Auditory and Language Development after Cochlear Implantation in Children with Inner Ear Malformation
-
摘要:
目的 通过对内耳结构异常患儿进行人工耳蜗植入手术，评估该类患儿术后听觉言语发育情况，对比分析此类患儿与内耳结构正常患儿在听觉言语发育上的差异。 方法 回顾性分析52例行单侧人工耳蜗植入手术患儿，根据内耳结构有无异常分为结构异常组与结构正常组，每组各26例。对比分析2组在术前、术后1月、3月、6月、12月时听觉言语发育情况，其中听觉功能使用CAP与ITMAIS量表评估，言语功能使用SIR与MUSS量表评估。 结果 全部患儿在行人工耳蜗植入术后1、3、6、12月，听觉言语发育相关评分（CAP、ITMAIS、SIR、MUSS）较术前均有明显差异，且呈现逐步升高的趋势。结构正常组与结构异常组的听觉功能分别在术前、术后1、3、6、12月对比，差异有统计学意义（P < 0.001）。结构正常组与结构异常组在术前的言语功能SIR评分中对比，无明显差异，P = 0.303。但2组言语功能分别在术后1、3、6、12月对比，差异有统计学意义（P < 0.05）。 结论 内耳结构异常患儿行人工耳蜗植入手术，在术后1 a内的听觉言语能力较术前有明显提高，但内耳结构异常患儿在术后听觉言语发育上与内耳结构正常患儿有一定差异。 Abstract:Objective To systematically evaluate the development of auditory and language in children with inner ear malformation after cochlear implantation, in addition, to compare and analyze the differences of auditory and language development between these children and children with normal inner ear structure. Methods The 52 children with unilateral cochlear implantation were retrospectively selected and analyzed, they were divided into abnormal inner ear structure group and normal inner ear structure group according to whether the inner ear structure was abnormal or not, with 26 cases in each group. The auditory and language development of the two groups were compared and analyzed before operation, the 1st month, 3rd month, 6th month and 12th month after operation. The auditory function was assessed with CAP and ITMAIS scales, while the language function was assessed with SIR and MUSS scales. Results At the 1st month, 3rd month, 6th month and 12th month after cochlear implantation, the scores of auditory and language development （CAP, ITMAIS, SIR and MUSS） were significantly different from those before cochlear implantation, which has showed a gradually increasing trend. The auditory function of normal inner ear structure group and abnormal inner ear structure group were compared before operation, the 1st month, 3rd month, 6th month and 12th month after operation, there was statistical significant difference （P < 0.001）. There was no significant difference between the normal inner ear structure group and the abnormal inner ear structure group in the preoperative language function SIR score （P = 0.303）, however, there were significant differences in language function between the two groups at the 1st month, 3rd month, 6th month and 12th month after operation （P < 0.05）. Conclusion Within one year after cochlear implantation, the auditory and language ability of children with inner ear malformation has been significantly improved, however, there are some differences between the children with abnormal inner ear structure and those with normal inner ear structure. -
图 1 2组在不同时期听觉功能CAP变化趋势
Figure 1. The change trend of auditory function CAP in different periods of both groups
图 2 2组在不同时期听觉功能ITMAIS变化趋势
Figure 2. The change trend of auditory function ITMAIS in different periods of both groups
图 3 2组在不同时期言语功能SIR变化趋势
Figure 3. The change trend of speech function SIR in different periods of both groups
图 4 2组在不同时期言语功能MUSS变化趋势
Figure 4. The change trend of speech function MUSS in different periods of both groups
图 5 颞骨CT：冠位显示双侧耳蜗不完全分隔（红色箭头所示）
