The Evaluation Of Auditory And Speech Ability In Prelingual Children After Cochlear Implantation And Analysis Of Influencing Factors

BackgroundCochlear implants are the first successful example of a neural prosthesis that can substitute a sensory organ. The core functions of a cochlear implant are to convert the input sounds into meaningful electrical stimulation patterns to the cochlea, then stimulating the residual auditory nerve make the patients have some sense of hearing. Cochlear implantation is the most effective treatment of severe to profound sensorineural hearing loss and wearing hearing aids in children with poor effect to help them enter the world of sound. At present, worldwide, nearly 400000 deaf people have been fitted with cochlear implants. Since the first cochlear implantation was successfully carried out in China in 1995, more than 10 thousand people have been implanted with the cochlear implant. The number of cochlear implantation is growing at 25% to 50% per year, and 85% of the patients are under 7 years old. In recent years, under the impetus of national projects, the growth rate of cochlear implantation is rapidly accelerating, more and more deaf children obtain the hearing under the help of the state to return to the mainstream society.Cochlear implantation provides a prerequisite for the hearing reconstruction.To achieve a better hearing and speech rehabilitation, postoperative rehabilitation, regular assessment of rehabilitation of hearing and speech ability after surgery and the exploring of the development law of the rehabilitation are very important. However, not all children with cochlear implant can listen to say, the individual is quite different,therefore the study of influencing factors on postoperative hearing and speech rehabilitation is very necessary. ObjectiveThis retrospective study aimed to evaluate the auditory and speech rehabilitation effectiveness of one hundred and eighty-two prelingually deaf children after cochlear implantation and analyze the duration of implant use, gender, age at implantation, the using of the preoperative hearing aid and whether inner ear malformations on the effect of rehabilitation to provide reference for the implantation of families and hearing-impaired related workers. MethodsOne hundred and eighty-two prelingually deaf children from KangYuan Auditory and Speech Rehabilitation Center of ZhengZhou in 2009-2014 were included in this study.Their auditory performance and speech intelligibility were respectively rated using the Categories of Auditory Performance(CAP) and the Speech Intelligibility Rating(SIR)scales.The auditory and speech ability of the patients were evaluated before and after 3, 6, 12, 18, and 24 months of the operation. The effects of the age at implantation duration of implant use, gender, the using of the preoperative hearing aid and whether inner ear malformations on auditory and speech rehabilitation were compared and analyzed. SPSS21.0 statistical software was used for statistical description and analysis of the data. Results1. The average ages of the cochlear implantation in prelingually children were 40 months.The average ages of boys and girls were 39.8, 40.3 months respectively. 2 patients were implanted within 18 months which accounted for 1.1% of the total number.84 patients were implanted before the age of 3 which accounted for 46.2% of the total number.98 patients were implanted after 3 years old which accounted for 53.8% of the total number.The proportion of the patients implanted before the age of 6 years was 95.6% of the total number.2. After cochlear implantation, the CAP and SIR grades were gradually increased with the prolongation of the rehabilitation time. The growth rate of CAP grades was the fastest with 3~12 months. The difference compared between any two means was significant statistical difference(P<0.05). After 12 months of the rehabilitation, the rate of CAP increasing was significantly slowed down.The growth rate of SIR grades was the fastest with 6~18 months. The difference compared between any two means was significant statistical difference(P<0.05).After 18 months of the rehabilitation, the rate of SIR increasing was significantly slowed down.3. With prolonged recovery time, the CAP and SIR grades of each group were gradually increased.The difference of CAP and SIR was no significant statistical difference between different genders(P>0.05). The difference of CAP and SIR influenced by age at implantation, duration of implant use, the using of the preoperative hearing aids and the inner ear malformation had significant statistical difference(P<0.05). Conclusion1. Cochlear implantation can significantly improve auditory and speech ability of the severe to profound sensorineural hearing loss in children.2. Two of the most important factors affecting post-operational rehabilitation results are age at implantation and duration of implant use. The younger the age at implantation and the longer the duration of implant use, the better the rehabilitation results.3. Whether preoperative hearing aids wearing have an impact on auditory and speech rehabilitation in prelingual children after cochlear implantation.4. A part of children with the inner ear malformations after cochlear implantation can obtain auditory and speech ability.