Bimodal Stimulation in Children With Bilateral Profound Sensorineural Hearing Loss: A Suitable Intervention Model for Children at the Early Developmental Stage
Bimodal Stimulation in Children With Bilateral Profound Sensorineural Hearing Loss: A Suitable Intervention Model for Children at the Early Developmental Stage
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DOI：
10.1097/mao.0000000000002812
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发表时间：
2020-12-01
影响因子：
2.1
通讯作者：
Wu, Hao
中科院分区：
文献类型：
--
作者：
Chen, Ying;Huang, Meiping;Wu, Hao
目的：评价双模态刺激对语前聋人工耳蜗植入患者的听觉和言语功能的改善作用。研究设计：回顾性比较研究。设置：三级转诊中心。患者：入选五十六例双侧语前极重度感音神经性聋患儿，其中单侧人工耳蜗植入组（CI组）28例，双模态刺激组（BI组）28例，对侧耳使用额外助听器（HA）。主要结局指标：听力评估包括婴幼儿有意义听觉整合量表（IT-MAIS）和听觉表现分类（CAP）。言语评价包括言语有意义使用量表（MUSS）和言语清晰度评级（SIR）。在人工耳蜗植入后第一次标测时以及植入后0.5、1、3、6、12、18、24个月时对这些测量值进行评价。数据采用重复测量分析。结果：BI组和CI组的平均年龄相似（17.6 +/- 6.87 vs 19.0 +/- 8.10个月，p = 0.497）。除了IT-MAIS外，两组之间听力和言语评估的初始评分无差异（BI组为2.46 +/- 0.631 vs CI组为0.50 +/- 0.279，p = 0.004）。如IT-MAIS（p < 0.001）、CAP（p = 0.029）、MUSS（p < 0.001）和SIR（p <0.001）所示，两组随时间推移的听觉和语言发育不同。分别在首次标测后3个月、18个月和12个月，CAP、MUSS和SIR观察到持续但稳定的差异。此外，与CI组相比，BI组在3个月和6个月时的IT-MAIS评分更好;然而，12个月后差异不显著。结论：双模态刺激对舌前聋CI受者是有益的，当双侧CI不可用时，这些受者具有最小的对侧残余听力。单侧人工耳蜗植入后，对侧耳使用助听器可能会被推荐用于儿童，以促进听觉和语言技能的发展。
Objective: To evaluate the auditory and speech benefit of bimodal stimulation for prelingual deafened cochlear implantation recipients. Study Design: Retrospective and comparative study. Setting: Tertiary referral center. Patients: Fifty-six children with bilateral prelingual profound sensorineural hearing loss were enrolled, including 28 consecutive children with unilateral cochlear implantation (CI group), and 28 consecutive children with bimodal stimulation (BI group) who used an additional hearing aid (HA) in the contralateral ear. Main Outcome Measures: Hearing assessments included the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and Categories of Auditory Performance (CAP). Speech evaluations included the Meaningful Use of Speech Scale (MUSS), and Speech Intelligibility Rating (SIR). These measurements were evaluated at the first mapping of cochlear implants and 0.5, 1, 3, 6, 12, 18, 24 months after. Data were analyzed by repeated measures analysis. Results: The mean ages of BI and CI groups were similar (17.6 +/- 6.87 vs 19.0 +/- 8.10 months, p = 0.497). The initial scores for hearing and speech assessments showed no differences between the two groups, apart from IT-MAIS (2.46 +/- 0.631 in BI group vs 0.50 +/- 0.279 in CI group, p = 0.004). The auditory and speech development over time were different in the two groups as seen in IT-MAIS (p < 0.001), CAP (p = 0.029), MUSS (p < 0.001), and SIR (p < 0.001). A continuing but stable difference was observed in CAP, MUSS, and SIR at 3, 18, and 12 months after the first mapping, respectively. In addition, the BI group had better IT-MAIS scores at 3 and 6 months compared with the CI group; however, the difference was not significant after 12 months. Conclusion: Bimodal stimulation is beneficial for prelingually deafened CI recipients who have minimal contralateral residual hearing when bilateral CIs are not available. Hearing aid use in the contralateral ear might be recommended for children after unilateral cochlear implantation to facilitate the development of auditory and speech skills.