Figure 5. CT of the temporal bone: Coronary view shows that the cochlea is incompletely separated on both sides （the red arrows show）
图 6 耳蜗不完全分隔患儿右耳植入人工耳蜗（红色箭头显示植入的人工耳蜗电极）
Figure 6. The child with incomplete cochlea separation is implanted with cochlear implant in the right ear （the red arrow shows the implanted cochlear implant electrode）
表 1 患儿基本情况（n）
Table 1. The information of patients （n）
年龄（岁） 结构异常组 结构正常组 耳蜗前庭及半规管共同腔 耳蜗不完全分隔 耳蜗发育不全 大前庭导水管 0～ 1 2 6 1～ 1 1 7 1 10 2～ 5 7 3～ 1 3 3 4～ 1 5～ 6～ 1 2 0 合计 1 1 10 14 26 
下载: 导出CSV
表 2 同一时间不同组间和同组不同时间听觉言语功能比较[M（P25，P75）]
Table 2. Comparison of auditory and speech functions among different groups during the same period or in the same group at different times [M（P25，P75）]
听觉言语功能 结构正常组（n = 26） 结构异常组（n = 26） U P CAP 术前 0.00（0.00，1.00） 0.00（0.00，0.00） 182.000 < 0.001* 术后1月 1.00（1.00，2.00） 0.00（0.00，0.00） 77.500 < 0.001* 术后3月 3.00（2.00，4.00） 1.00（0.00，2.00） 44.000 < 0.001* 术后6月 4.00（3.00，4.00） 2.00（1.00，3.00） 114.500 < 0.001* 术后12月 6.00（4.00，7.00） 3.00（3.00，5.00） 99.000 < 0.001* H 102.879 98.399 P < 0.001* < 0.001* ITMAIS 术前 1.50（1.00，2.00） 0.00（0.00，1.00） 65.000 < 0.001* 术后1月 4.00（2.75，5.00） 1.00（1.00，2.00） 58.500 < 0.001* 术后3月 12.00（10.00，13.25） 7.00（5.75，8.00） 0.000 < 0.001* 术后6月 18.50（15.75，22.25） 9.00（9.00，11.00） 0.000 < 0.001* 术后12月 28.50（24.75，31.25） 14.50（11.00，17.00） 0.000 < 0.001* H 119.569 119.282 P < 0.001* < 0.001* SIR 术前 1.00（1.00，1.00） 1.00（1.00，1.00） 312.000 0.303 术后1月 1.00（1.00，1.25） 1.00（1.00，1.00） 273.000 0.044* 术后3月 2.00（2.00，2.00） 1.00（1.00，1.00） 73.000 < 0.001* 术后6月 3.00（2.00，3.00） 1.00（1.00，1.00） 16.000 < 0.001* 术后12月 4.00（3.00，4.00） 2.00（1.00，2.00） 13.500 < 0.001* H 101.841 56.114 P < 0.001* < 0.001* MUSS 术前 5.00（5.00，5.00） 2.50（2.00，3.00） 0.000 < 0.001* 术后1月 5.00（5.00，6.00） 4.00（3.00，4.25） 59.500 < 0.001* 术后3月 11.00（9.75，11.25） 6.50（5.00，8.00） 12.000 < 0.001* 术后6月 15.00（13.00，16.25） 10.00（8.00，11.00） 0.000 < 0.001* 术后12月 20.50（18.00，21.00） 13.00（11.00，14.25） 0.000 < 0.001* H 121.564 115.497 P < 0.001* < 0.001* *P < 0.05。
下载: 导出CSV
-
[1] 田勇泉. 耳鼻咽喉头颈外科学[M]. 第9版. 北京: 人民卫生出版社, 2020: 126-129. [2] 陈艳丹,陈柳,华清泉. 内耳发育畸形的人工耳蜗植入术[J]. 中国医药导报,2017,14(12):113-116. [3] Varadarajan V V,Sydlowski S A,Li M M,et al. Evolving criteria for adult and pediatric cochlear implantation[J]. Ear,Nose,& Throat Journal,2021,100(1):31-37. [4] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会,中国残疾人康复协会听力语言康复专业委员会. 人工耳蜗植入工作指南(2013)[J]. 中华耳鼻咽喉头颈外科杂志,2014,49(2):89-95. doi: 10.3760/cma.j.issn.1673-0860.2014.02.001 [5] Sennaroglu L,Saatci I. A new classification for cochleovestibular malformations[J]. Laryngoscope,2002,112(112):2230-2241. [6] 张帆,何波,阮标,汤勇. CT辅助下人工耳蜗植入患儿面神经隐窝发育研究[J]. 昆明医科大学学报,2015,36(2):62-64,70. doi: 10.3969/j.issn.1003-4706.2015.02.016 [7] Archbold S,Lutman M E,Nikolopoulos T. Categories of auditory performance:inter-user reliability[J]. British Journal of Audiology,1998,32(1):7-12. doi: 10.3109/03005364000000045 [8] Nikolopoulos T P,Archbold S M,Gregory S. Young deaf children with hearing aids or cochlear implants:early assessment package for monitoring progress[J]. International Journal of Pediatric Otorhinolaryngology,2005,69(2):175-186. doi: 10.1016/j.ijporl.2004.08.016 [9] 原皞,张华,梁巍,等. 不同康复模式听障婴幼儿听觉言语能力研究[J]. 