不同开机年龄人工耳蜗植入儿童术后早期语前听能康复效果的研究

目的 探讨不同开机年龄人工耳蜗(CI)植入儿童术后早期语前听能(EPLAD)康复效果，并与健听儿童进行横向比较。方法 选取2015-2022年四川大学华西医院完成CI术后开机的1～4岁听障儿童共141例，按开机年龄分为1～2岁组(n=50)、2～3岁组(n=50)、3～4岁组(n=41)。采用婴幼儿有意义听觉整合量表(ITMAIS)和有意义听觉整合量表(MAIS)进行评估，构建广义估计方程(GEE)模型，分析受试者在开机前和开机后1、3、6、12个月时的EPLAD,并与健听儿童进行比较。结果 141例1～4岁CI植入儿童在开机后各个随访时间点的ITMAIS/MAIS得分均有提高，各个随访时间点量表得分两两比较差异有统计学意义(P<0.05);基于3组不同开机年龄组的ITMAIS/MAIS得分，组间比较差异无统计学意义(P>0.05);3组CI植入患儿在开机12个月内与健听儿童12个月内的得分水平相当。结论 1～4岁CI植入患儿在开机后12个月内，其听能发展水平随着术后康复时间的延长而逐渐提高，EPLAD康复效果与健听儿童一致。不同开机年龄对CI植入患儿术后开机12个月内的ITMAIS/MAIS得分无明显影响。

Study on the effect of early pre lingual hearing rehabilitation after cochlear implantation in children of different ages

Objective To explore the rehabilitation effects of early prelingual auditory development(EPLAD)inchildren withdifferent activation ages after cochlear implantation(CI),and to compare the differences in their auditorydevelopment with that of normal children.Methods A total of 141 children aged 1 to 4 years who received device activationafter CI in West China Hospital of Sichuan University from 2015 to 2022 were selected.They were divided into three groupsaccording to their age of device activation:the 1-2 years old group(n=50),the 2-3 years old group(n=50),and the 3-4years old group(n=41).The Infant-Toddler Meaningful Auditory Integration Scale(ITMAIS)and Meaningful AuditoryIntegration Scale(MAIS)were used to assess their auditory ability.The generalized estimating equation(GEE)model wasconstructed.The EPLAD of the subjects at baseline,and 1,3,6,and 12 months after activation were analyzed andcompared with that of normal children.Results The ITMAIS/MAIS scores of the 141 children aged 1 to 4 years with Cwere improved with time after activation.Pairwise comparisons of the scale scores at each follow-up time point showedstatistically significant differences(P<0.05).There was no significant difference in ITMAIS/MAIS scores among the threegroups(P>0.05).The three groups of children with CI had comparable levels of ITMAIS/MAIS scores within 12 monthsafter device activation to those of normal children within 12 months of physiological age.Conclusion For children with CIaged 1 to 4 years,their early auditory ability gradually improved with the extension of rehabilitationtime within 12 monthsafter activation.The rehabilitation effects of EPLAD were consistent with that of normal children.Different activation ageshave no significant effect on ITMAIS/MAIS scores of CI children within 12 months after activation.