语前聋患儿分期双侧人工耳蜗植入术后短期效果分析
|
摘要
目的评估语前聋患儿分期双侧人工耳蜗植入术后的言语感知、声源定位能力、听觉能力等,探讨双耳助听的优越性。方法选取40例于2014～2015年间第一次行单侧人工耳蜗植入的语前聋患儿,其中20例于2016～2017年间再次行对侧人工耳蜗植入(A组),另20例单侧人工耳蜗植入患儿作为B组。采用言语空间特性父母版(the speech,spatial and qualities of hearing scale-parent's version,SSQ-P)、听觉行为分级-Ⅱ(categories of auditory performance-Ⅱ,CAP-Ⅱ)两个量表,首先对40例患儿第一次人工耳蜗植入术后2年(T_1)的空间听力、听觉及言语能力等方面进行评估,在A组20例患儿完成对侧人工耳蜗植入术后1年时(T_2),对40例患儿进行第二次评估,比较两组的SSQ-P得分、CAP-Ⅱ分级。结果第一次人工耳蜗植入术后2年(T_1),两组间SSQ-P得分和CAP-Ⅱ分级差异无统计学意义(P>0.05)。第二次评估时(T_2)A组的SSQ-P得分和CAP分级均高于B组,差异有统计学意义(P<0.01,P<0.05)。结论双侧人工耳蜗植入较单侧人工耳蜗植入的听觉效果更好,尤其是患者的空间听力显著提高。
Objective To evaluate the speech perception, sound localization and auditory ability of prelingual deafness children after bilateral cochlear implantation, and to explore the advantages of binaural hearing.Methods Forty cases of pre-deafness with cochlear implantation in 2014～2015 were selected, of which 20 cases were implanted in the contralateral cochlea again in 2016～2017 as group A, and 20 cases of unilateral cochlear implant were listed as group B. The children and their families of the two groups were followed up by questionnaires. The two scales of the speech,spatial and qualities of hearing scale-parent's version(SSQ-P) and categories of auditory performance-Ⅱ(CAP-Ⅱ) were used to evaluate the spatial hearing, hearing and speech ability of 40 children after the first cochlear implantation. In group A, 20 children completed contralateral cochlear implantation for 1 year, and then 40 children were evaluated for the second time.Results After the first cochlear implantation, there was no significant difference in the scores of SSQ-P and CAP-Ⅱ between the two groups(P>0.05).The scores of SSQ-P in group A after the second cochlear implantation were significantly higher than that in group B(P<0.01), and the scores of CAP in group A were also higher than that in group B(P<0.05).Conclusion Bilateral cochlear implantation(binaural hearing) has better auditory effects than unilateral cochlear implantation, especially in the patient's spatial hearing.
Objective To evaluate the speech perception, sound localization and auditory ability of prelingual deafness children after bilateral cochlear implantation, and to explore the advantages of binaural hearing.Methods Forty cases of pre-deafness with cochlear implantation in 2014～2015 were selected, of which 20 cases were implanted in the contralateral cochlea again in 2016～2017 as group A, and 20 cases of unilateral cochlear implant were listed as group B. The children and their families of the two groups were followed up by questionnaires. The two scales of the speech,spatial and qualities of hearing scale-parent's version(SSQ-P) and categories of auditory performance-Ⅱ(CAP-Ⅱ) were used to evaluate the spatial hearing, hearing and speech ability of 40 children after the first cochlear implantation. In group A, 20 children completed contralateral cochlear implantation for 1 year, and then 40 children were evaluated for the second time.Results After the first cochlear implantation, there was no significant difference in the scores of SSQ-P and CAP-Ⅱ between the two groups(P>0.05).The scores of SSQ-P in group A after the second cochlear implantation were significantly higher than that in group B(P<0.01), and the scores of CAP in group A were also higher than that in group B(P<0.05).Conclusion Bilateral cochlear implantation(binaural hearing) has better auditory effects than unilateral cochlear implantation, especially in the patient's spatial hearing.
引文
1 Aronoff JM,Yoon YS,Freed DJ,et al.The use of interaural time and level difference cues by bilateral cochlear implant users[J].The Journal of the Acoustical Society of America,2010,127:EL87.
2 Kühn-Inacker H,Shehata-Dieler W,Müller J.Bilateral cochlear implants: a way to optimize auditory perception abilities in deaf children[J]?International Journal of Pediatric Otorhinolaryngology,2004,68:1257.
3 Peters BR,Litovsky R,Parkinson A.Importance of age and postimplantation experience on speech perception measures in children with sequential bilateral cochlear implants[J].Otology & Neurotology,2007,28:649.
