植入年龄对婴幼儿人工耳蜗植入患者早期言语可懂度的影响

Effect of age on speech intelligibility at the early stage after surgery in infants with cochlear implantation

目的本研究评估使用人工耳蜗的婴幼儿患者早期言语可懂度发育并探讨植入年龄对言语可懂度的影响,为患儿的听力言语康复提供指导。方法共有272例极重度语前聋人工耳蜗植入婴幼儿参加本次研究。手术年龄9～36个月,平均(21±7)个月。根据植入年龄将患儿分为3个组:A组小于18个月,B组为19～24个月,C组为25～36个月。使用言语可懂度分级(speech intelligibility rating,SIR)问卷在术前及术后开机后1、3、6、9个月和1年时对患儿进行评估。结果患儿SIR平均得分在术前、术后开机后1、3、6、9个月和1年之间的差异有显著性。3个组患儿SIR平均得分在术后开机后3个月、6个月之间的差异有显著性,在术前、术后开机后1个月、9个月、1年之间的差异无显著性。结论极重度语前聋人工耳蜗植入婴幼儿患者的言语可懂度在术后1年内有显著提高。植入年龄对婴幼儿人工耳蜗患者术后早期言语可懂度发育没有显著影响。

OBJECTIVE The aim of this research is to assess the speech intelligibility of infants with cochlear implants within the first year after operation and to explore the effect of age on speech intelligibility in order to provide a database for their hearing and speech rehabilitation program.METHODS 272 infants participated in this study,ranging in age from 9 to 36 months with a mean of 21 months.They were all diagnosed with prelingually profound hearing loss before surgery.They were divided into three groups according to their age at implantation.Infants in group A were implanted under 18 months.Infants in group B were implanted between 19 and 24 months of age.Infants in group C were implanted between 25 and 36 months of age.Speech Intelligibility Rating（SIR）was used to evaluate their speech intelligibility.The evaluation was performed by audiologists before operation and 1 month,3 months,6 months,9 months,1 year after switch-on.RESULTS The mean scores of SIR showed significant differences at each interval for all infants with cochlear implants.The differences were statistically significant in mean scores of SIR among these three groups in 3 and 6 months after switch-on.However no significant differences were observed in pre-operation,1,9 months and 1 year after switch-on.CONCLUSION Speech intelligibility of infants with prelingually profound hearing loss developed rapidly at the early stage after cochlear implantation.The age of cochlear implantation in infants had no significant influence on the development of speech intelligibility within the first year after surgery.