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儿童人工耳蜗植入术后前庭功能受损:静态姿势描记法的作用

Impaired Vestibular Function After Cochlear Implantation in Children: Role of Static Posturography.

作者信息

Nair Satish, Gupta Atul, Nilakantan Ajith, Mittal Ruchika, Dahiya Ruchi, Saini Sachin, Prasad Rachana, Vajpayee Deepika

机构信息

Department of Otolaryngology and Head and Neck Surgery, Apollo Hospitals, Bangalore, India.

Department of ENT-HNS, Base Hospital Delhi Cantt, Delhi, 10010 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2017 Jun;69(2):252-258. doi: 10.1007/s12070-017-1124-3. Epub 2017 Apr 18.

Abstract

To identify vestibular dysfunction in children after cochlear implant surgery and to study the utility of static posturography in evaluating vestibular function in children. A prospective study was carried out on 25 children between 2 and 7 years of age with sensorineural hearing loss with no overt vestibular dysfunction. All children underwent static posturography using Synapsis Posturographic System (SPS) software (Version 3.0, REV C) using a static platform with foam. The centre of pressure (COP) shift was recorded as statokinesiogram on the software and the mean vestibular, visual and somesthetic scores were obtained. Cochlear implantation (CI) surgery was done with insertion of Med-El Pulsar standard cochlear implant with 12 twin electrodes. Children were evaluated again after 4 weeks of CI surgery (2 weeks after switch on) with static posturography on the same SPS software. The scores obtained were compared with pre op value and data analyzed statistically by paired t tests on SPSS 18 software. The mean age was 4.6 years with range 2-7 years. All the children in the study were able to complete the test with no difficulty and the mean time required for each child was 10.2 min. The mean pre op somesthetic score was 95.16 (SD 1.52) and post op score was 94.06 (SD 1.79). The mean pre op visual score was 86.64 (SD 2.24) and post op score was 82.55 (2.89). The mean pre op vestibular score was 84.11 (SD 2.20) and post op score was 73.66 (SD 4.25). Correlation and statistical analysis of the pre and post values of each score revealed statistically significant reduction in vestibular scores post CI. The vestibular system is at high risk of injury leading to vestibular dysfunction in children during CI. Our study found the static posturography as a simple, fast and efficient tool to screen children for vestibular dysfunction post CI. Identifying the dysfunction early can help in initiating early rehabilitation measures.

摘要

识别人工耳蜗植入术后儿童的前庭功能障碍,并研究静态姿势描记法在评估儿童前庭功能中的效用。对25名2至7岁无明显前庭功能障碍的感音神经性听力损失儿童进行了一项前瞻性研究。所有儿童均使用Synapsis姿势描记系统(SPS)软件(3.0版,REV C)在带有泡沫的静态平台上进行静态姿势描记。压力中心(COP)偏移在软件上记录为姿势运动图,并获得平均前庭、视觉和本体感觉分数。采用插入带有12个双电极的Med-El Pulsar标准人工耳蜗进行人工耳蜗植入(CI)手术。在CI手术后4周(开机后2周),使用相同的SPS软件对儿童再次进行静态姿势描记评估。将获得的分数与术前值进行比较,并在SPSS 18软件上通过配对t检验进行统计学数据分析。平均年龄为4.6岁,范围为2至7岁。研究中的所有儿童均能顺利完成测试,每个儿童所需平均时间为10.2分钟。术前本体感觉平均分数为95.16(标准差1.52),术后分数为94.06(标准差1.79)。术前视觉平均分数为86.64(标准差2.24),术后分数为82.55(2.89)。术前前庭平均分数为84.11(标准差2.20),术后分数为73.66(标准差4.25)。对每个分数术前和术后值的相关性及统计分析显示,CI术后前庭分数有统计学意义的降低。在儿童CI手术期间,前庭系统极易受损导致前庭功能障碍。我们的研究发现,静态姿势描记法是筛查CI术后儿童前庭功能障碍的一种简单、快速且有效的工具。早期识别功能障碍有助于启动早期康复措施。

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