Fan Huiru, Li Dan, Xie Wen, Wang Jing, Cheng Huamao, Kong Weijia
Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Brain Sci. 2023 Nov 1;13(11):1540. doi: 10.3390/brainsci13111540.
To analyze the association between stable asymptomatic white matter lesions (WMLs) and the cochlear implantation (CI) effect in congenitally deaf children, 43 CI children with stable asymptomatic WMLs determined via preoperative assessments and 86 peers with normal white matter were included. Outcome measurements included closed-set Mandarin Chinese (tone, disyllable, and sentence) recognition tests; categories of auditory performance (CAPs); and speech intelligibility rating (SIR) scales at 1, 12, and 24 months post-CI. Generalized estimating equation (GEE) models were used to analyze the association between WML and outcomes. In the WML group (control group), median CAP and SIR scores were 5 (5) and 4 (4) with mean rates of tone, disyllable, and sentence recognition of 84.8% (89.0%), 87.9% (89.7%), and 85.8% (88.0%) at 24 months post-CI, respectively. Auditory and speech performance improved significantly with implant use. Compared to their peers in the control group, for the participants with stable asymptomatic WMLs, auditory and speech abilities were not significantly different ( > 0.05). Stable asymptomatic WMLs might not be associated with poor auditory and speech intelligibility post-CI, which indicates that it is feasible to use comprehensive assessments to screen suitable candidates with WMLs who are likely to present with a good prognosis.
为分析先天性耳聋儿童中稳定无症状脑白质病变(WMLs)与人工耳蜗植入(CI)效果之间的关联,纳入了43名经术前评估确定存在稳定无症状WMLs的CI儿童以及86名脑白质正常的同龄人。结局指标包括封闭式汉语普通话(声调、双音节和句子)识别测试;听觉表现类别(CAPs);以及CI术后1个月、12个月和24个月时的言语可懂度评分(SIR)量表。采用广义估计方程(GEE)模型分析WML与结局之间的关联。在WML组(对照组)中,CI术后24个月时,CAP和SIR评分中位数分别为5(5)和4(4),声调、双音节和句子识别平均率分别为84.8%(89.0%)、87.9%(89.7%)和85.8%(88.0%)。使用人工耳蜗后听觉和言语表现有显著改善。与对照组中的同龄人相比,对于存在稳定无症状WMLs的参与者,听觉和言语能力无显著差异(>0.05)。稳定无症状WMLs可能与CI术后听觉和言语可懂度不佳无关,这表明使用综合评估来筛选可能预后良好的WMLs合适候选人是可行的。