Professor Dr Md Zakaria Sarker, Professor, Department of Otology, National Institute of ENT, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2023 Jan;32(1):213-220.
Hearing loss can be congenital or acquired. Most of the time congenital hearing loss means profound sensorineural hearing loss. The invention of cochlear implantation has already an established role in improving the hearing capability in congenital sensorineural hearing loss. To speak properly after cochlear implant, one needs to go for speech therapy or audio-verbal therapy. Speech therapy has become an integral part of the cochlear implantation program. In Bangladesh cochlear implantation (CI) programs started around 15 years ago, which was limited to Bangabandhu Sheikh Mujib Medical University (BSMMU) and Combined Military Hospital (CMH). Our government takes initiative to provide this service to poor and lower income people. National Institute of ENT (NIENT) was the first government hospital where CI started in 2018 and the project is now ongoing. After CI auditory, verbal therapy (AVT) was given at the same institute. No study has not been done to find out the outcome of AVT. NIENT has taken steps to find out the functional and speech outcome of cochlear implanted children considering the two standard criteria: CAP and SIR score. This retrospective study was done to find out the auditory verbal outcome of unilaterally CI children in different ages and conducted at department of Audiology, National Institute of ENT, Tejgaon, Dhaka, Bangladesh from January 2021 to June 2021. The children who underwent cochlear implants and took the auditory verbal therapy were included in this study. Though it is a retrospective study, a written informed consent has been taken from the patient's parents as the cases are minor in age. From the record review, CAP and SIR scores were recorded four times: before implantation 1 time, after cochlear implantation 3 times (At the end of 3, 6 and 12 months after starting of AVT of Cochlear implantees). From the study it has been observed that out of 50 implantees, 48.0% of children's age range was in between >3 to ≤5 years. Most of the implantees were from rural areas and also from lower income group. The study showed significant association with CAP and SIR score at the end of one year of AVT. No significant association was found in different age groups with scores of CAP and SIR. But the parent's education showed significant association with CAP score at the end one year of AVT. Though the age of the recipient is not significantly associated with the AVT outcome but maternal education plays an important role in improving CAP and SIR score. So, maternal education or understanding along with professional speech therapy is vital for better AVT outcome.
听力损失可分为先天性和后天性。大多数情况下,先天性听力损失意味着严重的感音神经性听力损失。人工耳蜗植入的发明已经在改善先天性感音神经性听力损失的听力能力方面发挥了重要作用。为了在人工耳蜗植入后正常说话,需要进行言语治疗或听觉言语治疗。言语治疗已成为人工耳蜗植入计划的一个组成部分。在孟加拉国,人工耳蜗植入 (CI) 项目大约在 15 年前开始,仅限于班加班杜谢赫·穆吉布医学大学 (BSMMU) 和联合军事医院 (CMH)。我们的政府主动向贫困和低收入人群提供这项服务。国家耳鼻喉研究所 (NIENT) 是第一家于 2018 年开始进行 CI 的政府医院,该项目目前仍在进行中。CI 后,在同一研究所进行听觉言语治疗 (AVT)。尚未进行任何研究来确定 AVT 的结果。NIENT 已采取措施,根据两项标准:CAP 和 SIR 评分,找出人工耳蜗植入儿童的功能和言语结果。这项回顾性研究旨在找出不同年龄段单侧人工耳蜗植入儿童的听觉言语结果,并在 2021 年 1 月至 2021 年 6 月期间在达卡 Tejgaon 的国家耳鼻喉研究所听觉学部进行。该研究纳入了接受人工耳蜗植入并接受听觉言语治疗的儿童。尽管这是一项回顾性研究,但由于病例年龄较小,已从患者家长处获得书面知情同意。从记录审查中,CAP 和 SIR 评分共记录了 4 次:植入前 1 次,植入后 3 次(在开始听觉言语治疗后的第 3、6 和 12 个月)。研究表明,在 50 名植入者中,48.0%的儿童年龄在>3 至≤5 岁之间。大多数植入者来自农村地区,也来自低收入群体。研究表明,在听觉言语治疗一年后,CAP 和 SIR 评分与结果有显著关联。但在不同年龄组中,CAP 和 SIR 的评分与结果没有显著关联。但是,父母的教育水平与听觉言语治疗一年后的 CAP 评分有显著关联。虽然接受者的年龄与听觉言语治疗结果没有显著关联,但母亲的教育在提高 CAP 和 SIR 评分方面起着重要作用。因此,母亲的教育或理解以及专业的言语治疗对于更好的听觉言语治疗结果至关重要。