Pediatric Cochlear Implants: Additional Disabilities Prevalence, Risk Factors, and Effect on Language Outcomes
Pediatric Cochlear Implants: Additional Disabilities Prevalence, Risk Factors, and Effect on Language Outcomes
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DOI：
10.1097/mao.0b013e31826939cc
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发表时间：
2012-10-01
影响因子：
2.1
通讯作者：
Gibson, William P. R.
中科院分区：
文献类型：
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作者：
Birman, Catherine S.;Elliott, Elizabeth J.;Gibson, William P. R.
目的：确定小儿人工耳蜗植入人群中其他残疾的患病率，确定与其他残疾相关的医疗和放射学条件，并确定术后12个月时其他残疾对言语感知和语言的影响。研究设计：回顾性病例回顾。设置：三级转诊中心和人工耳蜗植入项目。患者：记录进行了审查，为0至16岁的儿童，谁有人工耳蜗植入相关的操作超过12个月periods.Interventions：诊断和康复。结果：88例患儿接受了96次手术，术后12个月的听力分级（CAP）评分均较术前明显改善。其他残疾（包括发育迟缓、脑瘫、视力障碍、自闭症和注意力缺陷障碍）的总体患病率为33%。与其他残疾相关的主要疾病是综合征和染色体异常（87%）、黄疸（86%）、早产（62%）、巨细胞病毒（60%）和内耳异常，包括耳蜗神经发育不全或发育不全（75%）和半规管异常（56%）。术后12个月，几乎所有（96%）无其他残疾的儿童CAP评分为5或更高（言语），而有其他残疾的儿童为52%。发育迟缓的儿童有一个中位CAP评分为4，在12个月相比，6为那些没有developmental delay.Conclusion：额外的残疾是普遍存在的约三分之一的小儿人工耳蜗植入患者。其他残疾会显著影响人工耳蜗植入的结果。
Objective: To determine the prevalence of additional disabilities in a pediatric cochlear population, to identify medical and radiologic conditions associated with additional disabilities, and to identify the effect of additional disabilities on speech perception and language at 12 months postoperatively.Study Design: Retrospective case review.Setting: Tertiary referral center and cochlear implant program.Patients: Records were reviewed for children 0 to 16 years old inclusive, who had cochlear implant-related operations over a 12-month period.Interventions: Diagnostic and rehabilitative.Main Outcome Measures: Additional disabilities prevalence; medical history and radiologic abnormalities; and the effect on Categories of Auditory Performance (CAP) score at 12 months postoperatively.Results: Eighty-eight children having 96 operations were identified. The overall prevalence of additional disabilities (including developmental delay, cerebral palsy, visual impairment, autism and attention deficit disorder) was 33%. The main conditions associated with additional disabilities were syndromes and chromosomal abnormalities (87%), jaundice (86%), prematurity (62%), cytomegalovirus (60%), and inner ear abnormalities including cochlea nerve hypoplasia or aplasia (75%) and semicircular canal anomalies (56%). At 12 months postoperatively, almost all (96%) of the children without additional disabilities had a CAP score of 5 or greater (speech), compared with 52% of children with additional disabilities. Children with developmental delay had a median CAP score of 4, at 12 months compared with 6 for those without developmental delay.Conclusion: Additional disabilities are prevalent in approximately a third of pediatric cochlear implant patients. Additional disabilities significantly affect the outcomes of cochlear implants.