听力学及言语疾病杂志,2015,23(6):630-634. doi: 10.3969/j.issn.1006-7299.2015.06.015 [10] Lu X,Qin Z. Auditory and language development in Mandarin-speaking children after cochlear implantation[J]. International Journal of Pediatric Otorhinolaryngology,2018,107(4):183-189. [11] Fan X,Sui R,Qi X,et al. Analysis of the developmental trajectory and influencing factors of auditory and speech functions after cochlear implantation in Mandarin Chinese speaking children[J]. Acta Oto-laryngologica,2020,140(6):501-508. doi: 10.1080/00016489.2020.1736622 [12] 梁云,陈秀兰. 内耳畸形语前聋患儿人工耳蜗术后康复效果分析[J]. 中国耳鼻咽喉头颈外科,2017,24(3):136-139. [13] 徐艳艳,晁秀华,徐磊,等. 共同腔畸形患儿蜗神经对电刺激的反应及耳蜗术后效果研究[J]. 中国听力语言康复科学杂志,2019,17(5):337-341. doi: 10.3969/j.issn.1672-4933.2019.05.004 [14] Catli T,Uckan B,Olgun L. Speech and language development after cochlear implantation in children with bony labyrinth malformations:long-term results[J]. European Archives of Otorhinolaryngology,2015,272(11):3131-3136. doi: 10.1007/s00405-014-3319-5 [15] Daneshi A,Farhadi M,Ajalloueyan M,et al. Cochlear implantation in children with inner ear malformation:A multicenter study on auditory performance and speech production outcomes[J]. International Journal of Pediatric Otorhinolaryngology,2020,132(5):109901. [16] Chen X,Yan F,Liu B,et al. The development of auditory skills in young children with Mondini dysplasia after cochlear implantation.[J]. PLoS ONE,2014,9(9):e108079. doi: 10.1371/journal.pone.0108079 [17] 李雯. 伴内耳畸形语前聋患儿人工耳蜗植入术后效果评估[D]. 安徽: 安徽医科大学硕士论文, 2015: 5-10. [18] Ibraheem O A,Kolkaila E A,Nada E H,et al. Auditory cortical processing in cochlear-implanted children with different language outcomes[J]. Eur Arch Otorhinolaryngology,2020,277(7):1875-1883. doi: 10.1007/s00405-020-05958-0 [19] Pisoni D B,Kronenberger W G. Recognizing spoken words in semantically-anomalous sentences:Effects of executive control in early-implanted deaf children with cochlear implants[J]. Cochlear Implants International,2021,22(4):223-236. doi: 10.1080/14670100.2021.1884433 [20] Caldwell A,Nittrouer S. Speech perception in noise by children with cochlear implants[J]. Journal of Speech,Language,and Hearing Research,2013,56(1):13-30. doi: 10.1044/1092-4388(2012/11-0338) [21] Hura N,Stewart M,Walsh J. Progression of hearing loss and cochlear implantation in large vestibular aqueduct syndrome[J]. International Journal of Pediatric Otorhinolaryngology,2020,135(8):110-133. [22] Suri N M,Prasad A R,Sayani R K,Anand A,Jaychandran G. Cochlear implantation in children with Mondini dysplasia:our experience[J]. The Journal of Laryngology and Otology,2021,135(2):125-129. doi: 10.1017/S0022215121000372 [23] Qi S,Kong Y,Xu T,et al. Speech development in young children with Mondini dysplasia who had undergone cochlear implantation[J]. International Journal of Pediatric Otorhinolaryngology,2019,116(1):118-124. [24] Al-Mahboob A,Alhabib S F,Abdelsamad Y. Cochlear implantation in common cavity deformity:a systematic review[J]. European Archives of Oto-Rhino-Laryngology,2021,278(5):1387-1394. [25] 王宇,潘滔,米思,等. 中文版言语可懂度分级标准的建立及其信度检验[J]. 听力学及言语疾病杂志,2013,21(5):465-468. doi: 10.3969/j.issn.1006-7299.2013.05.007 -
点击查看大图
计量
- 文章访问数: 4195
- HTML全文浏览量: 2474
- PDF下载量: 18
- 被引次数: 0
