内耳结构正常与畸形患者人工耳蜗植入术后效果分析

An Analysis of Postoperative Outcomes of Patients with Normal and Malformed Inner Ear after Cochlear Implantation

目的分析对比内耳结构正常患者与不同类型内耳畸形患者人工耳蜗植入术后听觉言语康复效果。方法选择2010年3月～2014年11月于郑州大学第一附属医院耳科住院行人工耳蜗植入术的语前聋患者共448例，按是否存在内耳畸形和畸形特点分组，回顾性分析对比各组术后开机6个月、1年的听觉行为分级标准（categories of auditory performance，CAP）、言语可懂度分级标准（speech intelligibility rating，SIR）评分。结果各组患儿术后开机1年内，CAP、SIR评分均有提高趋势。单纯前庭导水管扩大组、Mondini畸形组在术后开机6个月、1年时的CAP、SIR得分分别与内耳结构正常组患儿比较，差异均无统计学意义（P〉0．05），共同腔畸形组和蜗神经发育不良组在术后开机6个月、1年时的CAP和SIR得分显著低于内耳结构正常组，差异有统计学意义（P〈0．05）。结论内耳畸形患者能从人工耳蜗植入术中获益，其听觉感知及言语表达能力均有提高，但严重的畸形术后效果仍不及内耳结构正常患者。

Objective To analyze and compare the auditory and speech rehabilitation outcomes of patients with normal and malformed inner ear after cochlear implantation. Methods From March 2010 to November 2014,448 patient who received cochlear implantation in the First Affiliated Hospital of Zhengzhou University were selected. The patient were divided into 5 groups according to imaging results of inner ear.A retrospective analysis was performed to compar the categories of auditory（CAP） and speech intelligibility rating（SIR） scores 6 months and 1 year after the swith-on amon the different groups. Results The CAP and SIR scores increased gradually within 1 year after the implantation. There wa no significant difference in CAP and SIR scores between enlarged vestibular adequate group and normal group 6 month and 1 year after the swith-on（P〉0.05）, and the similar result was observed between Mondini deformity group and normal group（P〉0.05）. The scores of the common cavity group and cochlear nerve deficiency group were significantly lower tha those of the normal group 6 months and 1 year after the swith-on（P〈0.05）. Conclusion The patients with malformed innerear can benefit from cochlear implantation and the auditory and speech abilities show significant improvements, but th outcomes of the patients with severe malformation is not as good as those with normal inner ear.