Zhang Lifang, Chen Biao, Kong Ying, Liau Natalia, Wei Xingmei, Shi Ying, Chen Jingyuan, Yang Mengge, Dhanasingh Anandhan, Li Yongxin
Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China.
Front Neurosci. 2022 Mar 23;16:857855. doi: 10.3389/fnins.2022.857855. eCollection 2022.
To investigate the long-term development of auditory and speech in patients with common cavity deformity (CCD) after cochlear implantation (CI) and its relationship to imaging characteristics.
Twenty-three CCD patients and 59 age- and sex-matched CI children with normal inner ear structure were recruited. The auditory and speech development of these two groups were evaluated at 0, 1, 3, 6, 12, and 18 months after CI activation using four parent reports questionnaires [Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), Meaningful Auditory Integration Scale/Infant-Toddler Meaningful Auditory Integration Scale (MAIS/ITMAIS), and Meaningful Use of Speech Scale (MUSS)]. Computed tomography-based 3-dimensional reconstruction of the surgical side of 18 CCD children was performed, the volume and surface area were calculated. Correlation analysis was performed on the imaging performance and post-operative outcomes.
The percentages of MAIS/IT-MAIS scores and CAP scores at different evaluation time points are significantly different ( < 0.05). When comparing SIR results across time points, significant growth was observed in most of the comparisons. In addition, significant differences ( < 0.05) are observed among the percentages of MUSS scores at different time points except the comparison between 0 and 1 month after CI activation. Patients in the CCD group had poorer auditory and speech performances at different stages after CI compared with those in the control group. According to the reconstruction of CCD patients, the volume ranged from 12.21 to 291.96 mm; the surface area ranged from 27.81 to 284.7 mm. When the lumen surface area was <190.45 mm or the volume was <157.91 mm, the survival time for CCD children to achieve a CAP score of 4 after CI was significantly shorter.
Cochlear implantation are less effective in CCD patients than in patients with normal inner ear structures, but they can still achieve significant improvement post-operatively. The morphology and size of the inner ear vary in CCD patients, which reflects the degree of inner ear development influences the outcome after CI surgery.
探讨人工耳蜗植入(CI)后共同腔畸形(CCD)患者听觉和言语的长期发育情况及其与影像学特征的关系。
招募23例CCD患者和59例年龄及性别匹配、内耳结构正常的CI儿童。在CI开机后0、1、3、6、12和18个月,使用四份家长报告问卷[听觉表现分类(CAP)、言语可懂度评分(SIR)、有意义听觉整合量表/婴幼儿有意义听觉整合量表(MAIS/ITMAIS)和言语有意义使用量表(MUSS)]对两组患者的听觉和言语发育情况进行评估。对18例CCD儿童手术侧进行基于计算机断层扫描的三维重建,计算其体积和表面积。对影像学表现与术后结果进行相关性分析。
不同评估时间点MAIS/IT-MAIS评分和CAP评分的百分比差异有统计学意义(P<0.05)。比较各时间点的SIR结果时,大多数比较中观察到显著增长。此外,除CI开机后0和1个月的比较外,不同时间点MUSS评分的百分比差异有统计学意义(P<0.05)。与对照组相比,CCD组患者在CI后的不同阶段听觉和言语表现较差。根据CCD患者的重建结果,体积范围为12.21至291.96mm;表面积范围为27.81至284.7mm。当管腔表面积<190.45mm或体积<157.91mm时,CCD儿童CI后达到CAP评分4的生存时间显著缩短。
人工耳蜗植入对CCD患者的效果低于内耳结构正常的患者,但术后仍可实现显著改善。CCD患者内耳的形态和大小各不相同,这反映了内耳发育程度影响CI手术的结果。