Zahnert Thomas, Mürbe Dirk
Laryngorhinootologie. 2017 Jun;96(6):396-419. doi: 10.1055/s-0043-104067. Epub 2017 Jul 11.
About 4000 patients receive a cochlear implant in Germany every year. Adults have become the main group for cochlear implantation candidacy.Elderly people with progressive and profound hearing loss experienced high communication restraints due to the limits of conventional hearing aids in the past. Nowadays cochlear implants can be offered as a well-established extension to the supply chain of hearing systems. The option of cochlear implantation for children with profound hearing impairment has led to a paradigm shift in hearing rehabilitation. However, there is still great variability in spoken language outcomes in CI children. These range from communicative and linguistic competencies similar to normal hearing children to clearly limited receptive and productive language skills. Besides age of implantation and the quality of previous auditory stimulation, there are additional factors that likely influence the outcome after cochlea implantation. Among them are the quality of caregivers' linguistic input and an intensive post-operative rehabilitation and intervention program. Ideally, children with CI are included into mainstream educational settings. Considering the high incidence of additional disabilities in children with hearing loss, it seems obvious that this goal cannot be achieved by all implanted children. Therefore, highly complex and individualized rehabilitation concepts are needed, which, in addition to oral language intervention programs, include total communication approaches as well.
在德国,每年约有4000名患者接受人工耳蜗植入。成年人已成为人工耳蜗植入候选的主要群体。过去,由于传统助听器的局限性,患有进行性重度听力损失的老年人在沟通方面受到很大限制。如今,人工耳蜗植入已成为听力系统供应链中成熟的补充手段。为重度听力障碍儿童植入人工耳蜗的选择引发了听力康复领域的范式转变。然而,接受人工耳蜗植入的儿童在口语语言能力方面仍存在很大差异。这些差异范围从与正常听力儿童相似的沟通和语言能力到明显有限的接受性和表达性语言技能。除了植入年龄和先前听觉刺激的质量外,还有其他因素可能影响人工耳蜗植入后的效果。其中包括照顾者语言输入的质量以及强化的术后康复和干预计划。理想情况下,接受人工耳蜗植入的儿童应融入主流教育环境。鉴于听力损失儿童中合并其他残疾的发生率很高,显然并非所有接受植入的儿童都能实现这一目标。因此,需要高度复杂且个性化的康复理念,除了口语语言干预计划外,还应包括全面沟通方法。