语后聋成人人工耳蜗植入后听觉、言语和生活质量评估

Evaluation of Hearing,Speech and Quality of Life after Cochlear Implantation in Postlingually Deafened Adults

目的探讨语后聋成人人工耳蜗植入术后的听力、言语识别能力和生活质量改善的特点,为成人语后聋人工耳蜗植入患者的术前咨询和术后效果评估提供参考。方法研究对象为21例植入人工耳蜗1年以上的成人语后聋患者,分别进行助听听阈测试、采用心爱飞扬言语测听系统评估言语识别能力、使用Nijmegen人工耳蜗植入量表(NCIQ)评估术后生活质量,并与言语识别能力做相关性分析。结果所有植入者术后助听听阈、言语识别能力和生活质量均有明显改善,术后250~4000 Hz各频率平均助听听阈分别为30.16±8.51、33.88±6.98、35.23±10.41、34.11±6.66和33.67±7.78 dB HL;安静条件下单音节词平均言语识别率为53.37%±20.31%,双音节词平均言语识别率为56.50%±24.21%,语句平均言语识别率为65.28%±38.08%;噪声条件下的平均言语识别阈为0.32±5.76 dB SNR;术后NCIQ总分及基本声音感知、高级声音感知、言语功能、自信心、活动能力和社会交流能力等得分与术前相比均有明显改善,手术前后高级声音感知和社会交流得分差值与言语识别平均得分有显著相关性(分别为r=0.472,P<0.05;r=0.318,P<0.05)。结论语后聋成人人工耳蜗植入患者术后听力、言语识别能力和生活质量均明显改善,高级声音感知和社会交流能力的改善程度与言语识别能力显著相关。

Objective To investigate the improvement of hearing,speech recognition and quality of life in postlingually deafened adults with cochlear implants(CI),and to provide a reference for preoperative consultation and postoperative evaluation for adults with postlingual hearing loss.Methods The study subjects were 21 postlingually deafened adults with cochlear implants.Aided thresholds were tested to obtain the current hearing threshold level of the subjects.The speech audiometry system was used to evaluate the speech recognition ability.The Nijmegen cochlear implantation questionnaire(NCIQ)was used to evaluate the postoperative quality of life.Correlation analysis was underwent between results of NCIQ and speech recognition.Results The aided threshold,speech recognition percentage and quality of life of all implanted patients were significantly improved.The average aided thresholds from 250 to 4000 Hz after CI were 30.16±8.51 dB HL,33.88±6.98 dB HL,35.23±10.41 dB HL,34.11±6.66 dB HL,33.67±7.78 dB HL,respectively.The average speech recognition percent of monosyllable words was 53.37±20.31%,disyllable words was 56.50±24.21%,and sentences was 65.28±38.08%under quiet conditions.Average speech recognition threshold under noisy condition was 0.32±5.76 dB SNR.NCIQ score and scores in six sub-dimensions such as basic sound perception,advanced sound perception,speech production,self-esteem,limitations in social activities and functions were all significantly improved,and were significantly related to speech recognition results(P<0.05)of advanced sound perception,limitations in social activities.Conclusion Hearing,speech recognition,and quality of life were significantly improved after cochlear implantation in postlingually deafened adults after cochlear implantation.The improvement of advanced sound perception and limitations in social activities of quality of life were significantly related to speech recognition.