Sharma Anuradha, Panda Naresh, Munjal Sanjay
Department of Otolaryngology, New OPD, PGIMER, Sector 12, Chandigarh, India.
Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Iran J Otorhinolaryngol. 2021 Sep;33(118):281-289. doi: 10.22038/ijorl.2021.48909.2621.
The present study reviews our experience with children with white matter disturbances and the benefits they get from rehabilitation post cochlear implantation.
It is a retrospective cohort study of 7 cochlear implanted children with white matter disturbances. Preoperatively all the subjects had undergone a complete Audiological test battery for confirmation of hearing thresholds. Post assessment, a digital hearing aid trial was followed by three months' therapy. Unilateral cochlear implant surgery and monitored auditory-verbal therapy sessions were the next line of treatment for at least one year. The therapist regularly monitored hearing and communication outcomes on an Auditory verbal ongoing scale, revised CAP, MAIS, word, and sentence discrimination scores.
The age range of Implantation was between 48 to 60 months. 5 out of 7 participants showed remarkable improvement with regular therapy. Their Meaningful Auditory Integration Scale (MAIS) scores were greater than 35 indicating good auditory integration and Categories of Auditory Performance (CAP) revealed scores of even 9 and higher indicating good telephone conversation. Speech Intelligibility Rating (SIR) showed a rating of 4 meaning thereby that an unfamiliar Listener could understand Speech without additional cues. However, all of them reported difficulty perceiving speech in noisy environments. Two cochlear implantees needed speech reading cues in conjunction with the audition.
Our experience with cochlear Implantation in children with white matter abnormalities has been positive and satisfactory. The presence of white matter abnormalities on MRI should not be a contraindication for Implantation. Successful outcomes can be expected with regular and dedicated auditory-verbal therapy sessions.
本研究回顾了我们对患有白质紊乱儿童的治疗经验以及他们在人工耳蜗植入后康复所获得的益处。
这是一项对7名患有白质紊乱的人工耳蜗植入儿童的回顾性队列研究。术前,所有受试者都接受了完整的听力学测试组,以确认听力阈值。术后评估时,先进行数字助听器试验,然后进行三个月的治疗。接下来是单侧人工耳蜗植入手术以及至少为期一年的监测听觉言语治疗课程。治疗师定期使用听觉言语进展量表、修订后的CAP、MAIS、单词和句子辨别分数来监测听力和沟通结果。
植入年龄范围在48至60个月之间。7名参与者中有5名通过定期治疗有显著改善。他们的有意义听觉整合量表(MAIS)得分大于35,表明听觉整合良好,听觉表现类别(CAP)显示得分甚至达到9分及以上,表明电话交谈良好。言语可懂度评级(SIR)显示为4级,这意味着不熟悉的听众无需额外提示就能理解言语。然而,他们所有人都报告在嘈杂环境中感知言语有困难。两名人工耳蜗植入者需要结合言语阅读提示来辅助听觉。
我们对患有白质异常儿童进行人工耳蜗植入的经验是积极且令人满意的。MRI上白质异常的存在不应成为植入的禁忌症。通过定期且专门的听觉言语治疗课程,可以预期获得成功的结果。