时间延长对性能的影响较小。多变量分析未发现影响该比率的其他因素。对听力损失稳定的患者进行的最佳拟合线表明，设备间隔时间小于3至4年时结果最佳。超过7至8年，很少有人能从第二次CI获得有用的言语识别。
在可能的情况下，第二次植入应在第一次植入后的3至4年内进行，以使稳定的重度至极重度感音神经性听力损失患者的结果最大化。
4。《喉镜》，126:2389 - 2394，2016年。
