Karltorp Eva, Eklöf Martin, Östlund Elisabet, Asp Filip, Tideholm Bo, Löfkvist Ulrika
Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
Department of CLINTEC, Karolinska Institutet, Stockholm, Sweden.
Acta Paediatr. 2020 Feb;109(2):332-341. doi: 10.1111/apa.14954. Epub 2019 Sep 10.
Evidence suggests that cochlear implants are beneficial for language development, but there is no consensus about the ideal age for surgery. We investigated how language development and surgical safety were affected by patients' ages.
This study comprised 103 children (52 boys) aged 4.3-16 years who received cochlear implants at 5-29 months at the Karolinska University Hospital, Stockholm, Sweden, between 2002 and 2013. All showed typical development and were from monolingual homes. Bilateral implants were common (95%). The children were regularly assessed on language understanding, vocabulary and speech recognition by a multi-disciplinary team for 10.0 ± 3.7 (4.7-16.0) years.
There were no associations between complications after surgery and the age when children had their first implant. Children implanted at 5-11 months reached an age-equivalent level of language understanding and better vocabulary outcome sooner than subgroups implanted later. Children who had surgery at 12-29 months demonstrated more atypical and delayed language abilities over time. Early implantation, preferably before 9 months, may lead to a more typical trajectory of spoken language development.
Our findings showed that cochlear implantation before 9 months was safe. Early implantation may reduce the negative effects of auditory deprivation and promotes more natural and synchronised language development.
有证据表明人工耳蜗对语言发育有益，但对于手术的理想年龄尚无共识。我们研究了患者年龄如何影响语言发育和手术安全性。
本研究纳入了2002年至2013年期间在瑞典斯德哥尔摩卡罗林斯卡大学医院接受人工耳蜗植入的103名儿童（52名男孩），年龄在4.3至16岁之间，他们在5至29个月时接受了植入。所有儿童发育均正常，来自单语家庭。双侧植入很常见（95%）。多学科团队对这些儿童的语言理解、词汇和语音识别进行了定期评估，为期10.0±3.7（4.7至16.0）年。
手术后的并发症与儿童首次植入时的年龄之间没有关联。在5至11个月时植入的儿童比晚些时候植入的亚组更快达到年龄相当的语言理解水平，词汇量结果也更好。在12至29个月时接受手术的儿童随着时间推移表现出更多非典型和延迟的语言能力。早期植入，最好在9个月之前，可能会导致更典型的口语语言发育轨迹。
我们的研究结果表明9个月前进行人工耳蜗植入是安全的。早期植入可能会减少听觉剥夺的负面影响，并促进更自然和同步的语言发育。
