用有意义听觉整合量表评估儿童人工耳蜗植入后听觉能力

Auditory capability evaluation for children after cochlear implantation using meaningfnl auditory integration scale

目的使用有意义听觉整合量表（meaningful auditory integration scale，MAIS）对学龄前儿童人工耳蜗植入术前后听觉能力的发展情况进行分析和讨论。方法共有82例语前聋儿童患者参加本次调查。手术年龄为3岁至6岁11个月。评估使用MAIS量表由经过培训的听力学专业人员进行评估。主要调查患者使用人工耳蜗的情况（问题1和2）、对声音的觉察能力（问题3～6）和对声音的理解能力（问题7～10）等三方面的内容。分别在术前和术后开机后1个月、3个月、6个月、1年、1年半、2年时对患者的上述情况进行评估。结果经单因素方差分析，问题1a和1b在术后各评估时间的得分的差异无统计学意义。问题2～10在术后各评估时间的得分的差异有统计学意义。结论学龄前儿童人工耳蜗植入术后听觉能力及其发展规律存在较大的个体差异。患者术前对日常生活中的声音不能做出准确的反应，而术后使用人工耳蜗能力、对声音的觉察能力和对声音的理解能力均有显著改善。患者术后对声音的觉察能力和理解能力的发展较使用人工耳蜗能力的发展慢。

Objective To analyze the auditory capability of preschool children before and after cochlear implantation using meaningful auditory integration scale （MAIS） questionnaire. Methods Eighty-two prelingually deaf patients participated in this study. They received a cochlear implant at the age of 3 to 6 years and 11 months. The audiologists who were trained for the research used the MAIS questionnaire. Audiologists asked for the parents＇ answers and recorded all the information about the device using （Q1, 2） and the patient＇s spontaneous auditory behavioural responses including spontaneous alerting to sound Q3～6 and deriving meaning from sound （Q7～10）. The evaluation was performed before operation and 1, 3, 6 months, 1, 1.5, 2 years after switch-on. Results The scores of question la and lb were not significantly different among the different periods after switch-on. The scores of question 2 to 10 were significantly different among the different periods after switch-on. Conclusions Considerable variability across subjects＇ auditory ability after cochlear implantation was noted. Most of the patients showed no consistent response to sound in everyday life before implantation. After cochlear implantation, a significant increase in auditory capability occurred. The children demonstrated faster development of device using relative to spontaneous alerting to sound and deriving meaning from sound.