Chiossi Julia Santos Costa, Hyppolito Miguel Angelo
Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
Int J Pediatr Otorhinolaryngol. 2017 Sep;100:119-127. doi: 10.1016/j.ijporl.2017.06.036. Epub 2017 Jul 1.
to investigate if preoperative residual hearing in prelingually deafened children can interfere on cochlear implant indication and outcomes.
a systematic-review was conducted in five international databases up to November-2016, to locate articles that evaluated cochlear implantation in children with some degree of preoperative residual hearing. Outcomes were auditory, language and cognition performances after cochlear implant. The quality of the studies was assessed and classified according to the Oxford Levels of Evidence table - 2011. Risk of biases were also described.
From the 30 articles reviewed, two types of questions were identified: (a) what are the benefits of cochlear implantation in children with residual hearing? (b) is the preoperative residual hearing a predictor of cochlear implant outcome? Studies ranged from 04 to 188 subjects, evaluating populations between 1.8 and 10.3 years old. The definition of residual hearing varied between studies. The majority of articles (n = 22) evaluated speech perception as the outcome and 14 also assessed language and speech production.
There is evidence that cochlear implant is beneficial to children with residual hearing. Preoperative residual hearing seems to be valuable to predict speech perception outcomes after cochlear implantation, even though the mechanism of how it happens is not clear. More extensive researches must be conducted in order to make recommendations and to set prognosis for cochlear implants based on children preoperative residual hearing.
探讨语前聋儿童术前残余听力是否会影响人工耳蜗植入的适应证及效果。
截至2016年11月,在五个国际数据库中进行了系统评价,以查找评估有一定程度术前残余听力儿童人工耳蜗植入情况的文章。结果为人工耳蜗植入后的听觉、语言和认知表现。根据2011年牛津证据水平表对研究质量进行评估和分类。还描述了偏倚风险。
在 reviewed 的30篇文章中,确定了两类问题:(a)人工耳蜗植入对有残余听力的儿童有哪些益处?(b)术前残余听力是否是人工耳蜗植入效果的预测指标?研究对象从4例到188例不等,评估的人群年龄在1.8岁至10.3岁之间。不同研究中残余听力的定义有所不同。大多数文章(n = 22)将言语感知作为结果进行评估,14篇文章还评估了语言和言语产生情况。
有证据表明人工耳蜗植入对有残余听力的儿童有益。术前残余听力似乎对预测人工耳蜗植入后的言语感知结果有价值,尽管其发生机制尚不清楚。必须进行更广泛的研究,以便根据儿童术前残余听力提出建议并制定人工耳蜗植入的预后。