儿童听力障碍双模式干预远期效果分析  

Analysis of Long-Term Effect of Bimodal Intervention in Children with Hearing Loss

作　　者：黄美萍[1] 李进 杨璐 周嵌 李蕴[1] 黄治物[1] HUANG Mei-ping;LI Jin;YANG Lu;ZHOU Qian;LI Yun;HUANG Zhi-wu

机构地区：[1]上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科,上海200012

出　　处：《中国听力语言康复科学杂志》2023年第2期125-129,共5页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：上海市自然科学基金项目(20ZR1431200);上海交通大学“交大之星”计划医工交叉研究基金(YG2021ZD14)。

摘　　要：目的 调查双侧极重度听力损失儿童双模式干预[一侧人工耳蜗植入(CI),一侧使用助听器(HA)]情况及影响因素,评估双模式干预(bimodal intervention,BI)远期效果。方法 招募术前诊断为双侧极重度听力损失,单侧植入CI且开机时间≥5年的儿童受试者,共103人(男63名,女40名),平均植入年龄1.5±0.6岁,平均开机时长8.3±2.6年,问卷调查术后对侧HA使用情况,包括术后对侧是否曾使用HA、未曾使用HA的原因、是否坚持使用HA等;选择目前对侧仍在坚持使用HA的11名受试者(男6名,女5名)作为实验组(BI组),平均植入年龄1.5±0.4岁,平均开机时长5.7±0.7年;并选择目前对侧不使用HA且对侧耳残余听力、CI开机时长、性别、年龄与BI组相匹配的11名受试者为对照组(CI组),植入年龄1.7±0.6岁,开机时长5.7±0.8年;采用中文版噪声言语测试材料分别对两组受试者进行了三种模式下(言语声固定来自于前方,噪声分别来自于前方、植入侧、非植入侧)噪声言语识别能力评估。结果 问卷调查结果显示CI术后从未使用过HA的63人(61.17%),主要原因是HA效果不佳(50.79%);曾使用过HA的40人(38.83%),目前仍坚持使用的仅有21人(20.39%),对侧坚持使用HA受试者双模式干预效果比单独使用CI整体效益平均可以提升27.62%。噪声下言语识别能力测试结果显示三种模式下BI组的平均言语识别阈均低于CI组,但差异无统计学意义(P>0.05)。结论 双侧极重度听力损失儿童由于各种原因不能进行双侧CI时,建议单侧CI后对侧耳同时使用HA。对侧耳如无残余听力,HA受益可能有限。Objective To investigate the bimodal intervention(cochlear implant(CI) on one side and hearing aid(HA) on the other side) in children with bilateral profound hearing loss(HL) and its influencing factors, and evaluate the long-term effect of bimodal intervention(BI). Methods 103 children with preoperative diagnosis of bilateral profound HL, unilateral CI and the time of postactivation more than 5 years were recruited, including 63 males and 40 females. The average age of CI implantation was 1.5±0.6y and the average postactivation time was 8.3 ± 2.6y. To investigate the use of HA on the contralateral side after operation, including whether the contralateral ear had worn HA after operation, the reasons why they had not worn HA, and whether they insisted on wearing HA. A total of 11 cases who still insisted on wearing HA were taken as the experimental group(BI group). Another 11 cases without HA, with the matched residual hearing in the non-implanted ear, the experience of CI, gender and age, were taken as the control group(CI group). The mandarin hearing in noise test(M-HINT) was used to evaluate the speech recognition ability of subjects under noise. Three modes were set during the test: the fixed speech sound came from the front, and the noise came from the front, CI side and non-implant side respectively. Results 63 patients(61.17%) never wore HA after CI, mainly due to the poor performance of HA(50.79%);40 people(38.83%) had worn HA on the opposite side, and only 21 people(20.39%) still insist on wearing HA;For subjects who insisted on wearing HA, the average performance in BI modes was 27.62% higher than that in CI alone mode. The average speech recognition threshold of M-HINT in BI group was lower than that in CI group, but there was no significant difference between the two groups(P>0.05). Conclusion For those children with bilateral profound HL, it is recommended to wear HA on the contralateral ear after unilateral CI when they cannot have bilateral CI due to various reasons.However, if there is no residua

关 键 词：双模式干预 双侧极重度听力损失 儿童 远期效果 

分 类 号：R764[医药卫生—耳鼻咽喉科]