语后聋患者人工耳蜗植入术后效果分析
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摘要
目的探讨语后聋儿童及成人人工耳蜗植入术(CI)后听觉言语效果及个人和家庭的生活质量变化。方法在受试者接受人工耳蜗植入术后1月、3月、6月、9月、12月时,运用听阈(T)、听觉行为分级标准(CAP)、言语可懂度分级标准(SIR)、言语识别率(WRS)等指标对其听觉功能及言语能力进行评估,分别观察儿童(n=23)、成人(n=20)及两者总体(n=43)上述指标的变化情况;运用听力植入体儿童家庭生活质量(CuHIQol)问卷及Nijme-gen人工耳蜗植入量表(NCIQ)分别对儿童及成人术前、术后12月的生活质量进行评估和比较。结果术后1年内儿童(n=23)、成人(n=20)及两者总体(n=43)的T值均随时间逐渐降低,CAP、SIR、WRS值均随时间逐渐升高,不同时段之间的差异具有统计学意义(P<0.05);三者的T、CAP、SIR、WRS值在术后1-6月变化快速,6-12月变化缓慢;术后12月的CuHIQol及NCIQ各领域得分较术前增加,差异具有统计学意义(P<0.05)。结论语后聋儿童及成人术后听觉言语功能及个人和家庭的生活质量因人工耳蜗的植入得到明显改善,语后聋儿童及成人是人工耳蜗植入术的合适人选。
Objective To report auditory, speech and quality of life outcomes after cochlear implantation(CI) in children and adults with postlingual deafness and their families. Methods At 1, 3, 6, 9 and 12 months after cochlear implantation, auditory threshold(T), categories of auditory performance(CAP), speech intelligibility rating(SIR) and word recognition scores(WRS) were used to evaluate auditory and speech function in children(n=23) and adult(n=20)patients. Quality of life were assessed and compared using the CuHIQol and Nijmegen Cochlear Implantation Questionnaire(NCIQ) before and 12 months later the operation. Results The T value in both children and adults decreased in 1 year after the operation, while CAP, SIR and WRS scores increased(P <0.05); with the parameters changing rapidly in in the first 1-6 months and gradually thereafter. The CuHIQol and NCIQ scores at 12 months after operation were higher than those before operation(P < 0.05). Conclusion Auditory and speech function as well as quality of life in children and adults with postlingual deafness and their families improve after CI, making these patients suitable candidates for cochlear implantation.
Objective To report auditory, speech and quality of life outcomes after cochlear implantation(CI) in children and adults with postlingual deafness and their families. Methods At 1, 3, 6, 9 and 12 months after cochlear implantation, auditory threshold(T), categories of auditory performance(CAP), speech intelligibility rating(SIR) and word recognition scores(WRS) were used to evaluate auditory and speech function in children(n=23) and adult(n=20)patients. Quality of life were assessed and compared using the CuHIQol and Nijmegen Cochlear Implantation Questionnaire(NCIQ) before and 12 months later the operation. Results The T value in both children and adults decreased in 1 year after the operation, while CAP, SIR and WRS scores increased(P <0.05); with the parameters changing rapidly in in the first 1-6 months and gradually thereafter. The CuHIQol and NCIQ scores at 12 months after operation were higher than those before operation(P < 0.05). Conclusion Auditory and speech function as well as quality of life in children and adults with postlingual deafness and their families improve after CI, making these patients suitable candidates for cochlear implantation.
引文
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3 Cusumano C,Friedmann DR,Fang Y,et al.Performance Plateau in Prelingually and Postlingually Deafened Adult Cochlear Implant Recipients[J].Otol Neurotol,2017 Mar;38(3):334-338.
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5 Lenarz M,S?nmez H,Joseph G,et al.Long-term performance of cochlear implants in postlingually deafened adults[J].Otolaryngol Head Neck Surg,2012 Jul;147(1):112-118.
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7董瑞娟,刘博,彭小霞,等.Nijmegen人工耳蜗植入量表中文版信度和效度评价[J].中华耳鼻咽喉头颈外科杂志,2010,l0(45):818-823.Dong RJ,Liu B,Peng XX,et al.Evaluation of reliability and validity of the Chinese version of Nijmegen Cochlear Implant Scale[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2010,l0(45):818-823.
