植入年龄对婴幼儿人工耳蜗患者早期听力发育的影响

Effect of age at cochlear implantation on auditory performance at the early stage after surgery in infants

目的:评估使用人工耳蜗的婴幼儿患者的早期听觉能力,总结其发育规律,探讨植入年龄对患儿人工耳蜗植入术后1年内听觉能力发育的影响,为其有效康复提供临床资料。方法:将272例因极重度语前聋行人工耳蜗植入的婴幼儿根据植入年龄分为3组:A组,植入年龄<18个月(107例);B组,植入年龄18～24个月(74例);C组,植入年龄>24～36个月(91例)。使用听觉行为分级(CAP)问卷对患儿的听觉能力分别在术前及术后开机1、3、6、9、12个月进行评估。结果:患儿CAP得分在术前及术后开机1、3、6、9、12个月之间均差异有统计学意义(均P<0.05)。A、B、C 3组患儿的CAP得分在术后开机1、3个月间差异有统计学意义(P<0.05),而术前和术后开机6、9、12个月之间均差异无统计学意义(均P>0.05)。结论:极重度语前聋患儿人工耳蜗植入后的听觉能力在术后1年内有显著提高,植入年龄对患儿术后早期听觉能力的发育无显著影响,CAP问卷适合在中国临床工作中使用。

Objective：To evaluate the auditory performance of infants with cochlear implants at the early stage after surgery,summarize the development of auditory ability,investigate the effect of age at cochlear implantation on auditory performance within the first year after surgery and provide a reference for their habilitation program.Method：A total of 272 infants with prelingually profound hearing loss participated in this study,ranging in age at cochlear implantation from 18 to 36 months.The mean age was 21 months with a standard deviation of 7 months.Infants with cochlear implants were divided into three groups according to their age at implantation.Infants in group A were implanted under 18 months of age.Infants in group B were implanted between 18 and 24 months of age.Infants in group C were implanted between 25 and 36 months of age.Categories of auditory performance（CAP） was used to evaluate the auditory performance,which rates auditory abilities in eight categories for a scale of 0 to 7.Result：The mean scores of CAP for all infants at each interval were significantly different after implantation.Significant differences were observed in mean scores of CAP among these three groups in 1 and 3 months after switch-on.However there were no significant differences in pre-operation,6,9 and 12 months after switch-on.Conclusion：There is a significant improvement in auditory performance of infants with prelingually profound hearing loss within the first year after cochlear implantation.The age at cochlear implantation has no critical influence on the development of auditory capabilities at the early stage after surgery.CAP is a practical tool which can be used in clinic in China.