青少年患者人工耳蜗植入术后的舒适阈特点及变化

Characteristics and Changes of Comfortable Levels in Adolescent Patients after Cochlear Implants

目的 通过探讨人工耳蜗植入术后青少年患者舒适阈的特点及变化，为此类患者调试人工耳蜗提供基本资料。方法 选取手术年龄为9—20岁的青少年患者78例，术后进行心理物理测试，观察开机时、开机后1个月、3个月、6个月和1年时测试的舒适阈值和实际使用的舒适阈值的变化。结果 3号、10号和20号电极在开机时和开机后1年测试的舒适阈均值之间的差异均有统计学意义（均为P〈0．01），且这3个电极在开机时、开机后1个月分别测试的舒适阈均值和实际使用的舒适阈均值之间的差异均有统计学意义（均为P〈0．05）。测试舒适阈均值与实际使用舒适阈均值之间的差值在开机时最大，随时间的增加差值逐渐减小。结论 随着开机后时间的增加，舒适阈的均值也随之增加，测试舒适阈均值与实际使用舒适阈均值之间的差值在开机后6个月和1年时接近。对青少年患者舒适阈的设置要合适，以便帮助他们尽快渡过适应期。

Objective To investigate the characteristics and changes of comfortable levels after cochlear implants（CI） in adolescents in order to obtain the basic mapping data for adolescent patients. Methods 78 adolescent patients with CI at the age of 9 - 20 years old participated in this study. Psychophysical tests were administered to observe the changes of comfortable levels in test and comfortable levels in use at the time of switch - on 1 month,3 months,6 months and 1 year after switch - on. Results The average of comfortable levels in test of No. 3, No. 10 and No. 20 electrodes when switch- on and 1 year after switch- on were significantly different（ P 〈 0.01） and that for No.3 ,No. 10 and No.20 electrodes when switch - on and 1 month after switch - on were significantly different（ P 〈 0.05）. The differences between comfortable levels in test and comfortable levels in use were greatest at switch - on, and the data decreased gradually with time after switch - on. Conclusion The comfortable levels increase along with the time after switch - on. The difference between comfortable levels in test and comfortable levels in use are similar at the time of 6 months and 1 year after switch - on. It is important to set the right comfortable levels for adolescent patients because it can help them to go through adaptive period.