8 Hinderink JB,Krabbe PF,Van Den Broek P.Development and application of a health-related quality-of-life instrument for adults with cochlear implants:the Nijmegen cochlear implant questionnaire[J].JAMA Otolaryngol Head Neck Surg,2000;123:756-765.
9 Sousa AF,Couto MIV,Martinho-Carvalho AC.Quality of life and cochlear implant:results in adults with postlingual hearing loss[J].Braz J Otorhinolaryngol,2018 Jul-Aug;84(4):494-499.
10 Kobosko J,Jedrzejczak WW,Pilka E,et al.Satisfaction With Cochlear Implants in Postlingually Deaf Adults and Its Nonaudiological Predictors:Psychological Distress,Coping Strategies,and Self-Esteem[J].Ear Hear,2015 Sep-Oct;36(5):605-18.
11 Koszty?a-Hojna B,Moskal D.[The impact of cochlear implant(CI)on the process of phonation and quality of life of patients with pre-and postlingual deafness][J].Pol Merkur Lekarski,2012 Aug;33(194):70-9.
12 Lassaletta L,Castro A,Bastarrica M,et al.Quality of lifein postlingually deaf patients following cochlear implantation[J].Eur Arch Otorhinolaryngol,2006 Mar;263(3):267-70.
13 Klop WMC,Boermans PPBM,Ferrier MB,et al.Clinical relevance of quality of life outcome in cochlear implantation in postlingually deafened adults[J].Otol Neurotol,2008;29:615-21.
14 Damen GWJA,Beynon AJ,Krabbe PFM,et al.Cochlear implantation and quality of life in postlingually deaf adults:long-term follow-up[J].JAMA Otolaryngol Head Neck Surg,2007;136:597-604.
15 Abdellaoui A,Tran Ba Huy P.Success and failure factors for hearing-aid prescription:results of a French national survey[J].Eur Ann Otorhinolaryngol Head Neck Dis,2013;130:313-9.
16 Rumeau C,Frère J,Montaut-Verient B,et al.Quality of life and audiologic performance through the ability to phone of cochlear implant users[J].Eur Arch Otorhinolaryngol,2015;272:3685-92.
17 Sanderson G,Ariyaratne TV,Wyss J,et al.A global patient outcomes registry:cochlear paediatric implanted recipient observational study(CochlearTMP-IROS)[J].BMC Ear Nose Throat Disord,2014;14(1):10.
18 Looi V,Lee ZZ,Loo JH.Hearing-related quality of life outcomes for Singaporean children using hearing aids or cochlear implants[J].Eur Ann Otorhinolaryngol Head Neck Dis,2016 Jun;133 Suppl1:S25-30.
19 Spahn C,Burger T,Loschmann C,et al.Quality of life and psychological distress in parents of children with a cochlear implant[J].Cochlear Implants Int,2004;5(1):13-27.
20 Feher-Prout T.Stress and coping in families with deaf children[J].J Deaf Stud Deaf Educ,1996;1(3):155-165.
21 Looi V,Lee ZZ,Loo JH.Quality of life outcomes for children with hearing impairment in Singapore[J].Int J Pediatr Otorhinolaryngol,2016 Jan;80:88-100.
22张莉,邱建新.青少年语前聋患者人工耳蜗植入后生活质量评估[J].听力学及言语疾病杂志,2017,25(3):300-303.Zhang L,Qiu JX.The evaluation of the quality of life of prelingually deaf adolescents with cochlear implants[J].Journal of Audiology and Speech Diseases,2017,25(3):300-303.
2 Sarant JZ,Harris DC,Galvin KL,et al.Social Development in Children With Early Cochlear Implants:Normative Comparisons and Predictive Factors,Including Bilateral Implantation[J].Ear Hear,2018 Jul/Aug;39(4):770-782.
3 Cusumano C,Friedmann DR,Fang Y,et al.Performance Plateau in Prelingually and Postlingually Deafened Adult Cochlear Implant Recipients[J].Otol Neurotol,2017 Mar;38(3):334-338.
4 Ahmad FI,Demason CE,Teagle HF,et al.Cochlear implantation in children with postlingual hearing loss[J].Laryngoscope,2012Aug;122(8):1852-1857.
