UPMC Children's Hospital of Pittsburgh, Department of Otolaryngology, Pittsburgh, PA, United States of America.
UPMC Children's Hospital of Pittsburgh, Department of Otolaryngology, Pittsburgh, PA, United States of America.
Am J Otolaryngol. 2021 Mar-Apr;42(2):102887. doi: 10.1016/j.amjoto.2020.102887. Epub 2021 Jan 5.
To determine if barriers to cochlear implantation (CI) exist with respect to Amish children and to describe unique considerations associated with CI and subsequent otologic care in the Amish population.
Out of all patients who underwent CI at a tertiary care pediatric hospital from 2008 to 2019, Amish children were age-matched to the remainder of the cohort to compare demographics and care-related metrics including etiology of hearing loss, age at time of initial hearing-related appointment and at CI, total number of pre- and post-operative audiologic and otologic appointments, and post-operative complications. Social considerations that may pose barriers to care were collected for descriptive analysis.
Since 2008, 232 children underwent CI, of which 8 implants were performed on Amish children. Six (75%) Amish children underwent newborn hearing screening and 3(38%) were found to have syndromic etiology for hearing loss. While Amish patients had a lower number of both audiologic (15 vs 33.5, p<.001) and otologic (4.5 vs 8.5, p=.028) appointments when compared to age-matched controls, median age at the time of implantation for the whole sample was not different between groups (2.5 vs 2.0 years, p=.211). From a social standpoint, limitations in transportation, telephone communication, and ability to recharge processor batteries must be considered in the Amish population.
Amish children undergoing CI face unique barriers to care including transportation and technologic limitations, leading to overall fewer hearing-related appointments when compared to an age-matched cohort. Understanding societal differences is important to facilitate optimal care for Amish children with hearing loss.
确定在阿米什儿童中是否存在与人工耳蜗植入（CI）相关的障碍，并描述与 CI 相关的独特考虑因素以及在阿米什人群中的后续耳科护理。
在 2008 年至 2019 年期间，在一家三级儿科医院接受 CI 的所有患者中，与其余队列的年龄相匹配，以比较人口统计学和护理相关指标，包括听力损失的病因、初次听力相关预约和 CI 的年龄、术前和术后听力和耳科预约的总次数，以及术后并发症。收集了可能对护理构成障碍的社会因素进行描述性分析。
自 2008 年以来，共有 232 名儿童接受了 CI，其中 8 名植入物是在阿米什儿童中进行的。6 名（75%）阿米什儿童接受了新生儿听力筛查，其中 3 名（38%）患有听力损失的综合征病因。虽然与年龄匹配的对照组相比，阿米什患者的听力（15 次与 33.5 次，p<.001）和耳科（4.5 次与 8.5 次，p=.028）预约次数较少，但两组在整个样本中的植入年龄中位数没有差异（2.5 岁与 2.0 岁，p=.211）。从社会角度来看，在阿米什人群中，必须考虑交通、电话沟通和处理器电池充电能力的限制。
接受 CI 的阿米什儿童面临着独特的护理障碍，包括交通和技术限制，与年龄匹配的队列相比，他们的听力相关预约次数总体较少。了解社会差异对于为听力损失的阿米什儿童提供最佳护理非常重要。
