Lahlou Ghizlene, Daoudi Hannah, Ferrary Evelyne, Jia Huan, De Bergh Marion, Nguyen Yann, Sterkers Olivier, Mosnier Isabelle
Unité Fonctionnelle Implants Auditifs, Département d'Oto-Rhino-Laryngologie, Groupe Hospitalo-Universitaire Pitié-Salpêtrière, APHP Sorbonne Université, 75013 Paris, France.
Technologie et Thérapie Génique de la Surdité, Inserm/Institut Pasteur, Institut de l'Audition, 75012 Paris, France.
J Clin Med. 2022 Mar 28;11(7):1874. doi: 10.3390/jcm11071874.
Cochlear implantation is usually not recommended for prelingual profoundly deaf adults, although some of these patients might benefit from it. This study aims to define the candidates for cochlear implantation in this population. This retrospective study reviewed 34 prelingual profoundly deaf patients who had received a cochlear implant at 32 ± 1.7 years old (16−55), with at least 1 year of follow-up. Speech perception and quality of life were assessed before and 3, 6, and 12 months after cochlear implantation, then every year thereafter. According to the word speech intelligibility in quiet (WSI) 1 year after implantation, two groups were identified: good performer (GP) with WSI ≥ 50% (n = 15), and poor performer (PP) with WSI ≤ 40% (n = 19). At the 1 year mark, mean WSI improved by 28 ± 4.6% (−20−100) (p < 0.0001). In GP, the intelligibility for words and sentences, communication and quality of life scales improved. In PP, the communication scale improved, but not auditory performance or quality of life. GP and PP differed pre-operatively in speech production, communication abilities, and WSI in best-aided conditions. In prelingual profoundly deaf adults, a dramatic auditory performance benefit could be expected after cochlear implantation if the patients have some degree of speech intelligibility in aided conditions and have developed oral communication and speech production.
通常不建议为语前极重度聋的成年人植入人工耳蜗，尽管其中一些患者可能会从中受益。本研究旨在确定该人群中适合植入人工耳蜗的候选人。这项回顾性研究评估了34名语前极重度聋患者，他们在32±1.7岁（16 - 55岁）时接受了人工耳蜗植入，且随访时间至少为1年。在人工耳蜗植入前以及植入后3个月、6个月和12个月，随后每年评估言语感知和生活质量。根据植入后1年的安静环境下言语可懂度（WSI），将患者分为两组：WSI≥50%的表现良好组（GP，n = 15）和WSI≤40%的表现较差组（PP，n = 19）。在1年时，平均WSI提高了28±4.6%（-20 - 100）（p < 0.0001）。在GP组中，单词和句子的可懂度、沟通及生活质量量表均有所改善。在PP组中，沟通量表有所改善，但听觉表现和生活质量未改善。GP组和PP组在术前的言语产生、沟通能力以及最佳助听条件下的WSI方面存在差异。对于语前极重度聋的成年人，如果患者在助听条件下有一定程度的言语可懂度，并且已发展出口语交流和言语产生能力，那么人工耳蜗植入后有望获得显著的听觉表现改善。
