The Characteristics Of Auditory And Speech Development Of Prelingual Deafness Children With Domestic Cochlear Implants In China

ObjectiveTo observe the characteristics of speech and auditory growth in prelingual hearing loss patients using domestic Nurotron cochlear implants which including auditory development,speech recognition and language development.To analyze the effect of implant age on the development of auditory speech after CI by comparing the results of Infant-Toddler Meaningful Auditory Integration Scale(IT-MAIS),Meaningful Auditory Integration Scale(MAIS),Categories of Auditory Performance(CAP),Mandarin Early Speech Perception(MESP),Meaningful Use of Speech Scale(MUSS)and Speech Intelligibility Rating(SIR)in different age groups before and after CI.To summarize the rehabilitation effect and development regularity of CI in patients with different age groups,then to guide the operation timing and postoperative rehabilitation of cochlear implantation.Methods1?Subjects: We retrospectively studied the clinical data of hearing impaired children who received the Nurotron CI from December 2013 to March 2015 at the First Affiliated Hospital of Zhengzhou University.Selected Criteria: bilateral severe or profound sensorineural prelingual deafness children who was implanted in the age of 13 months to 96 months(mean age 47.42 ± 2.64 months),excluding auditory neuropathy,severe congenital inner ear malformation(Common Cavity,Mondini,cochlear aplasia,etc.),white matter lesions,etc.Their parents can cooperate with the completion of IT-MAIS,MAIS,CAP,MUSS,SIR questionnaire assessment.78 cases were in accordance with the above criteria.According to their implant age,patients were divided into group A(13-8 months,mean age 30.33 ± 1.8 months,45 cases),group B(49-72 months,mean age 58.11 ±1.52,18 cases)and Group C(73-96 months,mean age 84.73±1.26 months,15 cases).15 cases in group A,8 cases in group B,15 cases in group C had the history of wearing hearing aids(HA),all of them had worn HA more than 6 months and all of them were trained in speech rehabilitation,but they had poor speech ability.A total of 35 patients were enrolled in the Nurotron CI who were able to complete the MESP test.According to the age of implantation,the patients were divided into group A(13-48 months,mean age 31.64 ± 1.32 months,17 cases),group B(49-72 months,mean age 57.24±1.33 months,11 cases)and group C(73-96 months,mean age 83.15±1.67 months,7 cases).2?Test procedures: Children were evaluated by IT-MAIS/MAIS before CI and 1 month,3months,6 months,12 months,24 months after switch on.Children were evaluated by MUSS,CAP and SIR at 1 month?3 months?6 months?12 months and 24 months after switch on.MESP test is more difficult and was evaluated at 3 months,6 months,12 months,24 months after switch on.3?Statistical analysis: To enter data into the Microsoft Excel table database and process it.Using SPSS19.0 software,the single factor analysis of variance was used to analyze the scores of children of different age at different time after switch on,and P < 0.05,the difference was statistically significant.Result1?The changes of auditory and speech ability in children with CI.The average score of CAP,SIR,MESP,MUSS,IT-MAIS and MAIS after intervention has increased over time,and the differences were statistically significant.The patients' hearing and speech development abilities after intervention gradually improved over time(P<0.05).2?The scores of auditory development at different time and different groups.The results of IT-MAIS and MAIS showed that the scores of preoperative group B and group C were higher than that of group A(P<0.05),the differences were statistically significant.There was no difference between group B and group C.1st,3rd,6th month after intervention: There was significant difference between group A ?C(P<0.05)and there was no significant difference between group A ?B and group B?C.There was no significant difference in mean scores among group A?B and C after intervention at 12 months and 24 months.In terms of CAP,There was no significant difference in mean scores between group A and group B after intervention(at 1st,3rd,6th month).After intervention at 12 months Group C scored higher than group A,there was significant difference(P<0.05).There was no difference of scores among all groups after intervention at 24 months.3?The scores of speech recognition in different age groups.The scores of MESP has no difference of all groups after intervention at 3 months and 6 months.Group A and B scored higher than group C after intervention at 12 months and 24 months,that was significantly different(P<0.05).4?The scores of speech development at different times and age groups after intervention.The score of MUSS showed that group A scored lower than group C after intervention(at 1st,3rd,6th,12 th month).That was significantly different(P<0.05).There was no significant difference in mean scores among group A,B and C after intervention at 24 th month.In terms of SIR,There was no significant difference in mean scores between group A and group B after intervention at 1st month.There was no significant difference in mean scores among group A,B and C after intervention at 3rd month and 6th month.Group A and group B scored higher than group C after intervention at 12 th month and 24 th month(P<0.05).ConclusionThe auditory ability,speech recognition and speech intelligibility of CI children increased within two years after the operation.On the basis of hearing aid wearing history,cochlear implants under 8 years old have little influence on auditory ability of patients with prelingual deafness.The age of implantation seriously affects the speech development of children after cochlear implantation.It is better to implant cochlear implants within 6 years.