Study on bimodal stimulation for aural rehabilitationdevelopmentin infants with a unilateral cochlear implant
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摘要: 目的:探讨单侧人工耳蜗植入聋儿声电双模式下听觉康复效果及特点。方法:将36例行单侧人工耳蜗植入的双耳重度-极重度耳聋的婴幼儿随机分配到单纯人工耳蜗植入组(A组,18例)及单侧人工耳蜗加对侧耳助听器组(B组,18例),在康复3个月(T1)、6个月(T2)、12个月(T3)时间点对2组聋儿分别进行声场助听听阈评估、音节要素识别(韵母识别、声母识别、声调识别)及词语识别率(单音节识别、双音节词识别、三音节识别)和选择性听取等测试。结果:T2测试时间点B组500 Hz助听听阈低于A组,T3测试时间点B组500、1 000 Hz助听听阈均低于A组(P＜0.05)。T1测试时间点A组音节要素的3项评估指标、单音节识别率及双音节识别率均高于B组(P＜0.05),2组在T2测试时间点音节要素及词语识别的3项评估指标均差异无统计学意义(P＞0.05)。在T3测试时间点B组的声母识别率及声调识别率、双音节及三音节识别、双音节词选择性听取能力均高于A组(P＜0.05)。结论:人工耳蜗植入聋儿声电双模式的优势会随康复进程逐渐显现,应充分利用双耳聆听的优势,采用最适宜的助听模式。Abstract: Objective: To evaluated the aural rehabilitation development of the bimodal stimulation in deaf infants with a unilateral cochlear implant.Method: The 36 infants, suffering from severe-to-profound bilateral sensorineural hearing loss with residual hearing on at least one side, assigned into two groups randomly:18 wore only the cochlear implant(unilateral A group),while the other 18 used the CI and a contralateral hearing aid at the same time(bimodal group).The aural rehabilitation development was evaluated by sound field test and speech rehabilitation tests(including vowels, consonants, tones, monosyllables, disyllables, tri-syllables and selected hearing) after rehabilitation lasting 3 month(T1),6 month(T2)and 12 month(T3)respectively.Result: At time T1,free-field hearing threshold of 500 Hz of unilateral A group was statistically higher than bimodal group. Free-field hearing thresholds of 500 Hz and 1 000 Hz of unilateral A group were statistically higher than bimodal group attime T2(P＜0.05).At time T1, vowels, consonants, tones, monosyllables, and disyllables rehabilitation scores of unilateral A group were statistically higher than bimodal group(P＜0.05). At time T2,there were no statistically significant differences between two groups(P＞0.05).However,consonants, tones,disyllables, tri-syllables and selected hearing rehabilitation scores of bimodal group were statistically higher than unilateral group(P＜0.05).Conclusion: The cochlear implant infants with bimodal stimulation have better aural rehabilitation development with the process of aural rehabilitation gradually.Therefore, it is essential to make full use of the advantages of binaural hearing and to choose the appropriate aural rehabilitation mode for every deaf infant.
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Key words:
- cochlear implantation /
- bimodal stimulations /
- deafness /
- auditory rehabilitation
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