Blanc Fabian, Blanchet Catherine, Sicard Marielle, Merklen Fanny, Venail Frederic, Mondain Michel
Department of Otolaryngology and Head and Neck Surgery, Gui de Chauliac Hospital, 80 Avenue Augustin-Fliche, 34090 Montpellier, France.
Institute for Neurosciences of Montpellier (INM), Institut National de la Santé et de la Recherche Médicale U1289, University of Montpellier, 80 Avenue Augustin-Fliche, BP 74103, CEDEX 5, 34091 Montpellier, France.
J Clin Med. 2022 Jun 1;11(11):3148. doi: 10.3390/jcm11113148.
Cochlear implants are the most common and successful sensory neuroprosthetic devices. However, reimplantation can be required for medical reasons, device failure, or technological upgrading. Resolving the problem driving the intervention and offering stable or better audiological results are the main challenges. We aimed to analyze the success rate of this intervention and to identify factors influencing speech perception recovery after reimplantation in the pediatric population. We retrospectively collected the causes and the outcomes of 67 consecutive reimplantations in one cochlear implant center over 30 years. Reimplantation resolved the cause without recurrence for 94% of patients. The etiology of deafness, time since implantation, indication of reimplantation, sex, and age did not influence word discrimination test scores in silence, 3 years after surgery. However, adherence to a speech rehabilitation program was statistically associated with gain in perception scores: +8.9% [-2.2; +31.0%] versus -19.0% [-47.5; -7.6%] if no or suboptimal rehabilitation was followed ( = 0.0037). Cochlear reimplantation in children is efficient and is associated with predictable improvement in speech perception, 3 years after intervention. However, good adherence to speech rehabilitation program is necessary and should be discussed with the patient and parents, especially for the indication of reimplantation for technological upgrading.
人工耳蜗是最常见且成功的感觉神经假体装置。然而,由于医学原因、设备故障或技术升级,可能需要进行再次植入。解决导致干预的问题并提供稳定或更好的听力学结果是主要挑战。我们旨在分析这种干预的成功率,并确定影响儿科患者再次植入后言语感知恢复的因素。我们回顾性收集了一个人工耳蜗植入中心30年来连续67例再次植入的原因及结果。94%的患者再次植入解决了问题且未复发。耳聋病因、植入后时间、再次植入指征、性别和年龄对术后3年安静环境下的单词辨别测试分数没有影响。然而,坚持言语康复计划与感知分数的提高在统计学上相关:如果未进行或进行了次优康复,感知分数提高8.9%[-2.2;+31.0%],而如果未进行或进行了次优康复,则感知分数下降19.0%[-47.5;-7.6%](P = 0.0037)。儿童人工耳蜗再次植入是有效的,且与干预后3年言语感知的可预测改善相关。然而,必须坚持良好的言语康复计划,并且应该与患者及家长进行讨论,特别是对于因技术升级而进行再次植入的指征。