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目的 观察语前聋患儿植入诺尔康—晨星人工耳蜗(Nurotron-Venus cochlear implant,NurotronVenus CI)后的听觉言语发育情况及其安全性和稳定性。方法 回顾性分析郑州大学第一附属医院行NurotronVenus CI植入的78例语前聋患儿的临床资料,患儿植入年龄为13~96月,按植入年龄将患儿分为A组(13~24月,16例)、B组(25~36月,13例)、C组(37~48月,16例)、D组(49~72月,18例)、E组(73~96月,15例);在患儿术前及开机后1、3、6、12个月采用有意义听觉整合量表(meaningful auditory integration scale,MAIS)(C、D、E组)、婴幼儿有意义听觉整合量表(infant-toddler meaningful auditory integration scale,IT-MAIS)(A、B组)进行听觉能力评估,开机后1、3、6、12个月使用有意义言语使用量表(meaningful use of speech scale,MUSS)进行言语能力评估。术后行X线耳蜗平片检查明确电极位置及形态,定期随访了解术后相关并发症及佩戴人工耳蜗时间和使用情况。结果 所有患儿的术前及开机后1、3、6、12月IT—MAIS或MAIS得分分别为1.67±1.19、6.60±5.12、11.86±5.44、17.41±5.04、22.87±5.46分,术后1、3、6、12月M USS得分分别为5.01±3.26、8.38±3.58、11.88±3.88、16.58±4.95分,随着植入时间延长得分不断上升(均P<0.05);不同年龄组IT-MAIS或MAIS得分比较:术前A组低于C、D、E组,开机后1、3月A、B组低于E组,开机后6月A组低于C、D、E组,B组低于E组(均为P<0.05);不同年龄组MUSS得分比较:开机后1月B组低于E组,开机后3月A、B、C组低于E组,开机后6月A组低于C、D、E组,B组低于E组,开机后1年A组低于C、D、E组(均为P<0.05)。所有患儿在开机后1、3、6、12月MU SS与I T-MA IS或MA IS得分相关系数分别为0.918、0.808、0.881、0.756(均为P<0.05),两者呈正相关。78例患儿术后耳蜗位X线平片均显示电极位置正常,形态良好;2例患儿出现处理器故障,其余CI整体工作状态良好。结论 语前聋患儿国产人工耳蜗植入后1年内,所有患儿的听觉言语能力随时间延长不断提高;小龄组患儿听觉言语得分在术后早期低于大龄患儿;听觉能力在开机后12月时已无差异,但小龄组患儿的言语能力仍低于大龄患儿;听觉整合能力越强,言语使用能力越强;Nurotron-Venus CI安全、效果可靠。
Objective To observe the auditory and speech development, safety and stability of children with prelingual deafness after implantation of Nurotron-Venus cochlear implant (NurotronVenus CI). Methods The clinical data of 78 prelingual deaf children implanted with NurotronVenus CI at the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The children were implanted between the ages of 13 and 96 months. The children were divided into group A 13 to 24 months, 16 cases), group B (25 to 36 months, 13 cases), group C (37 to 48 months, 16 cases), group D (49 to 72 months, 18 cases) 96 months, 15 cases). The preoperative and postoperative 1, 3, 6, and 12 months after treatment, the patients were enrolled in the study. The patients were divided into two groups: the sensible auditory integration scale (MAIS) Auditory integration was assessed using IT-MAIS (Group A and B), using a meaningful speech-use scale at 1, 3, 6 and 12 months after booting use of speech scale, MUSS). Postoperative X-ray cochlear plain examination of the location and shape of the electrode clear, regular follow-up to understand postoperative complications and wearing cochlear time and use. Results All patients had IT-MAIS or MAIS score of 1.67 ± 1.19, 6.60 ± 5.12, 11.86 ± 5.44, 17.41 ± 5.04 and 22.87 ± 5.46 at preoperative and post-booting respectively, and postoperative 1 MUSS scores were 5.01 ± 3.26, 8.38 ± 3.58, 11.88 ± 3.88 and 16.58 ± 4.95 in March, June and December respectively. The scores of MUSS increased with the extension of implantation time (all P <0.05) The score of MAIS or MAIS was lower in group A than in groups C, D and E before operation, and in group A and B less than group E after booting (P <0.05). The score of MUSS in different age groups was lower in group B than in group E at 1 month after starting up, and was lower in group A, B and C at March after starting up than in group E Group A was lower than Group C, D and E, Group B was lower than Group E, Group A was lower than Group C, D and E at 1 year after starting up (all P <0.05). The correlation coefficients of MU SS and I T-MA IS or MA IS scores of 0.918,0.808,0.881,0.756 (all P <0.05) in all children at 1, 3, 6 and 12 months after booting were positive correlation. 78 cases of postoperative cochlear X-ray showed normal electrode position, good shape; processor failure occurred in 2 cases, the rest of the CI overall good working condition. Conclusions Within one year after the cochlear implantation, the hearing and speech abilities of all children increase continuously with time; the auditory and speech scores of children in early age group are lower than that of older children in the early postoperative period; There was no difference in the latter 12 months, but the children’s speech ability in the younger age group was still lower than that in older children. The stronger the ability of hearing integration was, the stronger the speech ability was. The Nurotron-Venus CI was safe and reliable.