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电声刺激在儿童中的应用效果。

Electric-Acoustic Stimulation Outcomes in Children.

机构信息

Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

出版信息

Ear Hear. 2019 Jul/Aug;40(4):849-857. doi: 10.1097/AUD.0000000000000658.

Abstract

OBJECTIVES

This study investigates outcomes in children fit with electric-acoustic stimulation (EAS) and addresses three main questions: (1) Are outcomes with EAS superior to outcomes with conventional electric-only stimulation in children? (2) Do children with residual hearing benefit from EAS and conventional electric-only stimulation when compared with the preoperative hearing aid (HA) condition? (3) Can children with residual hearing derive benefit from EAS after several years of listening with conventional electric-only stimulation?

DESIGN

Sixteen pediatric cochlear implant (CI) recipients between 4 and 16 years of age with an unaided low-frequency pure tone average of 75 dB HL in the implanted ear were included in two study arms. Arm 1 included new recipients, and Arm 2 included children with at least 1 year of CI experience. Using a within-subject design, participants were evaluated unilaterally with the Consonant-Nucleus-Consonant (CNC) word list in quiet and the Baby Bio at a +5 dB SNR using an EAS program and a conventional full electric (FE) program. Arm 1 participants' scores were also compared with preoperative scores.

RESULTS

Speech perception outcomes were statistically higher with the EAS program than the FE program. For new recipients, scores were significantly higher with EAS than preoperative HA scores for both the CNC and Baby Bio in noise; however, after 6 months of device use, results in the FE condition were not significantly better than preoperative scores. Long-term FE users benefited from EAS over their FE programs based on CNC word scores.

CONCLUSIONS

Whether newly implanted or long-term CI users, children with residual hearing after CI surgery can benefit from EAS. Cochlear implantation with EAS fitting is a viable option for children with HAs who have residual hearing but have insufficient access to high-frequency sounds and poor speech perception.

摘要

目的

本研究调查了适合电声刺激(EAS)的儿童的结果,并提出了三个主要问题:(1)EAS 的结果是否优于儿童传统电刺激的结果?(2)与术前助听器(HA)条件相比,具有残余听力的儿童是否从 EAS 和传统电刺激中受益?(3)在使用传统电刺激聆听数年之后,具有残余听力的儿童是否可以从 EAS 中受益?

设计

本研究纳入了 16 名年龄在 4 至 16 岁之间的儿童人工耳蜗植入(CI)受者,他们在植入耳的未助听低频纯音平均听阈为 75dB HL。在两个研究臂中,包括新受者的臂 1 和至少有 1 年 CI 经验的儿童的臂 2。使用自身对照设计,参与者在安静状态下使用辅音-核-辅音(CNC)词表进行单侧评估,并在+5dB SNR 下使用 EAS 程序和传统全电(FE)程序进行 Baby Bio 测试。臂 1 参与者的分数也与术前分数进行了比较。

结果

EAS 程序的言语感知结果明显高于 FE 程序。对于新受者,EAS 的分数在噪声环境下均明显高于 CNC 和 Baby Bio 的术前 HA 分数;然而,在设备使用 6 个月后,FE 条件下的结果并不明显优于术前分数。基于 CNC 单词分数,长期使用 FE 的患者从 EAS 中获益。

结论

无论是否为新植入的患者或长期 CI 用户,接受 CI 手术后具有残余听力的儿童都可以从 EAS 中受益。对于具有残余听力但高频声音获取不足且言语感知能力较差的有 HA 的儿童,EAS 拟合的 CI 植入是一种可行的选择。

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