Tay Sok Yan, Anicete Rosslyn, Tan Kun Kiaang Henry
Department of Otolaryngology, Head and Neck Surgery, National University Hospital System (NUHS), Singapore.
Department of Otolaryngology, KK Women's and Children's Hospital, Singapore.
Int J Otolaryngol. 2019 Dec 1;2019:6483714. doi: 10.1155/2019/6483714. eCollection 2019.
To evaluate children with inner ear malformations following cochlear implantation (CI) in a tertiary pediatric hospital in Singapore to identify factors influencing outcomes after CI.
This is a retrospective cohort study of children aged 0 to 18 years, who had CI between 2000 and 2013. Demographic information, data on risk factors, type of inner ear malformation (IEM), age at implantation, speech pre- and postimplantation, and duration of follow-up were collected from clinical records. Operative details and audiological outcomes were also analyzed.
A total of 70 children underwent 83 CI surgeries. The mean age of the patients was 4.05 ± 3.17 years (range 1-18 years). Twenty patients (28.57%) had abnormal CT scan findings. CSF gusher occurred in 15 out of 26 CI (57.69%) in the group with IEM. Nine out of twenty patients (45.00%) had poor IT-MAIS scores prior to implantation. The average preoperative IT-MAIS score for children with anomalous inner ear anatomy was 14.1. The older CI patients, 3/20 (15.00%), mean age 8.33 years (range 7-10 years), were mostly referred for persistently unclear speech following hearing aids. Eleven patients (55.00%) had good speech and aided hearing threshold within speech limits after CI and were eligible for reintegration into mainstream schools. Five patients (25.00%) had improvement in speech but continued to receive education in special schools. Four patients (20.00%) had poor progress after surgery.
The presence of absent cochlear nerve, electrode folding, and underlying neurological disorders seemed to be associated with poorer outcomes.
在新加坡一家三级儿科医院对接受人工耳蜗植入（CI）的内耳畸形儿童进行评估，以确定影响人工耳蜗植入术后效果的因素。
这是一项对2000年至2013年间接受人工耳蜗植入的0至18岁儿童的回顾性队列研究。从临床记录中收集人口统计学信息、危险因素数据、内耳畸形（IEM）类型、植入年龄、植入前后的言语情况以及随访时间。还分析了手术细节和听力学结果。
共有70名儿童接受了83次人工耳蜗植入手术。患者的平均年龄为4.05±3.17岁（范围1 - 18岁）。20名患者（28.57%）CT扫描结果异常。在有内耳畸形的组中，26例人工耳蜗植入中有15例（57.69%）发生脑脊液喷射。20名患者中有9名（45.0%）植入前IT - MAIS评分较差。内耳解剖结构异常的儿童术前平均IT - MAIS评分为14.1。年龄较大的人工耳蜗植入患者，3/20（15.0%），平均年龄8.33岁（范围7 - 10岁），大多因佩戴助听器后言语持续不清而转诊。11名患者（55.0%）人工耳蜗植入后言语良好且助听听阈在言语范围内，有资格重新融入主流学校。5名患者（25.0%）言语有改善但仍在特殊学校接受教育。4名患者（20.0%）术后进展不佳。
耳蜗神经缺如、电极折叠和潜在神经系统疾病似乎与较差的预后相关。