4 Steffens T,Lesinski-Schiedat A,Strutz J,et al.The benefits of sequential bilateral cochlear implantation for hearing-impaired children[J].Acta Otolaryngologica,2008,128:164.
5 Summerfield AQ,Lovett RE,Bellenger H.Estimates of the cost-effectiveness of pediatric bilateral cochlear implantation[J].Ear and Hearing,2010,31:611.
6 Ramos-Macías A, Deive-Maggiolo L, Artiles-Cabrera O, et al. Bilateral cochlear implants in children: acquisition of binaural hearing[J]. Acta Otorrinolaringol Esp, 2013, 64:31.
7 钟梅,邱建新.双耳双模式人工耳蜗植入患者术后听觉能力评估[J].听力学及言语疾病杂志,2018,26,312.
8 Galvin KL, Noble W. Adaptation of the speech, spatial, and qualities of hearing scale for use with children, parents, and teachers[J]. Cochlear Implants International, 2013, 14:135.
9 Robbins AM, Renshaw JJ,Berry SW,et al. Evaluating meaningful auditory integration in profoundly hearing-impaired children[J]. American Journal of Otology, 1991, 12(Suppl):144.
10 Strom-Roum H,Rodvik AK,Osnes TA,et al.Sound localising ability in children with bilateral sequential cochlear implants[J].International Journal of Pediatric Otorhinolaryngology,2012,76:1245.
11 Van Wanrooij MM.Contribution of head shadow and pinna cues to chronic monaural sound localization[J].The Journal of Neuroscience,2004,24:4163.
12 Scherf F, van DL, van WA, et al. Three-year postimplantation auditory out-comes in children with sequential bilateral cochlear implantation[J]. Ann Otol Rhinol Laryngol,2009,118:336.
13 Godar SP.Experience with bilateral cochlear implants improves sound localization acuity in children[J].Otology & Neurotology,2010,31:1287.
14 MacKeith NW, Coles RR. Binaural advantages in hearing of speech[J]. J Laryngol Otol, 1971, 85:213.
15 夏瑞明,余力生,马鑫.双侧人工耳蜗植入患者早期言语识别率的特点[J].中国听力语言康复科学杂志,2003(1):32.
2 Kühn-Inacker H,Shehata-Dieler W,Müller J.Bilateral cochlear implants: a way to optimize auditory perception abilities in deaf children[J]?International Journal of Pediatric Otorhinolaryngology,2004,68:1257.
3 Peters BR,Litovsky R,Parkinson A.Importance of age and postimplantation experience on speech perception measures in children with sequential bilateral cochlear implants[J].Otology & Neurotology,2007,28:649.
4 Steffens T,Lesinski-Schiedat A,Strutz J,et al.The benefits of sequential bilateral cochlear implantation for hearing-impaired children[J].Acta Otolaryngologica,2008,128:164.
5 Summerfield AQ,Lovett RE,Bellenger H.Estimates of the cost-effectiveness of pediatric bilateral cochlear implantation[J].Ear and Hearing,2010,31:611.
6 Ramos-Macías A, Deive-Maggiolo L, Artiles-Cabrera O, et al. Bilateral cochlear implants in children: acquisition of binaural hearing[J]. Acta Otorrinolaringol Esp, 2013, 64:31.
7 钟梅,邱建新.双耳双模式人工耳蜗植入患者术后听觉能力评估[J].听力学及言语疾病杂志,2018,26,312.
8 Galvin KL, Noble W. Adaptation of the speech, spatial, and qualities of hearing scale for use with children, parents, and teachers[J]. Cochlear Implants International, 2013, 14:135.
9 Robbins AM, Renshaw JJ,Berry SW,et al. Evaluating meaningful auditory integration in profoundly hearing-impaired children[J]. American Journal of Otology, 1991, 12(Suppl):144.
10 Strom-Roum H,Rodvik AK,Osnes TA,et al.Sound localising ability in children with bilateral sequential cochlear implants[J].International Journal of Pediatric Otorhinolaryngology,2012,76:1245.
11 Van Wanrooij MM.Contribution of head shadow and pinna cues to chronic monaural sound localization[J].The Journal of Neuroscience,2004,24:4163.
12 Scherf F, van DL, van WA, et al. Three-year postimplantation auditory out-comes in children with sequential bilateral cochlear implantation[J]. Ann Otol Rhinol Laryngol,2009,118:336.
13 Godar SP.Experience with bilateral cochlear implants improves sound localization acuity in children[J].Otology & Neurotology,2010,31:1287.
14 MacKeith NW, Coles RR. Binaural advantages in hearing of speech[J]. J Laryngol Otol, 1971, 85:213.
15 夏瑞明,余力生,马鑫.双侧人工耳蜗植入患者早期言语识别率的特点[J].中国听力语言康复科学杂志,2003(1):32.