多通道人工耳蜗植入术治疗儿童先天性耳聋的有效性研究  

Efficacy of Multi-Channel Cochlear Implantation in Children with Congenital Deafness And Their Correlation

作　　者：吴琼芳 马宁 蔡爱军[1] 梁佳 张社江[1] WU Qiongfang;MA Ning;CAI Aijun;LIANG Jia;ZHANG Shejiang(Handan Eye Hospital,Handan Third Hospital,Handan 056001,China)

机构地区：[1]邯郸市眼科医院(邯郸市第三医院)耳鼻咽喉头颈外科,邯郸056001

出　　处：《中华耳科学杂志》2024年第4期593-597,共5页Chinese Journal of Otology

基　　金：邯郸市科学技术研究与发展计划(21422083104)。

摘　　要：目的探讨先天性耳聋患儿多通道人工耳蜗植入术的临床效果。方法随机抽取2020年1月至2021年1月邯郸市眼科医院(邯郸市第三医院)耳鼻咽喉头颈外科收治的先天性耳聋患儿100例。实施多通道人工耳蜗植入手术,对比患儿术前、术后听觉行为分级标准评分、言语可懂度分级标准评分及脑灰质密度的变化差异及术后不良反应。结果术后1年,患儿后扣带回、额内侧回、梭状回脑灰质密度均高于术前,差异均有统计学意义(P<0.001)。术后1年,患儿言语可懂度分级标准(speech intelligengibity rating,SIR)评分、CAP评分均高于术前,差异均有统计学意义(P<0.001)。患儿SIR评分、听觉行为分级标准(categories of auditory performance,CAP)评分与后扣带回、梭状回、额内侧回脑灰质密度均呈显著正相关,差异均有统计学意义(P<0.001)。术后3月内,1例患儿出现味觉异常,并且在短期内消失。结论先天性耳聋患儿应用多通道人工耳蜗植入术治疗,可增强大脑皮层能量活动,增强患儿脑灰质密度、听觉皮层功能、视觉皮层功能,促进大脑皮层发育,增强视觉皮层功能补偿机制,提高听觉行为分级标准评分、言语可懂度分级标准评分,有效改善听力功能。Objective To report efficacy of multi-channel cochlear implantation in children with congenital deafness.Methods A total of 100 children with congenital deafness who were admitted to the Department of Otorhinolaryngology Head and Neck Surgery,Handan Eye Hospital(Handan Third Hospital),received multi-channel cochlear implantation from January 2020 to January 2021.Pre-and post-implant auditory performance scores,speech intelligibility scores and gray matter density changes were compared.Results One year after surgery,gray matter density of the posterior cingulate gyrus,medial frontal gyrus and fusiform gyrus was significantly higher than before surgery(P<0.001),and the SIR and CAP scores were also significantly higher than before operation(P<0.001).The SIR and CAP scores were positively correlated with gray matter density of the posterior cingulate gyrus,fusiform gyrus and medial frontal gyrus(P<0.001).One patient experienced transient abnormal taste.Conclusion Multi-channel cochlear implantation in children with congenital deafness can enhance activities in the cerebral cortex,increasing gray matter density and the function of auditory and visual cortices,promoting their development while enhancing compensation mechanisms of visual function,leading to improved hearing function indicators such as auditory performance and speech intelligibility scores.

关 键 词：多通道人工耳蜗植入术 先天性耳聋 治疗效果 脑灰质密度 听觉行为能力 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]