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儿童双侧顺序性人工耳蜗植入的时机:益处的确定

Timing of bilateral sequential cochlear implantation for children: determination of its benefit.

作者信息

Hsu Chiung-Wen, Ho Pei-Hsuan, Chu Chia-Huei, Chen Pey-Yu, Hsu Hsiao-Man, Cheng Yu-Lin, Chen Xiang-Xiang, Chen I-Hsiu, Sun Yung-Chen, Lin Hung-Ching

机构信息

Department of Audiology and Speech-Language Pathology, MacKay Medical College, New Taipei City, Taiwan.

Department of Otolaryngology Head and Neck Surgery, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, 10449, Taipei City, Taiwan.

出版信息

Eur Arch Otorhinolaryngol. 2025 Mar;282(3):1247-1255. doi: 10.1007/s00405-024-09030-z. Epub 2024 Oct 26.

Abstract

PURPOSE

To evaluate monosyllable word recognition in noise under different conditions in bilateral sequential cochlear implants (CIs). Second, to assess subjective hearing benefits among bilateral sequential CIs, bimodal hearing, and CI-only groups. Lastly, to analyze the prognostic factors affecting CI outcomes in children with bilateral sequential CIs.

METHODS

Sixty-five children with CI were enrolled. Mandarin monosyllable recognition tests in noise and the Speech, Spatial, and Qualities of Hearing Scale (SSQ) were used to assess post-CI outcomes. The SSQ benefits were compared among children with bilateral CIs, bimodal hearing, and CI-only.

RESULTS

Bilateral CIs significantly outperformed the first or second CI alone using in noise. The bilateral CI group had significantly better SSQ scores for speech, qualities, and total scores compared to the CI-only group. Additionally, 41% of the variance in speech perception of the second CI can be attributed to the inter-implantation interval between bilateral CIs.

CONCLUSION

Bilateral sequential CIs can enhance speech perception in noise and daily life-functioning for children. Earlier implantation of bilateral sequential CIs results in better outcomes, while inter-implantation interval exceeding 9.6 years between bilateral CIs may lead to poor second CI performance in noise. Therefore, early bilateral sequential CIs should be encouraged.

摘要

目的

评估双侧序贯人工耳蜗(CI)在不同条件下的噪声中对单音节词的识别能力。其次,评估双侧序贯CI组、双耳混合听力组和仅使用CI组之间的主观听力获益情况。最后,分析影响双侧序贯CI儿童CI效果的预后因素。

方法

招募65名接受CI的儿童。采用普通话噪声下单音节识别测试和听力言语、空间及质量量表(SSQ)评估CI术后效果。比较双侧CI组、双耳混合听力组和仅使用CI组儿童的SSQ获益情况。

结果

双侧CI在噪声中的表现显著优于单独使用的第一或第二枚CI。与仅使用CI组相比,双侧CI组在言语、质量和总分方面的SSQ得分显著更高。此外,第二枚CI言语感知中41%的差异可归因于双侧CI之间的植入间隔。

结论

双侧序贯CI可提高儿童在噪声中的言语感知能力和日常生活功能。早期植入双侧序贯CI可获得更好的效果,而双侧CI之间的植入间隔超过9.6年可能导致第二枚CI在噪声中的表现不佳。因此,应鼓励早期进行双侧序贯CI植入。

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