CAJ | 학술논문

目的：探讨人工耳蜗植入对植入耳残余听力的影响。方法34例行单侧人工耳蜗植入的重度或极重度感音神经性聋儿童，按术后检查时间分为A组（3～12个月）21例、B组（≥13个月）13例，分别于术前及术后3～21个月定期进行裸耳游戏测听，比较各组250、500、1000、2000 Hz各频率手术前后残余听力保存率及听阈变化。结果34例术前植入耳均有不同程度的残余听力，其中25例（73．53％）植入耳术后仍保留部分残余听力且主要分布于低频区，9例残余听力丧失；术后各频率听阈均值均较术前升高，差异有统计学意义（P＜0．05），250 Hz残余听力保留率最高，2000 Hz保留率最低；不同频率残余听力损失值差异有统计学意义（ P＜0．01），以500 Hz和1000 Hz损失最大；A组不同频率间残余听力损失值差异有显著统计学意义（P＜0．01），B组不同频率间残余听力损失值差异无统计学意义（P＞0．05），A组手术前后1000 Hz听阈差值大于B组（P＜0．05），其它频率间听阈差值差异无统计学意义（P＞0．05），随着人工耳蜗植入时间延长，各频率听力损失值总体呈逐渐下降的趋势。结论人工耳蜗植入对植入耳低频区残余听力的影响较高频区小，随着植入时间延长，残余听力有一定程度的恢复。
목적：탐토인공이와식입대식입이잔여은력적영향。방법34례행단측인공이와식입적중도혹겁중도감음신경성롱인동，안술후검사시간분위A조（3～12개월）21례、B조（≥13개월）13례，분별우술전급술후3～21개월정기진행라이유희측은，비교각조250、500、1000、2000 Hz각빈솔수술전후잔여은력보존솔급은역변화。결과34례술전식입이균유불동정도적잔여은력，기중25례（73．53％）식입이술후잉보류부분잔여은력차주요분포우저빈구，9례잔여은력상실；술후각빈솔은역균치균교술전승고，차이유통계학의의（P＜0．05），250 Hz잔여은력보류솔최고，2000 Hz보류솔최저；불동빈솔잔여은력손실치차이유통계학의의（ P＜0．01），이500 Hz화1000 Hz손실최대；A조불동빈솔간잔여은력손실치차이유현저통계학의의（P＜0．01），B조불동빈솔간잔여은력손실치차이무통계학의의（P＞0．05），A조수술전후1000 Hz은역차치대우B조（P＜0．05），기타빈솔간은역차치차이무통계학의의（P＞0．05），수착인공이와식입시간연장，각빈솔은력손실치총체정축점하강적추세。결론인공이와식입대식입이저빈구잔여은력적영향교고빈구소，수착식입시간연장，잔여은력유일정정도적회복。
Objective To study the influence of cochlear implantation on residual hearing in children .Methods Behavioral audiometry were performed pre -implant and 3~21 months post -implant on thirty -four cochlear implant recipients with severe to profound hearing loss .According to follow -up time ,they were divided into 2 groups which were Group A(3~12 months ,21 cases) and Group B(≥13 months ,13 cases) .The thresholds at 250 Hz ,500 Hz ,1 000 Hz and 2 000 Hz were analyzed .Results There were 25 out of 34 patients (73 .53% ) had partial residual hearing after cochlear implantation .Comparing to the hearing loss pre -operation and post -operation , which were most obvious at 500 Hz ,followed by 250 Hz ,1 000 Hz ,2 000 Hz (P<0 .05) ,and there were significant different among different frequencies .There was significant difference at different frequencies at hearing loss thresh-olds only in Group A .But there was no significant difference in Group B .With the prolonged time after the cochlear implantation ,residual hearing at all frequencies showed a trend of recovery .Conclusion The residual hearing could be partial preserved after cochlear implant in pediatric patients with severe to profound hearing impaired ,the residu-al hearing at lower frequencies (250 Hz ,500 Hz) were less affected than those at higher frequencies .With the pro-longed time after the cochlear implantation ,the residual hearing showed a certain degree of recovery .