成人语前聋和语后聋人工耳蜗植入效果分析  

Analysis of Effects of Cochlear Implantation in Adults with Pre-and Postlingual Deafness

作　　者：冯帅[1] 王菲[1] 臧健[1] 庞仕秀 姜学钧[1] FENG Shuai;WANG Fei;ZANG Jian;PANG Shixiu;JIANG Xuejun(First Hospital of China Medical University,Shenyang,China,110001)

机构地区：[1]中国医科大学附属第一医院,沈阳110001

出　　处：《中华耳科学杂志》2019年第2期222-226,共5页Chinese Journal of Otology

摘　　要：目的分析成人人工耳蜗植入术后听觉及言语康复效果情况,探讨成人行人工耳蜗植入适应症的选择。方法对中国医科大学附属第一医院耳鼻咽喉科收治的18岁以上行人工耳蜗植入术患者52例进行测试,分为语前聋无干预组(9例)、语前聋佩戴助听器组(27例)、语后聋(16例)三组。采用声场助听听阈测试、电刺激听觉反应阈值(Threshold,THR)、最大舒适阈值(Maximum comfort level,MCL)评价其声音感知能力;采用普通话言语测听材料MSTMs中双音节词表评价其言语分辨能力。分别在开机6个月及24个月进行评估。结果开机6个月后三组声场助听阈值、THR、MCL均值无统计学差异。双音节识别率在开机6个月时语前聋无干预组8.78%、语前聋助听器组16.44%、语后聋组53.13%;在开机24个月时各组双音节识别率均上升,语前聋无干预组达18.22%、语前聋助听器组达52.89%、语后聋组达84.31%,语前聋助听器组提高明显。结论成人语前聋患者术后可获得与语后聋相近的听觉感知水平,长期使用人工耳蜗可加强言语识别能力,对术前有听觉言语基础的成人语前聋患者应积极行人工耳蜗植入术。Objective To report hearing and speech rehabilitation outcomes after cochlear implantation in adults and discuss indication selection in this patient population. Methods Fifty two patients over 18 years who underwent cochlear implantation in the Department of Otolaryngology, First Hospital of China Medical University were enrolled, including 9 with prelingual deafness without intervention, 27 with prelingual deafness and use of hearing aids, and 16 with postlingual deafness. Sound field audiometry, electrical stimulation auditory response threshold (THR) and maximum comfort level (MCL) were used to evaluate sound perception. Speech discrimination ability was evaluated using the two-syllable MSTMs word list. Evaluation was performed at 6 months and 24 months after surgery. Results There were no statistical differences in sound field threshold, THR and MCL at 6 months after surgery among the three patient groups. The word recognition rate was 8.78% in the non-intervention prelingual deafness group, 16.44% in the hearing aided prelingual deafness group and 53.13% in the postlingual deafness group at 6 months after surgery. At 24 months after surgery, the word recognition rate in each group increased (18.22%, 52.89% and 84.31% in the three groups, respectively). The improvement was most significant for the hearing aided prelingual deafness group. Conclusion Adult patients with prelingual deafness can obtain auditory perception ability similar to those with postlingual deafness after cochlear implantation. Long-term use of cochlear implant can enhance speech recognition ability. Cochlear implant should be actively performed on adult patients with prelingual deafness and preoperative auditory and speech experiences.

关 键 词：人工耳蜗植入 语前聋 语后聋 成年人 

分 类 号：R764[医药卫生—耳鼻咽喉科]