Department of Otolaryngology-Head and Neck Surgery, Ninth People's Hospital.
Ear Institute, Shanghai Jiaotong University School of Medicine.
Otol Neurotol. 2020 Dec;41(10):1357-1362. doi: 10.1097/MAO.0000000000002812.
To evaluate the auditory and speech benefit of bimodal stimulation for prelingual deafened cochlear implantation recipients.
Retrospective and comparative study.
Tertiary referral center.
Fifty-six children with bilateral prelingual profound sensorineural hearing loss were enrolled, including 28 consecutive children with unilateral cochlear implantation (CI group), and 28 consecutive children with bimodal stimulation (BI group) who used an additional hearing aid (HA) in the contralateral ear.
Hearing assessments included the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and Categories of Auditory Performance (CAP). Speech evaluations included the Meaningful Use of Speech Scale (MUSS), and Speech Intelligibility Rating (SIR). These measurements were evaluated at the first mapping of cochlear implants and 0.5, 1, 3, 6, 12, 18, 24 months after. Data were analyzed by repeated measures analysis.
The mean ages of BI and CI groups were similar (17.6 ± 6.87 vs 19.0 ± 8.10 months, p = 0.497). The initial scores for hearing and speech assessments showed no differences between the two groups, apart from IT-MAIS (2.46 ± 0.631 in BI group vs 0.50 ± 0.279 in CI group, p = 0.004). The auditory and speech development over time were different in the two groups as seen in IT-MAIS (p < 0.001), CAP (p = 0.029), MUSS (p < 0.001), and SIR (p < 0.001). A continuing but stable difference was observed in CAP, MUSS, and SIR at 3, 18, and 12 months after the first mapping, respectively. In addition, the BI group had better IT-MAIS scores at 3 and 6 months compared with the CI group; however, the difference was not significant after 12 months.
Bimodal stimulation is beneficial for prelingually deafened CI recipients who have minimal contralateral residual hearing when bilateral CIs are not available. Hearing aid use in the contralateral ear might be recommended for children after unilateral cochlear implantation to facilitate the development of auditory and speech skills.
评估双侧聋人工耳蜗植入患者双耳听觉和言语康复效果。
回顾性和对比性研究。
三级转诊中心。
56 例双侧语前极重度感音神经性耳聋患儿，其中 28 例连续单侧人工耳蜗植入（CI 组），28 例双侧植入（BI 组）患儿对侧耳使用附加助听器（HA）。
听力评估包括婴幼儿意义听觉整合量表（IT-MAIS）和听觉表现分类（CAP）。言语评估包括言语有效使用量表（MUSS）和言语可懂度分级（SIR）。这些测量在人工耳蜗植入的第一次映射时以及植入后 0.5、1、3、6、12、18 和 24 个月进行评估。数据采用重复测量分析。
BI 组和 CI 组的平均年龄相似（17.6±6.87 岁 vs 19.0±8.10 岁，p=0.497）。两组在听力和言语评估的初始评分无差异，除 IT-MAIS 外（BI 组 2.46±0.631 vs CI 组 0.50±0.279，p=0.004）。两组随着时间的推移听觉和言语发育不同，表现在 IT-MAIS（p<0.001）、CAP（p=0.029）、MUSS（p<0.001）和 SIR（p<0.001）上。在第一次映射后 3、18 和 12 个月，分别在 CAP、MUSS 和 SIR 上观察到持续但稳定的差异。此外，BI 组在 3 和 6 个月时的 IT-MAIS 评分优于 CI 组，但在 12 个月后差异无统计学意义。
对于双侧人工耳蜗植入不可行且对侧残留听力有限的语前聋患者，双侧刺激是有益的。单侧人工耳蜗植入后，建议对儿童使用对侧耳助听器，以促进听觉和言语技能的发展。
