建立最新的循证指南,推荐幼儿人工耳蜗植入。
将早期植入儿童的言语感知结果与使用传统扩增的儿童进行比较。建立了人工耳蜗(CI)使用者的等效纯音平均(PTA)听力损失。对早期植入儿童的语言进行了六年的评估,并与听力同龄人进行了比较。
78名使用CI的儿童和62名使用传统放大的儿童,听力损失范围为25-120dBHLPTA(语音感知研究)。32名在2.5岁之前接受aCI的儿童(语言学习)。
语音感知结果表明,PTA大于60dBHL的儿童比传统放大有75%的机会受益。应用于数据的更保守的标准表明,PTA大于82dBHL的儿童受益的机会为95%。植入2.5岁以下无明显认知缺陷的儿童语言正常进步,但延迟约等于植入时的年龄。
3岁以下的听力受损儿童如果其两侧PTA超过60dBHL,可从人工耳蜗植入中获益。尽可能年轻的植入应最大程度地减少由于最初的听觉剥夺而导致的任何语言延迟。
Establish up-to-date evidence-based
guidelines for recommending cochlear implantation for young children.
Speech perception results for early-implanted children were compared to children using traditional amplification. Equivalent pure-tone average (PTA) hearing loss for cochlear implant (CI) users was established. Language of early-implanted children was assessed over six years and compared to hearing peers.
Seventy-eight children using CIs and 62 children using traditional amplification with hearing losses ranging 25-120 dB HL PTA (speech perception study). Thirty-two children who received a CI before 2.5 years of age (language study).
Speech perception outcomes suggested that children with a PTA greater than 60 dB HL have a 75% chance of benefit over traditional amplification. More conservative criteria applied to the data suggested that children with PTA greater than 82 dB HL have a 95% chance of benefit. Children implanted under 2.5 years with no significant cognitive deficits made normal language progress but retained a delay approximately equal to their age at implantation.
Hearing-impaired children under three years of age may benefit from cochlear implantation if their PTA exceeds 60 dB HL bilaterally. Implantation as young as possible should minimize any language delay resulting from an initial period of auditory deprivation.