【摘要】：目的探討伴腦白質病的語前極重度感音神經性聾患兒人工耳蝸植入的可行性及術后聽覺言語康復效果。方法海南省人民醫(yī)院耳鼻咽喉科2013年9~11月行人工耳蝸植入的14例伴腦白質病語前聾患兒為研究組(年齡1~6歲,平均3.79±1.93歲),同期無中樞神經系統(tǒng)病變的語前聾患兒16例為對照組(年齡1~6歲,平均4.38±1.93歲),術前均行臨床聽力學、影像學檢查及語言能力、智力水平等評估,經乳突后鼓室面神經隱窩入路一期行人工耳蝸植入術,術后均到海南省聾兒康復中心進行言語康復訓練;采用聽覺行為分級標準(categories of auditory performance,CAP)和言語可懂度分級標準(speech intelligibility rate,SIR)對兩組術后康復效果進行評估,比較兩組患兒術后不同階段的CAP和SIR分級。結果所有患兒人工耳蝸植入術后均獲得聽覺反應和不同程度的言語交流能力,隨著康復時間延長兩組患兒CAP及SIR分級均呈上升趨勢;研究組術后6、12和24個月CAP平均分級分別為2.571±0.416、3.714±0.496、5.000±0.492級,SIR平均分級分別為1.357±0.133、2.143±0.275、3.071±0.245級,與對照組CAP(分別為2.688±0.313、3.875±0.364、5.000±0.354級)及SIR(分別為1.500±0.129、2.313±0.176、2.875±0.221級)比較,差異均無統(tǒng)計學意義(P0.05)。結論伴腦白質病的語前極重度感音性聾患兒經過術前充分評估后可以實施人工耳蝸植入,術后2年內聽覺言語康復效果與不伴腦白質病的同齡患兒相當。
[Abstract]:Objective to investigate the feasibility of cochlear implantation in children with severe preverbal sensorineural hearing loss with leukoencephalopathy. Methods from September to November 2013, 14 children with prelingual hearing loss associated with leukoencephalopathy underwent cochlear implantation in Department of Otorhinolaryngology, Hainan Provincial people's Hospital. The mean age was 3.79 鹵1.93 years old, and 16 children without central nervous system disease were treated as control group (mean 4.38 鹵1.93 years old). The clinical audiology, imaging examination, language ability and intelligence level were evaluated before operation. One stage cochlear implantation was performed through the posterior tympanic recess approach. After the operation, speech rehabilitation training was performed at the Hainan Rehabilitation Center for Deaf Children. The rehabilitation effects of the two groups were evaluated by auditory behavior scale (categories of auditory performance,CAP) and speech intelligibility scale (speech intelligibility rate,SIR). The CAP and SIR grades of the two groups were compared at different stages after operation. Results after cochlear implantation, all the children received auditory response and different degree of verbal communication ability. The CAP and SIR grades of the two groups showed an increasing trend with the prolongation of rehabilitation time. The average score of CAP in the study group was 1.357 鹵0.1332.143 鹵0.275 鹵3.071 鹵0.245 at 12 and 24 months after operation respectively (2.571 鹵0.416 鹵3.714 鹵0.4965.000 鹵0.4965.000 鹵0.492). There was no significant difference between the two groups in CAP (2.688 鹵0.3133.875 鹵0.3645.000 鹵0.354) and SIR (1.500 鹵0.129n2.313 鹵0.1762.875 鹵0.221) (P0.05). Conclusion cochlear implantation can be performed in children with extremely severe prelingual sensorineural deafness with leukoencephalopathy. The effect of auditory speech rehabilitation within 2 years after operation is comparable to that of children without leukoencephalopathy.
【作者單位】： 海南省人民醫(yī)院耳鼻咽喉頭頸外科醫(yī)院;
【分類號】：R764.9

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