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目的:总结不同月龄婴幼儿人工耳蜗植入术后听觉能力的发育规律及特点,为婴幼儿患儿人工耳蜗植入年龄的选择及制定合理的术后听力言语康复训练计划提供依据。方法:共有139例极重度语前聋婴幼儿患儿参加本次研究。按手术时年龄将患儿分为A组(≤12个月)、B组(13～18个月)、C组(19～24个月)、D组(25～30个月)、E组(31～36个月)。使用婴幼儿有意义听觉整合量表(IT-MAIS)并由经过培训的听力学专业人员对患儿术后听觉能力进行评估。评估采用面对面询问的方式,由患儿家长或监护人回答。评估人员将家长或监护人对每一问题的回答进行详细记录并根据患儿听觉行为出现的频率对其进行评分。分别在术前和术后开机后1、3、6、12个月时对各组患儿进行评估。结果:经两组独立样本T检验,不同性别患儿在术前和术后不同时期听觉能力的差异均无统计学意义(均P>0.05)。经单因素方差分析,在术前和开机后1、3、6、12个月各年龄组患儿听觉能力的差异均无统计学意义(均P>0.05)。各年龄组患儿听觉能力得分随开机时间的增加而增加,其差异有统计学意义(P<0.05)。结论:不同性别婴幼儿患儿术后听觉能力的发育遵循相同的规律。婴幼儿患儿手术时年龄对术后听觉能力的发育影响不大。大部分患儿的听觉能力在术后6个月之内提高较快,其后进入较缓慢的发展期。
OBJECTIVE: To summarize the developmental rules and characteristics of auditory abilities of cochlear implants in infants and children of different ages, and to provide evidences for choosing the age of cochlear implants in infants and young children and formulating a reasonable rehabilitation program of hearing and speech after surgery. METHODS: A total of 139 children with severe prelingual deafness participated in this study. The patients were divided into group A (≤12 months), group B (13-18 months), group C (19-24 months), group D (25-30 months), group E (31 ~ 36 months). The pediatric auditory sensory integration scale (IT-MAIS) was used and the pediatric hearing ability assessed by a trained audiologist. The assessment uses face-to-face interrogation and is answered by the child’s parent or guardian. Assessors record parents or guardians’ responses to each question in detail and rate them based on how often the child’s hearing occurs. The patients in each group were evaluated before operation and at 1, 3, 6 and 12 months after operation. Results: There was no significant difference in hearing ability between two groups of children with different gender before and after operation (P> 0.05). After univariate analysis of variance, there was no significant difference in auditory ability of children in all age groups before and after operation (all P> 0.05). Auditory score of children in all age groups increased with the increase of boot time, the difference was statistically significant (P <0.05). Conclusion: The development of auditory ability in infants and young children of different genders follows the same pattern. The age of infants and young children had little effect on the development of auditory ability after operation. The hearing ability of most children increased rapidly within 6 months after surgery, and then entered a relatively slow period of development.