Koroleva I V, Kusovkov V E, Levin S V, Ogorodnikova E A, Yanov Yu K, Astashchenko S V
St.-Petersburg scientific research Institute of ear, throat, nose and speech, Bronnitskaya 9, St.-Petersburg, Russia, 190013.
Pavlov Institute of Physiology RAS, nab. Makarova 6, St.-Petersburg, Russia, 199034.
Vestn Otorinolaringol. 2019;84(2):29-35. doi: 10.17116/otorino20198402129.
The efficacy of sequential bilateral cochlear implantation with long interval between surgeries (18 years) was investigated in deaf-blind patient (22 years old man, lost hearing and vision after meningitis at the age 2.5 years). At the age 4 years he got cochlear implant at right ear. His speech skills completely disappeared before the implantation. Auditory-speech rehabilitation with cochlear implant was successful - patient has good auditory, language, speech, cognitive skills. At the age 22 years patient made decision to get cochlear implant at the left ear after breakdown of internal part of cochlear implant at right ear in spite of successful reoperation. After activation of new processor (all electrodes were activated) the patient got daily auditory training with cochlear implant at left ear (Concerto/Opus 2, Medel) on the base of 'auditory' method, in daily life patient uses 2 devices. After 1 month of using cochlear implant at left ear the patient recognized environmental sounds and music instruments, words and sentences in close set tests EARS battery, the score for OLSA test in quiet was 90%, but the perception in noise was complicated. The balance of parameters of fitting for 1-st and 2-nd processors and special auditory training with two cochlear implants provided the development of initial binaural interaction. Perilinqually deaf patients can achieve high effect after sequential bilateral cochlear implantation with long interval between surgeries. The necessary conditions are - preservation of electrical activity of auditory nerve, intensive structured auditory training with new 'ear', patient's motivation of using of cochlear implant at 'new' ear.
对一名失聪失明患者（22岁男性，2.5岁时因脑膜炎丧失听力和视力）进行了手术间隔时间较长（18年）的序贯双侧人工耳蜗植入疗效研究。4岁时他接受了右耳人工耳蜗植入。植入前他的言语技能完全丧失。人工耳蜗听觉言语康复取得成功——患者具备良好的听觉、语言、言语和认知技能。22岁时，尽管右耳人工耳蜗内部部件再次手术成功，但因右耳人工耳蜗内部部件故障，患者决定接受左耳人工耳蜗植入。新处理器激活后（所有电极均被激活），患者在“听觉”方法的基础上，使用左耳人工耳蜗（Medel公司的Concerto/Opus 2）进行每日听觉训练，日常生活中使用两台设备。使用左耳人工耳蜗1个月后，患者在EARS电池近距离测试中能够识别环境声音、乐器、单词和句子，安静环境下OLSA测试得分90%，但噪声环境下的感知较为复杂。第一和第二处理器适配参数的平衡以及使用两个人工耳蜗进行的特殊听觉训练促进了初始双耳交互的发展。对于蜗周性聋患者，手术间隔时间较长的序贯双侧人工耳蜗植入可取得较好效果。必要条件包括——保留听神经的电活动、使用新“耳朵”进行强化结构化听觉训练、患者使用“新”耳朵人工耳蜗的积极性。