5 Lenarz M,S?nmez H,Joseph G,et al.Long-term performance of cochlear implants in postlingually deafened adults[J].Otolaryngol Head Neck Surg,2012 Jul;147(1):112-118.
6 Sandmann P,Plotz K,Hauthal N,et al.Rapid bilateral improvement in auditory cortex activity in postlingually deafened adults following cochlear implantation[J].Clin Neurophysiol,2015 Mar;126(3):594-607.
7董瑞娟,刘博,彭小霞,等.Nijmegen人工耳蜗植入量表中文版信度和效度评价[J].中华耳鼻咽喉头颈外科杂志,2010,l0(45):818-823.Dong RJ,Liu B,Peng XX,et al.Evaluation of reliability and validity of the Chinese version of Nijmegen Cochlear Implant Scale[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2010,l0(45):818-823.
8 Hinderink JB,Krabbe PF,Van Den Broek P.Development and application of a health-related quality-of-life instrument for adults with cochlear implants:the Nijmegen cochlear implant questionnaire[J].JAMA Otolaryngol Head Neck Surg,2000;123:756-765.
9 Sousa AF,Couto MIV,Martinho-Carvalho AC.Quality of life and cochlear implant:results in adults with postlingual hearing loss[J].Braz J Otorhinolaryngol,2018 Jul-Aug;84(4):494-499.
10 Kobosko J,Jedrzejczak WW,Pilka E,et al.Satisfaction With Cochlear Implants in Postlingually Deaf Adults and Its Nonaudiological Predictors:Psychological Distress,Coping Strategies,and Self-Esteem[J].Ear Hear,2015 Sep-Oct;36(5):605-18.
11 Koszty?a-Hojna B,Moskal D.[The impact of cochlear implant(CI)on the process of phonation and quality of life of patients with pre-and postlingual deafness][J].Pol Merkur Lekarski,2012 Aug;33(194):70-9.
12 Lassaletta L,Castro A,Bastarrica M,et al.Quality of lifein postlingually deaf patients following cochlear implantation[J].Eur Arch Otorhinolaryngol,2006 Mar;263(3):267-70.
13 Klop WMC,Boermans PPBM,Ferrier MB,et al.Clinical relevance of quality of life outcome in cochlear implantation in postlingually deafened adults[J].Otol Neurotol,2008;29:615-21.
14 Damen GWJA,Beynon AJ,Krabbe PFM,et al.Cochlear implantation and quality of life in postlingually deaf adults:long-term follow-up[J].JAMA Otolaryngol Head Neck Surg,2007;136:597-604.
15 Abdellaoui A,Tran Ba Huy P.Success and failure factors for hearing-aid prescription:results of a French national survey[J].Eur Ann Otorhinolaryngol Head Neck Dis,2013;130:313-9.
16 Rumeau C,Frère J,Montaut-Verient B,et al.Quality of life and audiologic performance through the ability to phone of cochlear implant users[J].Eur Arch Otorhinolaryngol,2015;272:3685-92.
17 Sanderson G,Ariyaratne TV,Wyss J,et al.A global patient outcomes registry:cochlear paediatric implanted recipient observational study(CochlearTMP-IROS)[J].BMC Ear Nose Throat Disord,2014;14(1):10.
18 Looi V,Lee ZZ,Loo JH.Hearing-related quality of life outcomes for Singaporean children using hearing aids or cochlear implants[J].Eur Ann Otorhinolaryngol Head Neck Dis,2016 Jun;133 Suppl1:S25-30.
19 Spahn C,Burger T,Loschmann C,et al.Quality of life and psychological distress in parents of children with a cochlear implant[J].Cochlear Implants Int,2004;5(1):13-27.
20 Feher-Prout T.Stress and coping in families with deaf children[J].J Deaf Stud Deaf Educ,1996;1(3):155-165.
21 Looi V,Lee ZZ,Loo JH.Quality of life outcomes for children with hearing impairment in Singapore[J].Int J Pediatr Otorhinolaryngol,2016 Jan;80:88-100.
22张莉,邱建新.青少年语前聋患者人工耳蜗植入后生活质量评估[J].听力学及言语疾病杂志,2017,25(3):300-303.Zhang L,Qiu JX.The evaluation of the quality of life of prelingually deaf adolescents with cochlear implants[J].Journal of Audiology and Speech Diseases,2017,25(3):300-303.