Cochlear implants before 9 months of age led to more natural spoken language development without increased surgical risks
Cochlear implants before 9 months of age led to more natural spoken language development without increased surgical risks
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DOI：
10.1111/apa.14954
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发表时间：
2019-09-10
期刊：
影响因子：
3.8
通讯作者：
Lofkvist, Ulrika
中科院分区：
文献类型：
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作者：
Karltorp, Eva;Eklof, Martin;Lofkvist, Ulrika
目的有证据表明人工耳蜗术有利于语言发育，但对手术的理想年龄尚无共识。我们调查了患者年龄对语言发育和手术安全性的影响。方法本研究包括103名儿童(52名男孩)，年龄4.3-16岁，2002年至2013年在瑞典斯德哥尔摩卡罗林斯卡大学医院接受了5-29个月的人工耳蜗术。所有人都表现出典型的发育，都来自单语家庭。双侧种植体常见(95%)。一个多学科团队在10.0+/-3.7(4.7-16.0)年里定期对这些儿童进行语言理解、词汇和语音识别方面的评估。结果术后并发症与儿童首次植入种植体的年龄无关。植入5-11个月的儿童比植入较晚的小组更早达到与年龄相当的语言理解水平和更好的词汇结果。在12-29个月接受手术的儿童，随着时间的推移，表现出更多的不典型和延迟的语言能力。早期植入，最好是在9个月之前，可能会导致更典型的口语发展轨迹。结论9个月前植入人工耳蜗术是安全的。早期植入可能会减少听觉剥夺的负面影响，并促进更自然和同步的语言发展。
Aim Evidence suggests that cochlear implants are beneficial for language development, but there is no consensus about the ideal age for surgery. We investigated how language development and surgical safety were affected by patients' ages. Methods This study comprised 103 children (52 boys) aged 4.3-16 years who received cochlear implants at 5-29 months at the Karolinska University Hospital, Stockholm, Sweden, between 2002 and 2013. All showed typical development and were from monolingual homes. Bilateral implants were common (95%). The children were regularly assessed on language understanding, vocabulary and speech recognition by a multi-disciplinary team for 10.0 +/- 3.7 (4.7-16.0) years. Results There were no associations between complications after surgery and the age when children had their first implant. Children implanted at 5-11 months reached an age-equivalent level of language understanding and better vocabulary outcome sooner than subgroups implanted later. Children who had surgery at 12-29 months demonstrated more atypical and delayed language abilities over time. Early implantation, preferably before 9 months, may lead to a more typical trajectory of spoken language development. Conclusion Our findings showed that cochlear implantation before 9 months was safe. Early implantation may reduce the negative effects of auditory deprivation and promotes more natural and synchronised language development.