儿童软带骨锚式助听器使用效果评估  

The Effect Evaluation of Children with Soft-band Bone Anchored Hearing Aid

作　　者：李颖[1] 刘海红[1] 李靖[1] 金欣[1] 赵雅雯[1] 周怡[1] 郑之芃 郑军[2] 张杰[1] 陈敏[1] 郝津生[1] 杨扬[1] 刘薇[1] Li Ying;Liu Haihong;Li Jing;Jin Xin;Zhao Yawen;Zhou Yi;Zheng Zhipeng;Zheng Jun;Zhang Jie;Chen Min;Hao Jinsheng;Yang Yang;Liu Wei(Beijing Key Laboratory for Pediatric Diseases of Otolaryngology,Head and Neck Surgery,Department of Otolaryngology-Head and Neck Surgery, Beijing Children's Hospital,Capital University of Medical Sciences,National Center forChildren's Health,Beijing,100045,China)

机构地区：[1]国家儿童医学中心(北京),首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,儿童耳鼻咽喉头颈外科疾病北京市重点实验室,北京100045 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科

出　　处：《听力学及言语疾病杂志》2018年第6期646-650,共5页Journal of Audiology and Speech Pathology

基　　金：北京市科技新星计划交叉学科合作课题(xxjc201716);北京市医院管理局临床医学发展专项-2015年度“扬帆”计划临床技术创新项目(XMLX201514)联合资助。

摘　　要：目的探讨软带骨锚式助听器(bone anchored hearing aid,BAHA)对儿童使用者的效果,为软带BAHA适用人群的选择及听觉言语康复提供参考。方法以23例双侧外耳畸形儿童为研究对象,月龄5～135个月,平均35.52±36.60个月。对受试儿童进行裸耳听阈和助听听阈测试,并在选配软带BAHA前后分别以婴幼儿有意义听觉整合量表(infant-toddler meaningful auditory integration scale,IT-MAIS)、有意义听觉整合量表(meaningful auditory integration scale,MAIS)、有意义使用言语量表(meaningful use of speech scale,MUSS)、言语可懂度分级(speech intelligbility rating,SIR)、小龄儿童听觉发展问卷(lilltEARS auditory guestionnaire,LEAQ)进行听觉感知及言语表达能力评估。结果受试儿童配戴软带BAHA后,在0.25、0.5、1、2和4kHz处听阈值平均降低了34.13、37.36、36.39、31.52和27.22dB;选配软带BAHA前患儿的IT-MAIS/MAIS得分明显低于选配后3、6、12个月(均为P<0.05),选配软带BAHA前LEAQ得分仅明显低于选配后12个月时(P<0.05);选配软带BAHA后患儿MUSS得分提高,其选配前的MUSS得分与选配后12个月时差异有统计学意义,受试儿童各时期SIR得分差异均无统计学意义。结论软带BAHA可显著改善外耳畸形儿童听力水平,可作为BAHA手术植入前的替代听觉装置;佩戴软带BAHA后患儿听觉感知能力发育迅速,言语表达能力在佩戴后12个月时发育迅速。Objective To explore the hearing and speech in children using soft-band bone anchored hearing aids(BAHA),providing reasonable indications for BAHA.Methods Twenty three children diagnosed with bilateral external ear anomaly participated in this study,aged for 5~135 months old.All the children undertook hearing thresholds tests with and without soft-band BAHA.Further scale assesmants includes the infant-toddler meaningful auditory integration scale(IT-MAIS),meaningful auditory integration scale(MAIS),meaningful use of speech scale(MUSS),speech intelligibility rating(SIR)and LittlEARS auditory questionnaire(LEAQ).Results The average hearing thresholds got improved 34.13,37.36,36.39,31.52 and 27.22 dB HL at 0.25,0.5,1,2 and 4 kHz,respectively.When using soft-band BAHA,the average scores of IT-MAIS(or MAIS)scores significantly increased 3,6 and 12 months after using BAHA.The LEAQ scores significantly increased 12 months after BAHA.However,the MUSS scores also significantly improved 12 months after BAHA using.There were no significant differences SIR scores after BAHA using.Conclusion It helps to improve the hearing in children with external ear anamalies when using soft band BAHA,which may be considered to be substitute hearing aids before BAHA implantation.The soft-band BAHA helps in hearing and speech developments in these children.

关 键 词：儿童 骨传导助听设备 听觉感知 言语交流技能发展 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]