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患有乌舍尔综合征儿童的人工耳蜗植入:南亚经验

Cochlear Implantation in Children with Usher's Syndrome: A South Asian Experience.

作者信息

Nair Geetha, Dham Ruchima, Sekhar Arpana, Kumar Raghunandhan Sampath, Kameswaran Mohan

机构信息

Government Medical College, Ernakulam, Kochi, Kerala India.

Madras ENT Research Foundation, Chennai, Tamil Nadu India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2020 Mar;72(1):140-144. doi: 10.1007/s12070-019-01759-y. Epub 2019 Nov 7.

Abstract

Usher's syndrome is an autosomal recessive disorder characterized by dual sensory impairment involving both the ears and eyes. Cochlear implantation paves a way to restore hearing loss in such individuals but poor vision among these patients poses additional challenges for the habilitationists. This study aimed to compare the habilitation outcomes and hearing-related quality of life scores of cochlear implantees having Usher syndrome with age-matched cochlear implantees with no such syndromic association. 27 patients aged 1-6 years with Usher syndrome underwent cochlear Implantation over a period of 10 years from 2006 to 2016 and were included in this study along with an age-matched cohort of 30 implantees with no additional disabilities. Category of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were compared at 3, 6, 9 and 12 months respectively. Glasgow Benefit Inventory and Health Utility Index (HUI 3.0) questionnaires were used to assess the hearing-related quality of life in both groups at 1 year post implantation. There was significant difference in CAP and SIR scores between children with Usher's syndrome and the control group ( < 0.05). The overall scores in terms of quality of life as well were statistically different ( < 0.05). Though there was improvement in speech and language acquisition after cochlear Implantation this was found to be of lesser extent than the normative cohort. These children with additional visual disabilities required intensive, individualized therapy catering to their complex needs. Their family's perception of expected benefit from cochlear Implantation was guarded and needed to be appraised in detail prior to surgery. This experience helped prepare an institutional protocol for counseling such implantees in future.

摘要

尤塞综合征是一种常染色体隐性疾病,其特征为双耳和双眼均出现双重感觉障碍。人工耳蜗植入为恢复此类患者的听力损失开辟了一条道路,但这些患者的视力不佳给康复治疗师带来了额外挑战。本研究旨在比较患有尤塞综合征的人工耳蜗植入者与年龄匹配的无此类综合征关联的人工耳蜗植入者的康复效果及听力相关生活质量评分。2006年至2016年期间,27例年龄在1至6岁的尤塞综合征患者接受了人工耳蜗植入,并纳入本研究,同时还有一个由30名无其他残疾的年龄匹配植入者组成的队列。分别在3个月、6个月、9个月和12个月时比较听觉表现类别(CAP)和言语清晰度评分(SIR)。在植入后1年,使用格拉斯哥效益量表和健康效用指数(HUI 3.0)问卷评估两组的听力相关生活质量。尤塞综合征患儿与对照组之间的CAP和SIR评分存在显著差异(<0.05)。生活质量方面的总体评分在统计学上也存在差异(<0.05)。虽然人工耳蜗植入后言语和语言习得有所改善,但发现其程度低于正常队列。这些有额外视力残疾的儿童需要针对其复杂需求的强化、个性化治疗。他们的家人对人工耳蜗植入预期益处持谨慎态度,在手术前需要进行详细评估。这一经验有助于制定未来为此类植入者提供咨询的机构方案。

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Audiologic performance and benefit of cochlear implantation in Usher syndrome type I.
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