调机对人工耳蜗植入儿童听觉言语能力的影响个案报告

A Case Report:The Effects on Hearing and Speech Ability by Mapping for a Cochlear Implanted Child

目的分析患者在人工耳蜗调机前后听觉言语能力特点,探讨人工耳蜗调机的影响及大龄听障儿童的大脑可塑性。方法采用问卷法对人工耳蜗植入患儿术前及开机后1年的听觉言语能力进行定期随访,对比分析不同程序下患儿言语识别能力与听觉失匹配反应(mismatch response,MMR)的特点。结果患者两次调机前的林氏六音识别正确率分别为57%、67%,MMR的检出率均为50%;调机后识别正确率为87%,MMR检出率为83%;调机后的听觉言语能力有明显提高。结论对于人工耳蜗术后效果不佳的患者,可尝试专家会诊调机与主客观综合评估。调机可直接而显著地改变人工耳蜗植入儿童的听觉与言语识别能力,大龄听障儿童具有较好的大脑可塑性。

Objective To analyze the hearing and speech ability of an old cochlear implanted child before and after cochlear implant(CI)mapping,and to explore the brain plasticity of the older child implanted.Methods The patient was a cochlear implanted child with poor mapping and rehabilitation effect by routine mapping.Questionnaires were adopted to tacking hearing and speech development of the children from pre-operation to post-operation 1 year after follow-up.CI mapping was conducted by two sophisticated audiologists based on conclusive assessment results.The strategy was to increase both the C and T level of the electrodes related to all the frequency band to some extent.The recognition tests of ling’s six sounds were conducted,the event related potentials were recorded and mismatch response(MMR)was analyzed of the patient via the old and new program,respectively.Results The recognition percentage of six sounds were 57%and 67%,while the incidences of MMR were only 50%in two tests before the mapping,.Whereas,the recognition percentage was 87%and the incidence was 83%after the mapping.That is,the patient’s hearing and speech ability improved greatly after mapping.Conclusion Mapping by experts consultation and conclusive assessment can be took into account while the patient’s mapping or rehabilitation effect was always poor.CI mapping could probably change the hearing and speech ability of CI recipients.In addition,the brain plasticity of the old child proved quite robust.