Dieleman Eveline, Percy-Smith Lone, Caye-Thomasen Per
Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Patientforening Decibel, Rygårdsallé 43, 2900, Hellerup, Denmark.
Int J Pediatr Otorhinolaryngol. 2019 Feb;117:37-44. doi: 10.1016/j.ijporl.2018.11.002. Epub 2018 Nov 3.
To investigate the possible association between the etiology of hearing impairment (HI) and language outcome in children with congenital HI after an early medical-technical intervention and three years of AVT.
A retrospective, two-center study was conducted of 53 patients who were divided in four categories of etiology (degeneratio labyrinthi acustici (DLA) congenita hereditaria, DLA congenita non specificata, DLA congenita postinfectiosa and auditory neuropathy). Language outcome was assessed by examining receptive vocabulary (Peabody Picture Vocabulary Test, PPVT-4), receptive language (Reynell test) and productive language (the Danish 'Viborgmaterialet'). All tests were conducted 1, 2 and 3 years after the children received their hearing device. Test scores were calculated from the child's chronological age. Analysis of possible associations was performed using Fisher's exact test and McNemar's test was conducted to examine possible differences between each year of testing for every speech-language test. Subsequently, univariate analyses were performed to search for other possible covariates associated with language outcome.
No significant associations were found between the etiology of the HI and the language outcome of children with HI after 1 year of AVT (PPVT, p = 0,234; Reynell, p = 0,845; Viborgmaterialet, p = 0,667), neither after 2 years of AVT (PPVT, p = 0,228; Reynell, p = 0,172; Viborgmaterialet, p = 0,659) nor after 3 years of AVT (PPVT, p = 0,102; Reynell, p = 0,512 Viborgmaterialet, p = 0,580). Some significant associations were found between language outcome and the type of hearing device and between language outcome and additional disabilities, however no strong evidence was found.
Most children with congenital HI developed a comparable level of speech and language regardless of the etiology of their HI. This study highlights the interest of further research using objective assessments techniques in a larger and more homogeneous population. If the findings from this study will be confirmed in future studies, this will have a clinical and societal impact regarding the diagnostics of HI.
探讨先天性听力障碍（HI）患儿在早期医疗技术干预及三年听觉言语治疗（AVT）后，听力障碍病因与语言发育结果之间的可能关联。
进行了一项回顾性、双中心研究，纳入53例患者，根据病因分为四类（先天性遗传性迷路退变（DLA）、先天性未明确的DLA、先天性感染后DLA和听神经病）。通过检查接受性词汇（皮博迪图片词汇测验，PPVT - 4）、接受性语言（雷诺尔测验）和表达性语言（丹麦语“Viborgmaterialet”）来评估语言发育结果。所有测试均在儿童佩戴听力设备1、2和3年后进行。测试分数根据儿童的实际年龄计算。使用费舍尔精确检验进行可能关联的分析，并进行麦克尼马尔检验以检查每项言语语言测试每年测试之间的可能差异。随后，进行单因素分析以寻找与语言发育结果相关的其他可能协变量。
在AVT 1年后（PPVT，p = 0.234；雷诺尔，p = 0.845；Viborgmaterialet，p = 0.667）、AVT 2年后（PPVT，p = 0.228；雷诺尔，p = 0.172；Viborgmaterialet，p = 0.659）以及AVT 3年后（PPVT，p = 0.102；雷诺尔，p = 0.512；Viborgmaterialet，p = 0.580），均未发现HI病因与HI患儿语言发育结果之间存在显著关联。然而，在语言发育结果与听力设备类型以及语言发育结果与其他残疾之间发现了一些显著关联，但未找到有力证据。
大多数先天性HI患儿，无论其HI病因如何，都能达到相当的言语和语言水平。本研究强调了在更大且更具同质性的人群中使用客观评估技术进行进一步研究的意义。如果本研究结果在未来研究中得到证实，这将对HI的诊断产生临床和社会影响。
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