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12 个月龄前植入人工耳蜗的儿童的听觉理解结果。

Auditory comprehension outcomes in children who receive a cochlear implant before 12 months of age.

机构信息

Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.

Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.

出版信息

Laryngoscope. 2020 Mar;130(3):776-781. doi: 10.1002/lary.28061. Epub 2019 May 14.

Abstract

OBJECTIVE

The U.S. Food and Drug Administration guidelines for cochlear implantation (CI) include age greater than 12 months. Studies have suggested that implantation in children younger than 12 months with congenital deafness may be associated with better spoken language outcomes. Compare auditory comprehension (AC) outcomes for children with congenital deafness who received CI less than 12 months of age to those implanted at 12 to 24 months of age.

METHODS

Retrospective review of prospectively collected data in consecutively implanted patients under 2 years of age who received CI and had post-CI Preschool Language Scale (PLS)-AC scores. Receptive language was assessed with the AC subtest of the PLS. Patients without pre-CI PLS-AC scores were excluded. The association between age at implantation and post-CI PLS-AC scores up to 2 years after CI surgery was modeled using a linear mixed-effects model. Time from CI surgery, number of implants, risk factors for language delay, pre-CI PLS-AC score, and sex were included in the model. Patients implanted less than 12 months of age were compared to those implanted between 12 and 24 months.

RESULTS

Twenty-nine patients who had CI surgery by 12 months and 82 who had CI surgery between 12 and 24 months were included in the analysis. Younger age at implantation and better pre-CI PLS-AC scores were significantly associated with better post-CI PLS-AC scores.

CONCLUSION

Cochlear implantation in children with congenital deafness less than 12 months of age was associated with better PLS-AC than in children implanted over 12 months of age up to 2 years after implantation.

LEVEL OF EVIDENCE

4 Laryngoscope, 130:776-781, 2020.

摘要

目的

美国食品和药物管理局(FDA)关于人工耳蜗植入(CI)的指南包括年龄大于 12 个月。研究表明,对于先天性耳聋的 12 个月以下儿童进行植入可能与更好的口语语言结果相关。比较小于 12 个月接受 CI 的先天性耳聋儿童的听觉理解(AC)结果与 12 至 24 个月接受植入的儿童。

方法

对年龄在 2 岁以下接受 CI 并在植入后接受学前语言量表(PLS)-AC 评分的连续植入患者进行前瞻性数据回顾。采用 PLS 的 AC 子测验评估接受性语言。排除无植入前 PLS-AC 评分的患者。使用线性混合效应模型对植入年龄与植入后 2 年内 PLS-AC 评分之间的关系进行建模。模型中包括植入时间、植入物数量、语言延迟的危险因素、植入前 PLS-AC 评分和性别。比较植入年龄小于 12 个月与植入年龄在 12 至 24 个月之间的患者。

结果

在 12 个月内接受 CI 手术的 29 例患者和在 12 至 24 个月内接受 CI 手术的 82 例患者被纳入分析。植入年龄越小,植入前 PLS-AC 评分越高,与植入后 PLS-AC 评分越好呈显著相关。

结论

在植入后 2 年内,与植入年龄超过 12 个月的儿童相比,12 个月以下先天性耳聋儿童的 CI 植入与更好的 PLS-AC 相关。

证据水平

4 级喉镜,130:776-781,2020 年。

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