Comparison and study of multiple scales results in children with cochlear reimplantation, mainly the speech, spatial, and other qualities of hearing scale for parents
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摘要: 目的 比较人工耳蜗同侧与对侧再植入儿童以言语空间听觉质量量表-父母版(speech，spatial，and other qualities of hearing scale for parents，SSQ-P)为主的多量表结果。方法 纳入1999年4月至2024年6月接受人工耳蜗再植入手术患儿69例，根据进行同侧或对侧再植入分为2组，收集性别、年龄、初次植入年龄、再植入年龄等一般资料，并对患儿监护人进行听觉行为分级量表(categories of auditory performance，CAP)、言语可懂度分级量表(speech intelligibility rating，SIR)、SSQ-P电话随访评估。采用逐步回归、线性回归、置换检验等统计学方法，探讨同侧再植入组与对侧再植入组在CAP、SIR、SSQ-P总分、SSQ-P言语感知、SSQ-P空间听力及SSQ-P听觉质量维度的得分是否有统计学差异。结果 在纳入的69例患儿中，同侧再植入组62例，平均年龄11.1岁；对侧再植入组7例，平均年龄11.7岁。统计分析结果显示，对侧再植入组在SSQ-P总分(P < 0.05)及空间听力维度得分(P < 0.05)显著低于同侧再植入组。结论 人工耳蜗同侧再植入效果在日常生活中整体听功能及空间听力方面优于对侧再植入患儿，但具体原因和机制尚待研究。
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关键词:
- 人工耳蜗 /
- 再植入 /
- 同侧植入 /
- 言语空间听觉质量量表-父母版 /
- 效果评估
Abstract: Objective To compare the outcomes of multiple scales, primarily the speech, spatial, and other qualities of hearing scale for parents(SSQ-P), in children with ipsilateral vs. Contralateral cochleareimplantat ion(CRI).Methods A total of 69 children who received cochlear implantation surgery from April 1999 to June 2024 were included. Patients were divided into two groups based on whether the implantation was on the same side. General information such as gender, age, age at initial implantation and reimplantation was collected. The primary caregivers of the children were followed up by telephone using the categories of auditory performance(CAP), speech intelligibility rating(SIR), and SSQ-P questionnaires. Statistical methods including stepwise regression, linear regression, and permutation tests were employed to investigate if there were any statistically significant differences in the scores of CAP, SIR, SSQ-P total, SSQ-P speech perception, SSQ-P spatial hearing, and SSQ-P auditory quality dimensions between the ipsilateral and contralateral reimplantation groups.Results Of the 69 children included, 62 were in the ipsilateral reimplantation group with a mean age of 11.1 years, and 7 were in the contralateral reimplantation group with a mean age of 11.7 years. Statistical analysis showed that patients in the contralateral reimplantation group had significantly lower SSQ-P total scores (P < 0.05) and spatial hearing dimension scores (P < 0.05) than those in the ipsilateral reimplantation group after controlling for the corresponding confounders.Conclusion The effect of ipsilateral reimplantation of cochlear implants is superior to that of contralateral reimplantation in terms of overall auditory function and spatial hearing in daily life for children, but the mechanisms require further investigation. -
