Boys Town National Research Hospital, Department of Audiology, Omaha, NE 68131, United States.
Boys Town National Research Hospital, Department of Audiology, Omaha, NE 68131, United States.
Int J Pediatr Otorhinolaryngol. 2023 Aug;171:111642. doi: 10.1016/j.ijporl.2023.111642. Epub 2023 Jul 8.
Children with cochlear implants (CCI) have an increased rate of vestibular dysfunction. Vestibular dysfunction is associated with decreased balance and dynamic visual acuity ability. Hearing loss alone is associated with reduced speech perception and vocabulary in children. In adults, vestibular dysfunction is associated with reduced quality of life; however, similar relationships have not been studied in children with vestibular dysfunction. Therefore, the objective of the present study was to evaluate the effect of hearing loss and vestibular dysfunction on self-concept in CCI (n = 33) compared to children with normal hearing (CNH, n = 38). It was hypothesized that children with vestibular dysfunction would have reduced self-concept beyond that from hearing loss, secondary to the presence of balance and visual acuity deficits.
The Piers-Harris Children's Self-Concept Scale - 2, speech perception, vocabulary, video head impulse test (vHIT), rotary chair, balance using the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2), and dynamic visual acuity (DVA) testing were completed on all participants.
In the 34 CCI, 24 had normal vestibular function, 6 had unilateral vestibular dysfunction, and 4 had bilateral vestibular dysfunction. There were no significant mean differences in the Piers-Harris Children's Self-Concept Scale - 2 between groups. A Principal Component Analysis (PCA) was conducted on the predictor variables (average horizontal canal vHIT gain, BOT-2 score, DVA, speech perception, and vocabulary) resulting in two factors; factor 1 represented "vestibular" components (vHIT, BOT-2, and DVA) and factor 2 represented "auditory-language" components (speech perception and vocabulary). In addition to age and gender, the 2 PCA factors were analyzed using multivariate regression with stepwise selection to determine which factors best predicted self-concept. The PCA auditory-language factor was the only significant predictor of self-concept.
Auditory-language, not vestibular related factors, contribute to the self-concept of CCI. While adults with vestibular dysfunction have reduced quality of life, it could be that children with vestibular dysfunction have some psychosocial resilience.
患有人工耳蜗植入（CCI）的儿童前庭功能障碍的发生率较高。前庭功能障碍与平衡和动态视力能力下降有关。单纯听力损失与儿童言语感知和词汇量减少有关。在成年人中，前庭功能障碍与生活质量下降有关；然而，在患有前庭功能障碍的儿童中，尚未对此类关系进行研究。因此，本研究的目的是评估听力损失和前庭功能障碍对 33 例 CCI 儿童（CCI 组）自我概念的影响，并与听力正常的儿童（CNH 组，n=38）进行比较。研究假设，由于存在平衡和视力缺陷，前庭功能障碍儿童的自我概念下降程度超过听力损失所致的下降程度。
对所有参与者进行皮尔斯-哈里斯儿童自我概念量表-2、言语感知、词汇、视频头脉冲试验（vHIT）、转椅、布鲁因克斯-奥塞雷斯基运动能力测试（BOT-2）平衡测试和动态视力（DVA）测试。
在 34 例 CCI 中，24 例前庭功能正常，6 例单侧前庭功能障碍，4 例双侧前庭功能障碍。两组间皮尔斯-哈里斯儿童自我概念量表-2 的平均差异无统计学意义。对预测变量（平均水平半规管 vHIT 增益、BOT-2 评分、DVA、言语感知和词汇）进行主成分分析（PCA），结果得到两个因子；因子 1 代表“前庭”成分（vHIT、BOT-2 和 DVA），因子 2 代表“听觉-语言”成分（言语感知和词汇）。除了年龄和性别外，还使用逐步选择的多元回归分析对 2 个 PCA 因子进行分析，以确定哪些因子最能预测自我概念。PCA 听觉-语言因子是自我概念的唯一显著预测因子。
听觉-语言因素，而不是与前庭相关的因素，影响 CCI 的自我概念。虽然成年人前庭功能障碍会降低生活质量，但儿童可能具有一定的心理社会适应能力。
