中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2015年
4期
274-280
,共7页
傅莹%陈源%郗昕%洪梦迪%陈艾婷%王倩%黄丽娜
傅瑩%陳源%郗昕%洪夢迪%陳艾婷%王倩%黃麗娜
부형%진원%치흔%홍몽적%진애정%왕천%황려나
耳蜗植入术%听觉丧失%言语知觉%儿童
耳蝸植入術%聽覺喪失%言語知覺%兒童
이와식입술%은각상실%언어지각%인동
Cochlear implantation%Hearing loss%Speech perception%Child
目的 探索语前聋儿童人工耳蜗植入术后早期的听觉发展和言语识别,同时探讨现行中文听障儿童听觉和言语识别测试工具的可行性.方法 共有83例重度-极重度语前聋患儿参与本研究,按耳蜗植入手术时的年龄将患儿分为四组:A组(1～2岁)18例、B组(2～3岁)30例、C组(3～4岁)24例、D组(4～5岁)11例.使用婴幼儿/有意义听觉整合量表(Infant-Toddler/ Meaningful Auditory Integration Scale,MAIS/IT-MAIS)问卷,普通话早期言语感知测试(Mandarin Early Speech Perception Test,MESP)、普通话儿童言语能力测试(Mandarin Pediatric Speech Intelligibility Test,MPSI)等闭合式言语识别测试,由经过培训的听力学专业人员对患儿术后的听觉发展和言语识别能力进行评估.分别在术前和开机后3、6、12个月时对各组患儿进行评估,评估人员记录测试结果并采用SPSS19.0软件进行统计学分析.结果 术后早期的听觉发育和言语识别的发展随康复时间延长而逐步提高.各组受试患儿的MAIS/IT-MAIS得分随着康复时间的延长,均呈现相同的增长趋势,组间差异具有统计学意义(F=5.743,P=0.007).植入年龄3～4岁的C组儿童术前MAIS/IT-MAIS得分即已高于其他各组,在术后各随访节点得分也高于另外三组.术前助听器使用经验多的儿童,其MAIS/IT-MAIS得分也高于未使用助听器或使用经验少的儿童(F=4.947,P=0.000).MESP测试显示,在植入后1年内,患儿的言语察觉能力始终优先于言语识别能力,但言语识别能力随着人工耳蜗使用时间延长而有明显提高;各亚测试项的难度呈现较明显的渐次增大的层级.MPSI在开机12个月时才仅有约40％的受试儿童能完成安静条件下的测试,且随着语竞比的降低,能完成该测试的儿童的比例显著下降.结论 人工耳蜗植入术后1年,患儿即发展出一定的听力及言语识别能力.中文版IT-MAIS/MAIS、MESP、MPSI是评估植入后儿童早期听觉、言语识别的可用工具.
目的 探索語前聾兒童人工耳蝸植入術後早期的聽覺髮展和言語識彆,同時探討現行中文聽障兒童聽覺和言語識彆測試工具的可行性.方法 共有83例重度-極重度語前聾患兒參與本研究,按耳蝸植入手術時的年齡將患兒分為四組:A組(1～2歲)18例、B組(2～3歲)30例、C組(3～4歲)24例、D組(4～5歲)11例.使用嬰幼兒/有意義聽覺整閤量錶(Infant-Toddler/ Meaningful Auditory Integration Scale,MAIS/IT-MAIS)問捲,普通話早期言語感知測試(Mandarin Early Speech Perception Test,MESP)、普通話兒童言語能力測試(Mandarin Pediatric Speech Intelligibility Test,MPSI)等閉閤式言語識彆測試,由經過培訓的聽力學專業人員對患兒術後的聽覺髮展和言語識彆能力進行評估.分彆在術前和開機後3、6、12箇月時對各組患兒進行評估,評估人員記錄測試結果併採用SPSS19.0軟件進行統計學分析.結果 術後早期的聽覺髮育和言語識彆的髮展隨康複時間延長而逐步提高.各組受試患兒的MAIS/IT-MAIS得分隨著康複時間的延長,均呈現相同的增長趨勢,組間差異具有統計學意義(F=5.743,P=0.007).植入年齡3～4歲的C組兒童術前MAIS/IT-MAIS得分即已高于其他各組,在術後各隨訪節點得分也高于另外三組.術前助聽器使用經驗多的兒童,其MAIS/IT-MAIS得分也高于未使用助聽器或使用經驗少的兒童(F=4.947,P=0.000).MESP測試顯示,在植入後1年內,患兒的言語察覺能力始終優先于言語識彆能力,但言語識彆能力隨著人工耳蝸使用時間延長而有明顯提高;各亞測試項的難度呈現較明顯的漸次增大的層級.MPSI在開機12箇月時纔僅有約40％的受試兒童能完成安靜條件下的測試,且隨著語競比的降低,能完成該測試的兒童的比例顯著下降.結論 人工耳蝸植入術後1年,患兒即髮展齣一定的聽力及言語識彆能力.中文版IT-MAIS/MAIS、MESP、MPSI是評估植入後兒童早期聽覺、言語識彆的可用工具.