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表 1 2组临床资料比较
临床资料 同侧再植入组(62例) 对侧再植入组(7例) 性别(男︰女)/例 47︰15 5︰2 年龄/岁 11.1±3.1 11.7±3.4 内耳畸形(无︰有)/例 52︰10 7︰0 初次植入年龄/岁 2.7±1.6 1.8±0.8 初次植入侧别(左︰右)/例 13︰49 2︰5 初次植入品牌(A︰B︰C︰D)/例 6︰21︰32︰3 2︰2︰1︰2 再植入原因(设备故障︰医疗因素︰不明)/例 58︰3︰1 0︰7︰0 再植入年龄/岁 6.0±2.7 3.9±1.6 再植入侧别(左︰右)/例 13︰49 5︰2 再植入品牌(A︰B︰C︰D)/例 10︰22︰27︰3 2︰2︰1︰2 2次植入间隔时间/d 1 201.9±792.6 773.4±450.8 原植入体取出与再植入是否同步(是︰否)/例 59︰3 5︰2 2次植入品牌是否相同(是︰否)/例 57︰5 7︰0 初次植入前是否有HA佩戴史(是︰否)/例 54︰8 5︰2 再植入前是否有HA佩戴史(是︰否)/例 24︰38 2︰5 
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表 2 影响CI再植入患者SSQ-P总分的多元逐步回归分析
变量 回归系数 标准误 t P 截距 162.734 19.075 8.531 < 0.001 初次植入右侧 -33.418 17.806 -1.877 0.065 初次植入品牌A 42.570 23.478 1.813 0.075 初次植入品牌B 37.270 19.311 1.930 0.058 初次植入品牌C 22.072 19.661 1.123 0.266 再植入右侧 32.107 15.910 2.018 0.048 初次植入前有HA佩戴史 -28.130 14.518 -1.938 0.057
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表 3 CI再植入患者SSQ-P总分与是否同侧再植入的线性回归分析
变量 回归系数 标准误 t P 截距 193.404 22.758 8.498 < 0.001 对侧再植入 -41.998 18.250 -2.301 0.025 初次植入右侧 -9.946 20.014 -0.497 0.621 初次植入品牌A 24.243 24.060 1.008 0.318 初次植入品牌B 14.173 21.201 0.669 0.506 初次植入品牌C 0.135 21.269 0.006 0.995 再植入右侧 6.094 19.092 0.319 0.751 1次植入前有HA佩戴史 -34.254 14.289 -2.397 0.020
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表 4 CI再植入患者SSQ-P总分与是否同侧再植入的置换检验分析
变量 系数 标准误 t P 置换检验P 截距 193.404 22.758 8.498 < 0.001 0.266 对侧再植入 -41.998 18.250 -2.301 0.025 0.037 初次植入右侧 -9.946 20.014 -0.497 0.621 0.667 初次植入品牌A 24.243 24.060 1.008 0.318 0.333 初次植入品牌B 14.173 21.201 0.669 0.506 0.460 初次植入品牌C 0.135 21.269 0.006 0.995 0.909 再植入右侧 6.094 19.092 0.319 0.751 0.778 1次植入前有HA佩戴史 -34.254 14.289 -2.397 0.020 0.034
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表 5 CI再植入患者空间听力维度结果与是否同侧再植入的线性回归分析
变量 回归系数 标准误 t P 截距 40.943 9.474 4.322 < 0.001 对侧再植入 -15.839 7.598 -2.085 0.041 初次植入右侧 -1.834 8.332 -0.220 0.827 初次植入品牌A 1.350 10.016 0.135 0.893 初次植入品牌B 4.346 8.826 0.492 0.624 初次植入品牌C 1.136 8.854 0.128 0.898 再植入右侧 -0.604 7.948 -0.076 0.940 1次植入前有HA佩戴史 -3.976 5.949 -0.668 0.506
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表 6 CI再植入患者空间听力维度结果与是否同侧再植入的置换检验分析
变量 系数 标准误 t P 置换检验P 截距 40.943 9.474 4.322 < 0.001 0.670 对侧再植入 -15.839 7.598 -2.085 0.041 0.039 初次植入右侧 -1.834 8.332 -0.220 0.827 0.835 初次植入品牌A 1.350 10.016 0.135 0.893 0.879 初次植入品牌B 4.346 8.826 0.492 0.624 0.638 初次植入品牌C 1.136 8.854 0.128 0.898 0.898 再植入右侧 -0.604 7.948 -0.076 0.940 0.940 1次植入前有HA佩戴史 -3.976 5.949 -0.668 0.506 0.518
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