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内耳畸形儿童的双模式刺激:一侧人工耳蜗植入和对侧听脑干植入。

Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory brainstem implant.

机构信息

Department of Audiology, Hacettepe University Faculty of Health Sciences, Ankara, Turkey.

Department of Otorhinolaryngology, Hacettepe University, Ankara, Turkey.

出版信息

Clin Otolaryngol. 2020 Mar;45(2):231-238. doi: 10.1111/coa.13499. Epub 2020 Jan 22.

DOI:10.1111/coa.13499
PMID:31854074
Abstract

OBJECTIVE

To determine audiological outcomes of children who use a cochlear implant (CI) in one ear and an auditory brainstem implant (ABI) in the contralateral ear.

DESIGN

Retrospective case review.

SETTING

Tertiary referral hospital.

PARTICIPANTS

Twelve children followed with CI and contralateral auditory brainstem implant (ABI) by Hacettepe University Department of Otorhinolaryngology and Audiology in Turkey. All children were diagnosed with different inner ear malformations with cochlear nerve aplasia/hypoplasia. CI was planned in the ear with better sound detection during behavioural testing with inserted ear phones and with better CN as seen on MRI. Due to the limited auditory and speech progress with the cochlear implant, ABI was performed on the contralateral ear in all subjects.

MAIN OUTCOME MEASURES

Audiological performance and auditory perception skills of children with cochlear nerve deficiency (CND) who use bimodal electrical stimulation with CI and contralateral ABI.

RESULTS

Mean age of the subjects was 84.00 ± 33.94 months. Age at CI surgery and ABI surgery was 25.00 ± 10.98 months and 41.50 ± 16.14 months, respectively. However, hearing thresholds only with CI and only with ABI did not reveal significant difference, and auditory perception scores improved with bimodal stimulation. The MAIS scores were significantly improved from unilateral CI to bimodal stimulation (P = .002). Pattern perception and word recognition scores were significantly higher with the bimodal condition when compared to CI only and ABI only conditions.

CONCLUSION

Children with CND showed better performance with CI and contralateral ABI combined. Depending on the audiological and radiological results, bimodal stimulation should be advised for children with CND.

摘要

目的

确定在一只耳朵中使用人工耳蜗(CI),在对侧耳朵中使用听觉脑干植入物(ABI)的儿童的听力结果。

设计

回顾性病例研究。

地点

土耳其哈切特佩大学耳鼻喉科的三级转诊医院。

参与者

12 名在土耳其哈切特佩大学耳鼻喉科接受 CI 和对侧听觉脑干植入(ABI)的儿童。所有儿童均被诊断为不同的内耳畸形,伴有耳蜗神经发育不全/发育不良。CI 计划在耳朵中进行,该耳朵在行为测试中通过插入耳机更好地检测声音,并在 MRI 上更好地看到 CN。由于对侧耳朵的听力和言语进展有限,所有患者均在对侧耳朵中进行了 ABI。

主要观察指标

使用 CI 和对侧 ABI 进行双模式电刺激的患有耳蜗神经缺陷(CND)的儿童的听力表现和听觉感知技能。

结果

受试者的平均年龄为 84.00 ± 33.94 个月。CI 手术和 ABI 手术的年龄分别为 25.00 ± 10.98 个月和 41.50 ± 16.14 个月。但是,仅使用 CI 和仅使用 ABI 的听力阈值没有显著差异,并且听觉感知评分随双模式刺激而提高。从单侧 CI 到双模式刺激,MAIS 评分显著提高(P=0.002)。与仅使用 CI 和仅使用 ABI 的条件相比,模式感知和单词识别得分在双模式条件下显著更高。

结论

患有 CND 的儿童在 CI 和对侧 ABI 联合使用时表现更好。根据听力和影像学结果,应建议患有 CND 的儿童进行双模式刺激。

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