Necker - Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
Necker - Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Oct;138(5):337-341. doi: 10.1016/j.anorl.2021.01.002. Epub 2021 Jan 22.
To analyze the impact of bilateral cochlear implantation (CI) on perceptual and linguistic development in hearing-impaired children with congenital Cytomegalovirus (CMV) infection.
A retrospective study was performed for the period 1991-2016 in a pediatric CI reference center. Closed Set Word (CSW) recognition scores, Categories of Auditory Performance (CAP) and linguistic level on the MT Lenormand scale (MTL) were compared between bilateral (Bi) and unilateral (Uni) groups 12, 24 and 36 months after first CI (CI-1).
84 patients with congenital CMV infection who underwent CI were included, in 2 groups: sequential or simultaneous bilateral CI (Bi) (N=20), and unilateral CI (Uni) (N=64). Twelve, 24 and 36 months after CI-1, CSW scores were 35.56%, 64.52% and 82.93% in Uni and 60.3%, 85% (P=0.0084*), and 100% (P=0.00085*) in Bi. CAP scores 12, 24 and 36 months after CI-1 were 2.57, 3.85 and 4.3 in Uni and 3.91 (P=0.0068*), 5.00 (p=0.029*) and 5.50 (P=0.051*) in Bi. MTL linguistic level scores at 12, 24 and 36 months were 0.72, 1.25 and 1.65 in Uni, and 1.72, 3 (P=0.033) and 3.11 (P=0.045) in Bi. These significantly better scores in Bi at 24 and 36 months after CI-1 were also found on analysis of subgroups with no associated neurologic disorder (P=0.046* and P=0.032*), no associated psychiatric pathology (P=0.0055* and P=0.0073*), and no other associated disorder (P=0.0018* and P=0.035*), and for all subgroups together (P=0.0036 and P=0.037).
Bilateral CI is a faster way than unilateral CI for patients with congenital CMV infection to achieve structured fluent oral language. 50% of the series showed cerebral abnormalities on MRI, without difference between groups. This was not in itself predictive of poor progression of oral communication, unless associated with major neurologic disorder. Some children made little or no use of their CI in the medium term.
分析双侧人工耳蜗植入（CI）对先天性巨细胞病毒（CMV）感染听力障碍儿童感知和语言发展的影响。
这是一项回顾性研究，在一个儿科 CI 参考中心进行，时间为 1991 年至 2016 年。将首次 CI（CI-1）后 12、24 和 36 个月时的闭合集词（CSW）识别分数、听觉表现类别（CAP）和 MT Lenormand 量表（MTL）的语言水平，在双侧（Bi）和单侧（Uni）组之间进行比较。
84 例先天性 CMV 感染患者接受 CI 治疗，分为 2 组：顺序或同时双侧 CI（Bi）（n=20）和单侧 CI（Uni）（n=64）。CI-1 后 12、24 和 36 个月，Uni 组的 CSW 评分为 35.56%、64.52%和 82.93%，Bi 组为 60.3%、85%（P=0.0084*）和 100%（P=0.00085*）。CI-1 后 12、24 和 36 个月，Uni 组的 CAP 评分为 2.57、3.85 和 4.3，Bi 组为 3.91（P=0.0068*）、5.00（p=0.029*）和 5.50（P=0.051*）。12、24 和 36 个月时，Uni 组的 MTL 语言水平评分为 0.72、1.25 和 1.65，Bi 组为 1.72、3（P=0.033）和 3.11（P=0.045）。在分析无相关神经障碍（P=0.046和 P=0.032）、无相关精神病理学（P=0.0055和 P=0.0073）、无其他相关疾病（P=0.0018和 P=0.035）的亚组以及所有亚组（P=0.0036 和 P=0.037）中，Bi 组在 CI-1 后 24 和 36 个月时的这些评分明显更好。
与单侧 CI 相比，先天性 CMV 感染患者双侧 CI 是更快实现结构流畅口语的方法。该系列研究中有 50%的患者在 MRI 上显示出脑异常，但组间无差异。除非与主要神经障碍相关，否则这本身并不能预测口语交流的不良进展。一些儿童在中期很少或根本不使用他们的 CI。
