双侧极重度感音神经性聋患儿人工耳蜗植入效果分析

Analysis of the Effect of Cochlear Implantation in Children with Bilateral Profound Sensorineural Prelingual Deafness

目的分析双侧极重度感音神经性聋患儿人工耳蜗植入效果。方法选取2018年2月~2022年2月本院接诊的80例双侧极重度感音神经性聋患儿,将40例非对称性听力损失患儿纳入对照组,行单侧人工耳蜗植入;将40例对称性听力损失患儿纳入观察组,行双侧人工耳蜗植入;分析两组开机前和干预6、12、36个月后的听觉行为分级(CAP)、言语可懂度分级(SIR),并建立多因素logistic模型,分析双侧人工耳蜗植入后影响CAP、SIR评分的独立危险因素。结果观察组干预后12、36个月CAP、SIR评分显著高于对照组(P<0.05)。多因素logistic分析显示,年龄>3岁、术前未使用助听器、植入时间<1年、内耳畸形是影响双侧人工耳蜗植入儿童CAP、SIR评分的独立危险因素(P<0.05)。结论双侧人工耳蜗植入是极重度感音神经性聋患儿听觉补偿的有效手段,年龄、植入时间、内耳畸形等因素可能影响患儿的听觉、言语功能康复,尽早为患儿植入双侧人工耳蜗,加强相关干预,才能有效促使患儿听觉言语功能康复。

Objective To analyze the effect of cochlear implantation in children with bilateral profound sensorineural prelingual deafness.Methods A total of 80 children with bilateral extremely severe sensorineural prelingual deafness admitted to our hospital from February 2018 to February 2022 were selected,and 40 children with asymmetric hearing loss were included in the control group for unilateral cochlear implantation.In addition,40 children with symmetrical hearing loss were included in the observation group,and bilateral unilateral cochlear implantation was performed.The auditory behavior classification(CAP)and speech intelligibility classification(SIR)of the two groups before and after 6,12 and 36 months of intervention were analyzed,and a multivariate logistic model was established to analyze the independent risk factors affecting CAP and SIR scores after bilateral cochlear implantation.Results The CAP and SIR scores of the observation group were significantly higher than those of the control group at 12 and 36 months after intervention(P<0.05).Multivariate logistic analysis showed that age>3 years old,no use of hearing aids before surgery,time after implantation<1 year,and inner ear malformation were all independent risk factors affecting CAP and SIR scores in children with bilateral cochlear implantation(P<0.05).Conclusion Bilateral cochlear implantation is an effective means for hearing compensation in children with bilateral profound sensorineural prelingual deafness.However,age,time after implantation,inner ear malformation and other factors may affect the recovery of hearing and speech function in children.Bilateral cochlear implantation as soon as possible and strengthening the prevention and intervention of related influencing factors can effectively promote the recovery of hearing and speech function in children.