人工耳蜗植入后效果欠佳同侧助听器替代个案分析

A Case Study of Using Hearing Aid Instead of Ineffective Cochlear Implant for a Hearing-impaird Child

目的通过对1例5岁听障儿童植入人工耳蜗后同侧分别使用人工耳蜗及助听器进行听觉能力评估对比，寻求最优化的听觉康复手段，强调人工耳蜗植人手术适应证选择及术前科学选配助听器的重要性。方法使用《听力障碍儿童听觉语言能力评估》词表及听觉事件相关电位，对听障儿童同侧植入人工耳蜗及选配助听器的助听效果分别进行评估，对评估结果进行比较、分析。结果患儿植入人工耳蜗并接受康复训练后，言语识别率进步不明显，而用助听器替代，经科学验配及调试后，言语识别率很快达到100%，康复效果明显。结论在选择人工耳蜗植入手术适应证时应慎之又慎，术前至少3个月的助听器配戴史非常重要，尤其需强调助听器的科学验配及优化。

Oblective To seek for the optimization of auditory rehabilitation outcome through comparison of the speech recognition score（SRS） of a 5-year-old child with cochlear implant （CI） and with hearing aid （HA） respectively and to emphasize the importance of selection of indications for the cochlear implant surgery and appropriate fitting of hearing aids before surgery. Methods Speech recognition scores （SRS） and auditory event-related potentials were evaluated for the child with ipsilateral CI and HA respectively and the results were compared and analyzed. Results The progress of speech recognition of the child after cochlear implantation and rehabilitation training was not obvious, but the speech recognition score quickly increased to 100% and rehabilitation outcome was obviously improved when the CI was replaced with HA. Conclusion It is important to be careful when choosing CI indications, and it is essential to wear HA preoperatively at least 3 months with emphasis on the scientific fitting and optimization.