Zwolan T A, Zimmerman-Phillips S, Ashbaugh C J, Hieber S J, Kileny P R, Telian S A
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, USA.
Ear Hear. 1997 Jun;18(3):240-51. doi: 10.1097/00003446-199706000-00007.
The purpose of this study was to evaluate the postoperative performance of 12 children who demonstrated some open-set speech recognition skills before receiving a Nucleus multichannel cochlear implant with a view toward expanding the selection criteria for cochlear implant candidacy to include children who derive minimal benefit from amplification.
Pre- and postoperative performance of two groups of children were compared. Group 1 consisted of 12 children who demonstrated some open-set speech recognition skills before receiving a Nucleus multichannel cochlear implant (Borderline group). Group 2 consisted of 12 children who demonstrated no open-set speech recognition skills before implantation with a Nucleus device (Traditional group). In all children, candidacy was determined based on preimplant binaural aided performance. For most subjects, the poorer ear was selected for implantation. Mean pre- and postoperative speech recognition scores of the Borderline subjects were compared to determine the benefit provided by their cochlear implants. Secondly, matched-pair analyses were used to compare the mean speech recognition scores obtained by the Borderline and Traditional subjects.
The scores of the Borderline group improved significantly on five of six speech recognition measures when 6 mo postoperative scores obtained with the implant were compared with preoperative test scores obtained with hearing aids. By the 12 mo postoperative interval, the scores of the Borderline group had improved significantly (p < 0.05) on all six measures. In contrast, scores obtained by the Traditional group had improved significantly on three of six measures at both the 6 and 12 mo postoperative intervals. Comparison of postoperative test scores revealed that the Borderline group scored significantly higher than the Traditional group on three of six measures at the 6 mo test interval and on six of six measures at the 12 mo test interval (p < 0.05).
The findings of this study indicate that both groups derive significant benefit from their cochlear implants. Although the mean preoperative audiograms for the implanted ears did not differ significantly for the two groups of subjects, members of the Borderline group exhibited significantly better speech recognition skills than the Traditional group during the first year after implantation. These findings suggest that the increased auditory experience of the Borderline subjects positively influenced their performance with a cochlear implant. The authors advocate that the selection criteria used to determine pediatric cochlear implant candidacy be broadened to include consideration of children who demonstrate minimal open-set speech recognition skills.
本研究旨在评估12名儿童在接受Nucleus多通道人工耳蜗植入术前已具备一些开放式言语识别技能的术后表现，以期扩大人工耳蜗植入候选标准，将从放大装置中获益甚微的儿童纳入其中。
比较两组儿童的术前和术后表现。第1组由12名在接受Nucleus多通道人工耳蜗植入术前已具备一些开放式言语识别技能的儿童组成（临界组）。第2组由12名在植入Nucleus装置前未具备开放式言语识别技能的儿童组成（传统组）。所有儿童的植入候选资格均根据植入前双耳助听表现确定。对于大多数受试者，选择较差的耳朵进行植入。比较临界组受试者术前和术后的平均言语识别分数，以确定人工耳蜗带来的益处。其次，采用配对分析比较临界组和传统组受试者获得的平均言语识别分数。
将植入后6个月时获得的言语识别测试分数与使用助听器获得的术前测试分数相比较，临界组在六项言语识别测试中的五项上分数显著提高。到术后12个月时，临界组在所有六项测试中的分数均显著提高（p<0.05）。相比之下，传统组在术后6个月和12个月时，在六项测试中的三项上分数显著提高。术后测试分数的比较显示，在术后6个月测试时，临界组在六项测试中的三项上得分显著高于传统组，在术后12个月测试时，在六项测试中的六项上得分均显著高于传统组（p<0.05）。
本研究结果表明，两组儿童均从人工耳蜗植入中获得显著益处。尽管两组受试者植入耳的术前平均听力图无显著差异，但临界组成员在植入后的第一年表现出比传统组显著更好的言语识别技能。这些发现表明，临界组受试者增加的听觉体验对其人工耳蜗植入后的表现产生了积极影响。作者主张扩大用于确定儿童人工耳蜗植入候选资格的选择标准，将表现出极少开放式言语识别技能的儿童纳入考虑范围。
