山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (2): 43-48.doi: 10.6040/j.issn.1673-3770.0.2017.018

• 论著 • 上一篇    下一篇

合并脑白质异常聋儿人工耳蜗植入后听力言语及认知能力评估分析

董健菲1,陆玲1,2,3,杨烨2,3,高下1,2,3   

  1. 1.南京医科大学附属鼓楼临床医学院耳鼻咽喉头颈外科, 江苏 南京 210008;
    2.南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科, 江苏省医学重点学科, 江苏 南京 210008;
    3.南京鼓楼医院耳鼻咽喉研究所, 江苏 南京 210008
  • 收稿日期:2017-01-12 出版日期:2017-04-16 发布日期:2017-04-16
  • 通讯作者: 高下. E-mail:xiagaogao@hotmail.com
  • 基金资助:
    南京市重点项目(ZKX13027);江苏省科教强卫工程项目;江苏省医学青年人才项目

Evaluation of hearing levels, speech functions and cognitive abilities of cochlear implantation in deaf children with abnormal white matter.

  1. 1. Department of Otolaryngology Head and Neck Surgery, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing 210008, Jiangsu, China;2. Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Provincial Key Medical Discipline(Laboratory), Nanjing 210008, Jiangsu, China;3. Research Institution of Otolaryngology, Nanjing 210008, Jiangsu, China
  • Received:2017-01-12 Online:2017-04-16 Published:2017-04-16

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摘要： 目的 探讨合并脑白质异常聋儿行人工耳蜗植入手术的可行性及术后听觉、言语康复和认知发展情况。 方法 以2012年11月至2015年4月于南京鼓楼医院耳鼻咽喉头颈外科行人工耳蜗植入术的聋儿425例(425耳)中合并脑白质异常的6例患儿为实验组,选取同时期手术的6例脑白质正常聋儿为对照组。比较实验组手术前后言语能力,以及两组患儿术后听力、言语康复效果和认知发展水平。 结果 (1) 实验组和对照组手术前后的有意义听觉整合量表(MAIS)、听觉行为分级标准(CAP)和言语可懂度分级标准(SIR)差异有统计学意义(实验组:术后6个月,ZCAP=-3.127, PCAP=0.002; ZSIR =-3.146, PSIR=0.002; ZMAIS=-2.898, PMAIS=0.004;术后12个月,ZCAP=-3.317, PCAP=0.001, ZSIR=-3.108, PSIR=0.002, ZMAIS=-2.656, PMAIS=0.008。对照组:术后6个月,ZCAP=-3.108, PCAP=0.002; ZSIR=-3.127, PSIR=0.002; ZMAIS=-2.918, PMAIS=0.004;术后12个月,ZCAP=-3.146, PCAP=0.002, ZSIR=-3.207, PSIR=0.001, ZMAIS=-2.913, PMAIS=0.004); (2) 手术前后,实验组平均听阈与对照组相比,差异无统计学意义(F=0.797,P=0.393); (3) 实验组MAIS、CAP和SIR与对照组相比,术前差异均无统计学意义(ZCAP=0.000, PCAP=1.000; ZSIR=0.000, PSIR=1.000; ZMAIS=-0.756, PMAIS=0.450);开机后6个月差异均无统计学意义(ZCAP=-1.673, PCAP=0.094; ZSIR=-1.369, PSIR=0.171; ZMAIS=-0.978, PMAIS=0.32);开机后12个月,差异均有统计学意义(ZCAP=-2.667, PCAP=0.008; ZSIR=-2.272, PSIR=0.023; ZMAIS=-2.656, PMAIS=0.008); (4) 开机后12个月,实验组的韦氏幼儿智力量表(C-WYCSI)评分与对照组比较,总分差异有统计学意义(P<0.05)。 结论 合并脑白质异常聋儿接受人工耳蜗手术后言语能力较术前显著提高,且其术后平均听阈与脑白质正常聋儿相比差异无统计学意义。因此在进行严格术前筛选后,合并脑白质异常的聋儿可以通过人工耳蜗植入手术获益,手术是可行的。但由于合并脑白质异常聋儿术后12个月的言语康复效果及认知发展水平与脑白质正常聋儿差异有统计学意义,因此远期随访结果仍待进一步研究,且术前需与家长充分沟通。

关键词: 耳蜗植入术, 认知能力, 言语能力, 听觉能力, 脑白质异常

Abstract: Objective To analyze the feasibility cochlear implantation(CI)for deaf children with abnormal white matter and to compare their hearing levels, speech function, cognitive abilities before and after surgery. Methods Six deaf children with abnormal white matter among 425 patients who had received CI from November 2012 to April 2015 in our department were selected as the experimental group, and another 6 patients with normal white matter at almost the same time were enrolled as the control group. The outcome of speech functions in the experimental group before and after surgery were compared. Statistical analysis was conducted by repeated measures analysis of variance, Rank sun test, t test and Chi-squared test with the hardware SPSS19.0. Results (1) Statistical significances in meaningful auditory integration scale(MAIS), categories of auditory performance(CAP)and speech intelligibility rating(SIR)were found 山东大学耳鼻喉眼学报31卷2期 -董健菲,等.合并脑白质异常聋儿人工耳蜗植入后听力言语及认知能力评估分析 \=-in the experimental group before and after surgery. (2) No statistical significances in hearing threshold before and after surgery between the two groups were found. (3) No statistical significances in MAIS,CAP and SIR between the two groups were found before and after a 6-month follow-up, but statistical significances were found after a 12-month follow-up. (4) Statistical significances in Wechsler young children scale of intelligence(C-WYCSI)were found between the two groups after a 12-month follow-up. Conclusion Speech function of deaf children with abnormal white matter was significantly improved after CI. The hearing levels of deaf children with abnormal white matter are basically the same compared with deaf children with normal white matter after CI. As are result, CI could be conducted after strict examinations before operation. Nevertheless, speech functions and cognitive abilities between them were still different after a 12-month follow-up. Therefore, adequate communication with parents of deaf children whose white matter are abnormal should be done before surgery.

Key words: Speech function, Hearing Level, Cochlear implantation, Cognitive ability, Abnormal white matter

中图分类号: 

  • R764.43
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