Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston.
Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston.
Am J Audiol. 2022 Sep;31(3):613-632. doi: 10.1044/2022_AJA-21-00212. Epub 2022 Jun 29.
Characterizing and comparing speech recognition development in children with cochlear implants (CIs) is challenging because of variations in test type. This retrospective cohort study modified the Pediatric Ranked Order Speech Perception (PROSPER) scoring system to (a) longitudinally analyze the speech perception of children with CIs and (b) examine the role of age at CI activation, listening mode (i.e., unilateral or bilateral implantation), and interimplant interval.
Postimplantation speech recognition scores from 31 children with prelingual, severe-to-profound hearing loss who received CIs were analyzed (12 with unilateral CI [UniCI], 13 with sequential bilateral CIs [SEQ BiCIs], and six with simultaneous BiCIs). Data were extracted from the Massachusetts Eye and Ear Audiology database. A version of the PROSPER score was modified to integrate the varying test types by mapping raw scores from different tests into a single score. The PROSPER scores were used to construct speech recognition growth curves of the implanted ears, which were characterized by the slope of the growth phase, the time from activation to the plateau onset, and the score at the plateau.
While speech recognition improved considerably for children following implantation, the growth rates and scores at the plateau were highly variable. In first implanted ears, later implantation was associated with poorer scores at the plateau (β = -0.15, = .01), but not growth rate. The first implanted ears of children with BiCIs had better scores at the plateau than those with UniCI (β = 0.59, = .02). Shorter interimplant intervals in children with SEQ BiCIs promoted faster speech recognition growth of the first implanted ears.
The modified PROSPER score could be used clinically to track speech recognition development in children with CIs, to assess influencing factors, and to assist in developing and evaluating patient-specific intervention strategies.
由于测试类型的差异，描述和比较人工耳蜗植入儿童（CIs）的言语识别发展情况具有挑战性。本回顾性队列研究对小儿等级排序言语感知测试（PROSPER）评分系统进行了修改，目的是：（a）对 CIs 患儿的言语感知进行纵向分析；（b）研究 CI 激活年龄、听力模式（单侧或双侧植入）以及植入间隔对言语识别的影响。
对 31 名语前聋、重度至极重度听力损失且植入人工耳蜗的儿童的术后言语识别测试结果进行了分析（单侧植入 12 例，序贯双侧植入 13 例，双侧同步植入 6 例）。这些数据是从马萨诸塞州眼耳听力协会的数据库中提取的。PROSPER 评分的一个版本被修改，通过将不同测试的原始分数映射到单个分数，整合了不同的测试类型。使用 PROSPER 评分构建植入耳的言语识别增长曲线，这些曲线的特征是增长阶段的斜率、从激活到平台开始的时间以及平台期的分数。
尽管植入后儿童的言语识别能力有了显著提高，但增长率和平台期分数的差异很大。在初次植入耳中，植入时间越晚，平台期的得分越低（β = -0.15，P =.01），但与增长率无关。双侧植入的儿童的初次植入耳的平台期得分优于单侧植入的儿童（β = 0.59，P =.02）。双侧植入时，序贯植入的间隔越短，初次植入耳的言语识别增长越快。
改良后的 PROSPER 评分可用于临床追踪 CIs 患儿的言语识别发展情况，评估影响因素，并有助于制定和评估患者特定的干预策略。
