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中国山东人工耳蜗植入儿童听力和言语康复效果的长期功能结局。

Long-term functional outcomes of hearing and speech rehabilitation efficacy among paediatric cochlear implant recipients in Shandong, China.

机构信息

School of Public Health, Shandong University, Jinan, China.

International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.

出版信息

Disabil Rehabil. 2021 Oct;43(20):2860-2865. doi: 10.1080/09638288.2020.1720317. Epub 2020 Feb 5.

Abstract

PURPOSE

To evaluate the auditory performance and speech intelligibility of 100 children with bilateral profound sensorineural hearing loss up to 3 years after cochlear implantation.

METHODS

A cohort study was established consisting of 100 children who received cochlear implantation at Shandong Ear Nose and Throat Hospital from 2012 to 2015. Children were examined after 1 month, 1, 2, and 3 years of implantation to assess auditory performance and speech intelligibility using standard tools. The paired Wilcoxon signed-rank test was used to assess whether the scores obtained at different testing points differed significantly. The Mann-Whitney test was utilized to examine the between-group differences (e.g., age at implantation).

RESULTS

Three years after implantation, 60% out of 100 children reached the maximal category (7) of categorical auditory performance and 37% achieved the highest category (5) of speech intelligibility rating. Significant improvements were found over time in categorical auditory performance category and speech intelligibility rating (from month 1 to year 1,  < 0.001; from year 1 to year 2,  < 0.001; and from year 2 to year 3,  < 0.001). Larger improvements in auditory outcomes and speech intelligibility were observed in children with a younger age at implantation and those who received speech therapy.

CONCLUSIONS

Cochlear implantation appears to make a significant, positive contribution to the development of communication skills of young congenital and prelingually deaf children in China. These improvements continue for up to 3 years after implantation. Positive outcomes appear to be associated with earlier age at implantation and receipt of speech therapy.Implications for rehabilitationBilateral sensorineural hearing loss.Bilateral sensorineural hearing loss in children can cause delay in speech development, poor language skills and potentially disorders in psychological behaviour and social isolation.Cochlear implantation (CI) is an effective strategy that helps children with bilateral sensorineural hearing loss gain the ability to hear and continue to develop language.This study shows that the auditory performance and speech intelligibility of deaf children who speak Mandarin continued to improve up to 3 years of implantation, when follow-up ceased.

摘要

目的

评估 100 例双侧极重度感音神经性听力损失儿童在人工耳蜗植入后 3 年内的听觉表现和言语可懂度。

方法

建立了一项队列研究,纳入了 2012 年至 2015 年在山东省耳鼻喉医院接受人工耳蜗植入的 100 例儿童。在植入后 1 个月、1 年、2 年和 3 年对儿童进行检查,使用标准工具评估听觉表现和言语可懂度。采用配对 Wilcoxon 符号秩检验评估不同测试点的得分是否有显著差异。采用 Mann-Whitney 检验比较组间差异(如植入年龄)。

结果

植入后 3 年,100 例儿童中有 60%达到类别听觉表现的最大类别(7),37%达到言语可懂度评级的最高类别(5)。类别听觉表现和言语可懂度评级随时间显著改善(从第 1 个月到第 1 年, < 0.001;从第 1 年到第 2 年, < 0.001;从第 2 年到第 3 年, < 0.001)。植入年龄较小和接受言语治疗的儿童听觉结果和言语可懂度改善较大。

结论

人工耳蜗植入似乎对中国先天性和语前聋的年轻聋儿语言交流技能的发展产生了显著的积极影响。这些改善持续到植入后 3 年。积极的结果似乎与较早的植入年龄和接受言语治疗有关。

康复意义

双侧感音神经性听力损失。

双侧感音神经性听力损失会导致儿童言语发育迟缓、语言技能差,并可能导致心理行为障碍和社会隔离。

人工耳蜗植入(CI)是一种有效的策略,可以帮助双侧感音神经性听力损失的儿童获得听力,并继续发展语言能力。

本研究显示,当随访停止时,说普通话的聋儿的听觉表现和言语可懂度在植入后 3 年内继续提高。

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