Jallu Aleena Shafi, Hussain Tahir, Hamid Waqar Ul, Pampori Rafiq Ahmad
1Department of Otolaryngology, Head and Neck Surgery, Government Medical College Srinagar, Srinagar, Jammu & Kashmir India.
House No 166a, Shah Anwar Colony Hyderpora, Srinagar, Jammu & Kashmir 190018 India.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1078-1089. doi: 10.1007/s12070-017-1181-7. Epub 2017 Aug 20.
Prelingually deaf child is one who is either born deaf or who lost his or her hearing early in childhood, before acquiring language. A child with subnormal hearing acuity suffers from consequences of hearing loss compounded by impaired speech development. The period from birth to 3 years of life is critical for the development of speech and language, therefore, there is need for early identification and assessment of hearing loss and early rehabilitation in children. 40 patients were evaluated clinically, radiologically and audiologically to assess the degree of patient's handicap. The modes of treatment included use of hearing aid in patients with moderate, moderately-severe, severe or profound HL and cochlear implantation in patients with profound HL. Each patient was followed for 18 months and results were calculated in terms of speech perception (CAP) and language (REELS) development of the patient. Out of the 40 patients, 60% (n = 24) were females and 40% (16) were males. 50% (n = 20) patients had PSNHL, 32.5% (n = 13) had SSNHL, 10% (n = 4) had MSSNHL and 7.5% (n = 3) had MSNHL. 30% (n = 12) of patients had significant radiological findings. Among the hearing aid users patients with PSNHL got no benefit at the end of 18 months whereas the patients with cochlear implantation had significant improvement. Also the patients managed at a younger age (<3 years) had a significantly better outcome then those managed later. Early identification of hearing loss, that is followed by immediate and appropriate intervention results in better language, speech, and social-emotional development when compared to children treated at a later age.
语前聋儿童是指出生时即耳聋或在儿童早期、在获得语言之前就丧失听力的儿童。听力敏锐度低于正常水平的儿童，除了听力丧失的后果外，还会因言语发育受损而受到影响。从出生到3岁是言语和语言发育的关键时期，因此，有必要对儿童的听力损失进行早期识别和评估，并进行早期康复。对40例患者进行了临床、放射学和听力学评估，以评估患者的残疾程度。治疗方式包括对中度、中重度、重度或极重度听力损失（HL）患者使用助听器，对极重度HL患者进行人工耳蜗植入。对每位患者随访18个月，并根据患者的言语感知（CAP）和语言（REELS）发育情况计算结果。在这40例患者中，60%（n = 24）为女性，40%（16）为男性。50%（n = 20）的患者为感音神经性听力损失（PSNHL），32.5%（n = 13）为突发性聋（SSNHL），10%（n = 4）为梅尼埃病伴突发性聋（MSSNHL），7.5%（n = 3）为梅尼埃病（MSNHL）。30%（n = 12）的患者有明显的放射学表现。在使用助听器的患者中，PSNHL患者在18个月结束时没有受益，而人工耳蜗植入患者有显著改善。此外，在较年轻年龄（<3岁）接受治疗的患者比后来接受治疗的患者预后明显更好。与年龄较大时接受治疗的儿童相比，早期识别听力损失并随后立即进行适当干预，会带来更好的语言、言语和社会情感发育。
