婴儿人工耳蜗植入术后听力言语康复的影响因素

Factors Influencing Hearing and Speech Development after Cochlear Implantation in Infants

目的 探讨人工耳蜗手术年龄≤12个月婴儿听力及言语发育的影响因素。方法 收集从2017年7月至2020年1月行人工耳蜗植入术(Cochlear implant,CI)手术年龄≤12个月极重度感音神经性耳聋患儿45例的基本资料,分析最近一次随访听觉及言语评估结果与性别、手术年龄、手术方式及人工耳蜗使用时间的相关性。结果 45例患儿,男性25例,女性20例,平均手术年龄9.16±1.43月,人工耳蜗使用时间平均为25.77±12.16月,多因素线性回归分析显示女性、双侧同期植入及人工耳蜗使用时间会对CAP评分产生正向的影响,人工耳蜗使用时间对SIR评估结果产生正向的影响关系。SIR评估结果受CAP评估结果的影响,R2=0.604。结论 对于手术年龄为6-12个月婴儿,女性、同期双侧植入、CI使用时间越长的患儿的听觉感知越好,进而影响了言语技能的发展,手术年龄对听觉及言语康复无显著影响。

Objective To identify factors influencing auditory performance and speech intelligibility in children younger than 12 months after cochlear implant(CI) surgery.Methods Data from 45 children younger than 12 months with bilateral profound preverbal sensorineural deafness who underwent cochlear implantation from July 2017 to January 2020 were collected for analysis of correlations between auditory performance/speech intelligibility and gender,age at surgery,implantation methodology and time of cochlear implant use.Results Among the 45 children,25 were male and 20 were female.The average age at surgery was 9.16±1.43 months.The average time of cochlear implant use was25.77 ± 12.16 months.Linear regression analysis indicated that female gender,simultaneous bilateral implantation and time of CI use were positively correlated with auditory outcomes,Time of CI use was also positively correlated with speech intelligibility,while auditory outcomes showed a positive influence on development of speech intelligibility(R 2=0.604).Conclusion For infants aged 6-12 months at surgery,female gender,simultaneous bilateral implantion and the prolonged use of cochlear implant favor improvement of hearing perception,which in turn affects the development of speech skills.Age at surgery has no effect on hearing perception or speech development.