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儿科中的耳蜗植入:新生儿听力筛查对干预时间的影响。

Cochlear implantation in pediatrics: Impact of newborn hearing screening on intervention time.

机构信息

Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

Research Department, MED-EL GmbH, Riyadh, Saudi Arabia.

出版信息

Int J Pediatr Otorhinolaryngol. 2024 Jun;181:111990. doi: 10.1016/j.ijporl.2024.111990. Epub 2024 May 23.

Abstract

OBJECTIVES

The newborn hearing screening (NHS) program was globally established for early hearing loss (HL) identification and intervention. Early intervention is essential to minimize or prevent the negative consequences of HL. In Saudi Arabia, the NHS was officially implemented in 2016. Currently, its impact on the timing of cochlear implantations (CIs) in Saudi Arabia remains unclear, and information on potential hospital-related delays affecting early implantation is lacking. Thus, this study aimed to evaluate the effect of implementing the NHS on age at CI in children with prelingual deafness in a CI center in Saudi Arabia, and to evaluate the hospital timing in the CI process.

METHODS

All pediatric CI users who presented for the first time to the CI committee (CIC) at a tertiary center and received their implants between 2015 and 2022 were enrolled in this study. Date of birth (DOB), date of presentation to the CI committee (DOCIC), and date of CI surgery (DOCIS) were retrospectively reviewed.

RESULTS

In total, 304 CI children were included in the analysis. Approximately 55 % of the children (n = 167) were screened for HL through the NHS, whereas 45 % of the children (n = 137) were born before the launch of the NHS. Both age at the presentation to the CIC (i.e. difference between DOCIC and DOB) and age at implantation (i.e. difference between DOCIS and DOB) were significantly earlier in children who were screened for HL through the NHS than those who were not screened (P < 0.0001). The time difference between the DOCIC and DOCIS was not significantly different between the screened and unscreened children (P > 0.05).

CONCLUSION

The implementation of the NHS in the tertiary center has a significant positive effect on age at presentation to the CIC and age at implantation, but not on the actual CI surgery. Further research is needed to reduce the hospital delays before the actual surgery in order to increase the likelihood of children receiving implantation early in their life.

摘要

目的

新生儿听力筛查(NHS)计划在全球范围内建立,旨在早期发现听力损失(HL)并进行干预。早期干预对于将 HL 的负面影响最小化或预防至关重要。在沙特阿拉伯,NHS 于 2016 年正式实施。目前,它对沙特阿拉伯 Cochlear 植入(CI)时间的影响尚不清楚,并且缺乏有关潜在医院相关延迟影响早期植入的信息。因此,本研究旨在评估在沙特阿拉伯的一个 CI 中心实施 NHS 对患有语前聋的儿童 CI 年龄的影响,并评估 CI 过程中的医院时机。

方法

本研究纳入了 2015 年至 2022 年间首次向三级中心的 CI 委员会(CIC)就诊并接受植入物的所有儿科 CI 使用者。回顾性审查出生日期(DOB)、向 CI 委员会就诊日期(DOCIC)和 CI 手术日期(DOCIS)。

结果

共纳入 304 名 CI 儿童进行分析。大约 55%的儿童(n=167)通过 NHS 筛查 HL,而 45%的儿童(n=137)出生于 NHS 启动之前。通过 NHS 筛查 HL 的儿童的 CIC 就诊年龄(即 DOCIC 和 DOB 之间的差异)和植入年龄(即 DOCIS 和 DOB 之间的差异)均显著早于未筛查的儿童(P<0.0001)。筛查和未筛查儿童之间的 DOCIC 和 DOCIS 之间的时间差异无显著差异(P>0.05)。

结论

在三级中心实施 NHS 对 CIC 就诊年龄和植入年龄有显著的积极影响,但对实际的 CI 手术没有影响。需要进一步研究以减少实际手术前的医院延迟,以增加儿童尽早接受植入的可能性。

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