The Evaluation Of Cochlear Implant In Children With Leukodystrophies

Objective:To analysis the auditory and speech rehabilitation effect of the children with leukodystrophies after cochlear implantation and the influential factors.Mathods:388 deaf children who received cochlear implantation?CI?from January 2003 to December 2014 in Shanghai 6^th People's Hospital were investigated in this study.51 cases with leukodystrophies were in research group and other 337cases were in control group.The perioperative data were collected and all the cases were completed follow-up.Tools for assessment were Categories of auditory performance?CAP?,Speech intelligibility rating?SIR?,Meaningful auditory integration scale?MAIS?and Meaningful usage of speech scale?MUSS?.T-test of independent sampler was used to analysis all the scores of the two group.Stepwise Multiple Linear Regression?SMLR?and T-test of independent samper were used to analysis the factors of the auditory and speech rehabilitation effect of the children with leukodystrophies.Results:All of the children had the CI surgery safely and switch on after CI.The research group got lower scores in SIR in first half year after the CI surgery.In 1 or more years after CI,no significant difference was showed between the two groups.The result of SMLR showed that intelligence had direct impact on CAP scores of 1year after CI surgery,preoperative hearing aids had direct impact on SIR scores of 1year after CI surgery,intelligence and postoperative speech training had direct impact on SIR scores of 3 years after CI surgery.The patients with higher intelligence got higher scores on CAP of 0.5 year and 1 year after CI surgery and SIR of 1 year and 3years after CI surgery.The patients with longer time of speech training got higher scores on CAP of 3 years after CI surgery and SIR of 3 years after CI surgery.Conclusions:There are indications that the deaf children with leukodystrophies can receive CI.The evaluation of speech rehabilitation of the children with leukodystrophies were a bit poor than those of simple deaf children in the early age after CI.But as the rehabilitation training continues,the difference grew down gradually.The intelligence and the postoperative speech training are effective factors relative to the auditory and speech rehabilitation.