Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otolaryngology, Beijing 100005, China.
Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Chin Med J (Engl). 2019 Aug 20;132(16):1925-1934. doi: 10.1097/CM9.0000000000000370.
The development of auditory and speech perception ability of children with hearing loss is affected by many factors after they undergo cochlear implantation (CI). Age at CI (CI age) appears to play an important role among these factors. This study aimed to evaluate the development of auditory and speech perception ability and explore the impact of CI age on children with pre-lingual deafness present before 3 years of age.
Two hundred and seventy-eight children with pre-lingual deafness (176 boys and 102 girls) were included in this study, and the CI age ranged from 6 to 36 months (mean age, 19 months). Categorical auditory performance (CAP) was assessed to evaluate auditory ability, and the speech intelligibility rating was used to evaluate speech intelligibility. The evaluations were performed before CI and 1, 3, 6, 12, 18, 24, 36, 48, and 60 months after CI.
The auditory ability of the pre-lingually hearing-impaired children showed the fastest development within 6 months after CI (k = 0.524, t = 30.992, P < 0.05); then, the progress started to decelerate (k = 0.14, t = 3.704, P < 0.05) and entered a plateau at the 24th month (k = 0.03, t = 1.908, P < 0.05). Speech intelligibility showed the fastest improvement between the 12th and 24th months after CI (k = 0.138, t = 5.365, P < 0.05); then, the progress started to decelerate (k = 0.026, t = 1.465, P < 0.05) and entered a plateau at the 48th month (k = 0.012, t = 1.542, P < 0.05). The CI age had no statistical significant effect on the auditory and speech abilities starting at 2 years after CI (P > 0.05). The optimal cutoff age for CI was 15 months.
Within 5 years after CI, the auditory and speech ability of young hearing-impaired children continuously improved, although speech development lagged behind that of hearing. An earlier CI age is recommended; the optimal cutoff age for CI is at 15 months.
植入人工耳蜗后，儿童的听力和言语感知能力的发展受到许多因素的影响。人工耳蜗植入年龄（CI 年龄）似乎是这些因素中的一个重要因素。本研究旨在评估先天性耳聋患儿在植入人工耳蜗前 3 岁的听觉和言语感知能力的发展，并探讨 CI 年龄对这些儿童的影响。
本研究纳入 278 例先天性耳聋患儿（男 176 例，女 102 例），CI 年龄为 6 至 36 个月（平均 19 个月）。采用分类听觉测试（CAP）评估听觉能力，采用言语可懂度分级评估言语可懂度。在植入人工耳蜗前、植入后 1、3、6、12、18、24、36、48 和 60 个月进行评估。
先天性耳聋患儿的听觉能力在植入人工耳蜗后 6 个月内发展最快（k=0.524，t=30.992，P<0.05）；然后，进展开始减缓（k=0.14，t=3.704，P<0.05），并在 24 个月时进入平台期（k=0.03，t=1.908，P<0.05）。言语可懂度在植入人工耳蜗后 12 至 24 个月内提高最快（k=0.138，t=5.365，P<0.05）；然后，进展开始减缓（k=0.026，t=1.465，P<0.05），并在 48 个月时进入平台期（k=0.012，t=1.542，P<0.05）。植入后 2 年，CI 年龄对听觉和言语能力无统计学意义（P>0.05）。CI 的最佳年龄为 15 个月。
在植入人工耳蜗后 5 年内，年轻听力障碍儿童的听觉和言语能力持续提高，尽管言语发育滞后于听觉。建议尽早进行 CI，CI 的最佳截止年龄为 15 个月。
