脑白质异常聋儿人工耳蜗植入后效果初步分析

Primary outcome of surgery and rehabilitation of cochlear implant in children with abnormal white matter

目的探讨对脑白质异常的重度感音神经性聋患儿,人工耳蜗植入手术的可行性及听力言语康复效果分析。方法自2012年1月至2014年12月行人工耳蜗植入术的120例(120耳)重度感音神经性聋患儿中,有脑白质异常的患儿15例。随机抽取15例脑白质无异常的聋儿作为对照组,比较两组患儿植入人工耳蜗后手术效果、开机调试结果及听力言语康复效果。结果 130例(30耳)电极全部植入耳蜗内;2所有患者术后无脑膜炎、面瘫、脑脊液漏等并发症;3所有脑白质异常患儿在人工耳蜗植入术后都有听觉;4脑白质异常儿童术后平均听阈与对照组无明显区别;5随访6至24月后,脑白质异常患儿的听觉行为分级标准(categories of auditory performance,CAP)和言语可懂度分级标准(speech intelligibility rating,SIR)与对照组比较,差异均无显著性意义(P>0.05)。结论经过严格术前评估后,人工耳蜗植入可应用于脑白质异常伴重度感音神经性聋的患儿,其术后效果与脑白质无异常的聋儿植入效果基本一致,术后的听力言语康复效果无明显差异。

0bjective To study the outcome of cochlear implant in children with abnormal matter, and to evaluate the effect of rehabilitation. Methods Among 120 patients who received cochlear implants from Jan.2012 to Dec.2014 in our department, abnormal white matter was found in 15 patients.15 patients with normal white matter were enrolled randomly as control group.The outcome of surgery and rehabilitation between two groups were compared. Results 1）All electrodes were successfully inserted into cochleae.2）No serious postoperative complications occurred.3）All patients had auditory sensations after implantations. 4）No obvious difference in hearing threshold post surgery between two groups was found. 5）No significant differences in Categories of Auditory Performance（CAP） and Speech Intelligibility Rating（SIR） between two groups were found following 6~12-month follow-up. Conclusion The primary postoperative outcome and speech and language rehabilitation result for the patients with abnormal white matter are similar to those with normal white matter. Cochlear implants could be implanted safely and effectively in patients with abnormal white matter.