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内耳畸形儿童的人工耳蜗植入:听觉表现和言语产生结果的多中心研究。

Cochlear implantation in children with inner ear malformation: A multicenter study on auditory performance and speech production outcomes.

机构信息

ENT and Head & Neck Research Center and Department, Hazrat Rasoul Hospital, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.

Department of Otorhinolaryngology, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

Int J Pediatr Otorhinolaryngol. 2020 May;132:109901. doi: 10.1016/j.ijporl.2020.109901. Epub 2020 Jan 22.

Abstract

OBJECTIVES

This multicenter study evaluated the auditory performance and speech production outcomes of cochlear implantation in children with inner ear anomaly and compared the outcomes of patients with different kinds of malformation.

METHODS

Cochlear implantation was performed in 107 children with inner ear malformation at four tertiary academic centers. The categories of auditory performance (CAP) and speech intelligibility rating (SIR) scores were evaluated preoperatively and one year and two years postoperatively.

RESULTS

Types of inner ear malformation and their frequencies were: incomplete partition type-I, 19 (17.8%) patients; incomplete partition type-II, 31 (29%), common cavity, 17 (15.9%), cochlear hypoplasia, 17 (15.9%), and isolated enlarged vestibular aqueduct (isolated EVA), 23 (21.5%) patients. EVA was the coexisting anomaly in 27(25.2%) subjects. The median CAP and SIR scores improved significantly during the first two years after cochlear implantation in all groups (p-values <0.001 and < 0.001, respectively). No significant difference was seen in CAP and SIR scores of children with different inner ear malformations (p-value = 0.147 and 0.570, respectively) or in patients with isolated EVA compared to coexisting EVA (p-value = 0.538 and 0.075, respectively).

CONCLUSION

The median CAP and SIR scores two years after surgery were 5 (Understanding of common phrases without lip-reading) IQR: 4-6, and 3 (Connected speech is intelligible to a listener who concentrates and lip-reads within a known context) IQR: 3-4, respectively. Auditory performance and speech production were significantly improved in all inner ear malformation patient groups, and no significant difference was observed between the scores of patients with different types of anomaly.

摘要

目的

本多中心研究评估了内耳畸形儿童人工耳蜗植入的听觉表现和言语产生结果,并比较了不同畸形患者的结果。

方法

在四个三级学术中心对 107 例内耳畸形患儿进行人工耳蜗植入。在术前、术后 1 年和 2 年评估了听觉性能(CAP)和言语可懂度评分(SIR)的分类评分。

结果

内耳畸形的类型及其频率为:不完全分隔Ⅰ型,19 例(17.8%);不完全分隔Ⅱ型,31 例(29%);共同腔,17 例(15.9%);耳蜗发育不全,17 例(15.9%);孤立性扩大前庭导水管(孤立性 EVA),23 例(21.5%)。27 例(25.2%)患者有 EVA 合并畸形。所有组在人工耳蜗植入后前两年 CAP 和 SIR 评分均显著提高(p 值均<0.001)。不同内耳畸形儿童的 CAP 和 SIR 评分无显著差异(p 值分别为 0.147 和 0.570),或孤立性 EVA 与共存性 EVA 患者相比(p 值分别为 0.538 和 0.075)。

结论

术后两年的中位数 CAP 和 SIR 评分分别为 5(无需唇读即可理解常见短语)IQR:4-6 和 3(在已知语境下,集中和唇读的听众可以理解连贯的言语)IQR:3-4。所有内耳畸形患者组的听觉表现和言语产生均显著改善,不同类型畸形患者的评分无显著差异。

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