목적 탐색어전롱인동인공이와식입술후조기적은각발전화언어식별,동시탐토현행중문은장인동은각화언어식별측시공구적가행성.방법 공유83례중도-겁중도어전롱환인삼여본연구,안이와식입수술시적년령장환인분위사조:A조(1～2세)18례、B조(2～3세)30례、C조(3～4세)24례、D조(4～5세)11례.사용영유인/유의의은각정합량표(Infant-Toddler/ Meaningful Auditory Integration Scale,MAIS/IT-MAIS)문권,보통화조기언어감지측시(Mandarin Early Speech Perception Test,MESP)、보통화인동언어능력측시(Mandarin Pediatric Speech Intelligibility Test,MPSI)등폐합식언어식별측시,유경과배훈적은역학전업인원대환인술후적은각발전화언어식별능력진행평고.분별재술전화개궤후3、6、12개월시대각조환인진행평고,평고인원기록측시결과병채용SPSS19.0연건진행통계학분석.결과 술후조기적은각발육화언어식별적발전수강복시간연장이축보제고.각조수시환인적MAIS/IT-MAIS득분수착강복시간적연장,균정현상동적증장추세,조간차이구유통계학의의(F=5.743,P=0.007).식입년령3～4세적C조인동술전MAIS/IT-MAIS득분즉이고우기타각조,재술후각수방절점득분야고우령외삼조.술전조은기사용경험다적인동,기MAIS/IT-MAIS득분야고우미사용조은기혹사용경험소적인동(F=4.947,P=0.000).MESP측시현시,재식입후1년내,환인적언어찰각능력시종우선우언어식별능력,단언어식별능력수착인공이와사용시간연장이유명현제고;각아측시항적난도정현교명현적점차증대적층급.MPSI재개궤12개월시재부유약40％적수시인동능완성안정조건하적측시,차수착어경비적강저,능완성해측시적인동적비례현저하강.결론 인공이와식입술후1년,환인즉발전출일정적은력급언어식별능력.중문판IT-MAIS/MAIS、MESP、MPSI시평고식입후인동조기은각、언어식별적가용공구.
Objective To investigate the development of early auditory capability and speech perception in the prelingual deaf children after cochlear implantation,and to study the feasibility of currently available Chinese assessment instruments for the evaluation of early auditory skill and speech perception in hearing-impaired children.Methods A total of 83 children with severe-to-profound prelingual hearing impairment participated in this study.Participants were divided into four groups according to the age for surgery:A (1-2 years),B (2-3 years),C (3-4 years) and D (4-5years).The auditory skill and speech perception ability of CI children were evaluated by trained audiologists using the infant-toddler/ meaningful auditory integration scale (IT-MAIS/MAIS) questionnaire,the Mandarin Early Speech Perception (MESP)test and the Mandarin Pediatric Speech Intelligibility (MPSI) test.The questionnaires were used in face to face interviews with the parents or guardians.Each child was assessed before the operation and 3 months,6 months,12 months after switch-on.Results After cochlear implantation,early postoperative auditory development and speech perception gradually improved.All MAIS/IT-MAIS scores showed a similar increasing trend with the rehabilitation duration (F =5.743,P =0.007).Preoperative and post operative MAIS/IT-MAIS scores of children in age group C (3-4 years) was higher than that of other groups.Children who had longer hearing aid experience before operation demonstrated higher MAIS/IT-MAIS scores than those with little or no hearing aid experience(F =4.947,P =0.000).The MESP test showed that,children were not able to perceive speech as well as detecting speech signals.However as the duration of CI use increased,speech perception ability also improved substantially.However,only about 40％ of the subjects could be evaluated using the most difficult subtest on the MPSI in quiet at 12 months after switch-on.As MCR decreased,the proportion of children who could be tested using the MPSI reduced.Conclusions Within one year after CI,children develop early auditory and speech perception capabilities with time.Chinese versions of the IT-MAIS/MAIS,MESP and MPSI are useful instruments to document early auditory and speech perception skills in children after CI implantation.
