Bouquillon Édouard, Le Gac Marie-Suzanne, Godey Benoit
Service ORL, CHU de Caen, Caen, France.
Centre d'action médico-social précoce, Guipavas, France.
Rev Prat. 2018 Oct;68(8):870-873.
Cochlear implant in children. In a newborn, sensitive auditory stimulations allow the progressive central auditory development. In a congenital severe or profound deaf child, a cochlear implantation can be considered if auditory thresholds are too low to provide an efficient auditory stimulation with hearing aids. This device includes an external processor, which receives and analyses surrounding sounds, and send them to the internal part surgically implanted. The electrode array placed in the cochlea stimulates auditory pathways. The implantation is performed in a multidisciplinary centre and is followed by long-term implant fitting and speech therapy rehabilitation. 25 years of clinical experience since shows that cochlear implant allows a good speech understanding, speech production and mainstream schooling in a majority of severe and profound hearing loss. Early implantation is a major element of good performance. Implant can be contraindicated or can provide limited results in cases of cochlear ossification or fibrosis, inner ear malformation, auditory neuropathy, or additional handicaps.
儿童人工耳蜗植入。对于新生儿,敏感的听觉刺激有助于中枢听觉系统的逐步发育。对于先天性重度或极重度聋儿,如果听觉阈值过低,无法通过助听器提供有效的听觉刺激,则可考虑进行人工耳蜗植入。该装置包括一个外部处理器,它接收并分析周围的声音,然后将其发送到通过手术植入的内部部件。置于耳蜗内的电极阵列刺激听觉通路。植入手术在多学科中心进行,术后需要长期的植入调试和言语治疗康复。自开展25年的临床经验表明,人工耳蜗植入能使大多数重度和极重度听力损失患者获得良好的言语理解、言语表达能力,并能进入主流学校就读。早期植入是取得良好效果的关键因素。在耳蜗骨化或纤维化、内耳畸形、听神经病或伴有其他残疾的情况下,植入可能会被视为禁忌或效果有限。