摘要
目的探讨语前聋患儿双模式(一侧人工耳蜗植入,对侧配戴助听器)干预与双侧人工耳蜗植入(cochlear implantation,CI)后早期听觉言语康复效果以及生活质量,为语前聋患儿双侧干预模式的选择提供参考。方法回顾性分析2016~2019年行双侧CI 28例(双侧CI组)和双模式干预28例(双模式组)语前聋患儿的临床资料,双侧CI组的平均植入年龄和术前助听器使用时长低于双模式组。所有患儿均于开机时、开机1、3、6和12个月时完成听觉行为分级标准(CAP)、婴幼儿有意义听觉整合量表(IT-MAIS)、言语可懂度分级标准(SIR)、有意义使用言语量表(MUSS)问卷填写,并于术后2±0.76年完成中文版CI儿童家长观点调查问卷(MPP),比较两组结果。结果双模式组IT-MAIS得分在开机时(F=16.52,P<0.001)、开机1个月(F=12.02,P=0.001)、开机3个月(F=4.27,P=0.043)高于双侧CI组,之后两组间IT-MAIS得分无统计学差异(P>0.05)。双模式组CAP分级在开机时(F=9.50,P=0.003)、开机1个月(F=8.70,P=0.005)高于双侧CI组,随后两组间CAP分级无统计学差异(P>0.05)。双模式组术后MUSS得分高于双侧CI组(F=5.46,P=0.023)。在开机时、开机1个月两组间SIR分级无统计学差异(P>0.05),在开机3个月(F=4.50,P=0.039)、6个月(F=10.89,P=0.002)和12个月时(F=5.46,P=0.023)双模式组SIR分级高于双侧CI组。MPP问卷的幸福感(F=9.15,P=0.004)、社会关系(F=5.03,P=0.029)和教育(F=7.97,P=0.007)维度得分双模式组高于双侧CI组,在交流、基本功能、自立能力、CI的效果和影响以及对患儿的支持维度两组间得分无统计学差异(P>0.05)。结论双侧CI与双模式干预患儿术后听觉言语能力均能取得较大进步;尽管术后早期双模式干预患儿的听觉言语能力进步更明显,但考虑到植入年龄、术前助听器使用时间等因素的影响,尚不能认为双模式干预的效果优于双侧CI。
Objective To investigate early auditory and speech performance and quality of life in children with bilateral cochlear implantation and bimodal stimulation,and to provide reference for the decision of binaural listening mode.Methods Children with bilateral prelingual server to profound sensorineural hearing loss who received cochlear implantation from 2016 to 2019 were enrolled,including 28 children with bilateral cochlear implantation(BCI group)and 28 children with bimodal stimulation(HACI group).Hearing assessments included the infant-toddler meaningful auditory integration scale(IT-MAIS)and categories of auditory performance(CAP).Speech evaluations included the meaningful use of speech scale(MUSS)and speech intelligibility rating(SIR).These measurements were evaluated at the 0,1,3,6,12 months(T0,T1,T2,T3,T4)after the activity of cochlear implantation.Mandarin children with cochlear implants parental perspectives questionnaire(MPP)was employed to assess the quality of life.Results HACI group acquired a significantly better IT-MAIS score at T0(F=16.52,P<0.001),T1(F=12.02,P=0.001)and T2(F=4.27,P=0.043).At T0(F=9.50,P=0.003)and T1(F=8.70,P=0.005),the HACI group showed a significantly better score than the BCI group in CAP scores.The HACI group showed a significantly better score than the BCI group in MUSS scores(F=5.46,P=0.023).The HACI group acquired a significantly better SIR score than the BCI group at T2(F=4.50,P=0.039),T3(F=10.89,P=0.002)and T4(F=5.46,P=0.023).The HACI group received more positive ratings in the domains of well-being(F=9.15,P=0.004),social relations(F=5.03,P=0.029)and education(F=7.97,P=0.007).Conclusion Bilateral cochlear implantation or bimodal stimulation provides benefits to sensorineural hearing loss children.HACI children showed more positive progress than BCI children.However,it is uncertain whether the effect of bimodal stimulation is better than bilateral cochlear implantation considering the influence of confounding factors such as implantation age and preoperative hearing aid usage
作者
徐卓
周敏
林颖
张鑫雨
张域开
任寸寸
樊小勤
乔燕
邱建华
查定军
Xu Zhuo;Zhou Min;Lin Ying;Zhang Xinyu;Zhang Yukai;Ren Cuncun;Fan Xiaoqin;Qiao Yan;Qiu Jianhua;Zha Dingjun(Department of Otolaryngology-Head and Neck Surgery,Xijing Hospital,Air Force Military Medical University,Xi’an,710032,China)
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2022年第2期124-129,共6页
Journal of Audiology and Speech Pathology
基金
国家自然科学基金面上项目(81870732)
陕西省科技创新基地科技资源开放共享平台(2018PT-01)
空军军医大学第一附属医院学科助推计划-卫勤专项研究项目(XJZT15D02)。
关键词
双侧人工耳蜗植入
双模式
听觉言语康复
生活质量
Bilateral cochlear implantation
Bimodal stimulation
Hearing and speech rehabilitation
Quality of life
