Evaluation Of Post-operative Outcomes Of Cochlear Implants In Older Children With Prelingual Deafness

ObjectiveTo analyze the rehabilitation outcomes of auditory and speech ability for older children with prelingual deafness after cochlear implantation,using post-implant threshold tests in the sound field,questionnaires,and speech recognition rate audiometry,this paper assessed the speech abilities of patients with cochlear implants and examined the dynamics of auditory and speech abilities in older children with prelingual deafness within 2 years after switch-on of cochlear implant.MethodsPatients aged 7-18 years with prelingual deafness who underwent unilateral cochlear implantation at the First Affiliated Hospital of Zhengzhou University between January 2016 and December 2018 were selected for assessment of auditory and speech rehabilitation outcomes.Aided threshold tests were performed on 40 implants in the acoustic field at 6 months and 2 years after switch-on,and Categories of Auditory Performance,Speech Intelligibility Rating,Meaningful Auditory Integration Scale,and Meaningful Use of Speech Scale were performed on 40 implants at 3 months,6 months,1 year,and 2 years after switch-on.The Mandarin Lexical Neighborhood Test(M-LNT)was administered to 22 children 2 years after switch-on.A comprehensive comparative analysis was performed at different ages and different speech foundations before switch-on.Results①40 older children with prelingual deafness had lower aided thresholds 2 years after switch-on than 6 months after switch-on,and the difference was statistically significant(P<0.05);there was no significant difference in aided thresholds at 6 months and 2 years after switch-on for patients in different age groups.②The CAP、SIR、MAIS and MUSS scores of all groups showed an increasing trend with the time after switch-on.③The CAP scores of the low-age control group were lower than those of the school-aged group and the teenager group with no speech foundation at the 3 months and 6 months after switch-on,and reversed at 1year after switch-on(P<0.05),and there was no difference in CAP scores between the school-aged group and the teenager group;The SIR scores of the low-age control group was lower than the school-aged group and the teenager group at 3 months after switch-on,and are overtaken by low-age group between 1 year and 2 years after switch-on(P<0.05).There was no difference in SIR scores between the school-aged group and the teenager group;The MAIS scores of the low-age group was lower than the school-aged group at 3 months after switch-on(P<0.05)and there is no difference in MAIS scores of the three groups after 3months.There is no difference in MUSS scores of all groups from 3 months to 1 year after switch-on.The MUSS scores of the low-age group is better than the school-aged group,and the school-aged group is better than the teenager group 2 years after switch-on(P<0.05).④The CAP、SIR、MAIS and MUSS scores at 2 years points after switch-on were higher in the group with a speech foundation than in the group with no speech foundation(P<0.05).⑤The older implanters scored higher in both mono-syllable easy words group and disyllable-easy words group than in hard words groups(P<0.05),which was in accordance with the normal auditory pattern;the scores of all scales in the group with speech foundation were better than those in the group with no speech foundation(P<0.05);the scores of all test items in the older implanters were much lower than those of normal children(P<0.05).Conclusion①The auditory and speech abilities of older children with prelingual deafness improved over time within 2 years after switch-on.②Older children with prelingual deafness achieve better auditory levels early after switch-on,but increase more slowly than younger implant recipients.③Older children with prelingual deafness have poorer speech organization and expression abilities after switch-on than younger implant recipients,and have difficulty returning to normal levels.④Older children with prelingual deafness with some speech foundation before implantation can obtain better auditory level and speech level immediately after switch-on,and the rehabilitation effect of auditory and speech expression is better than that of patients with no speech foundation before surgery 2 years after switch-on.⑤The aided threshold of older children with prelingual deafness became lower 2 years after switch-on than 6 months after switch-on,and there was no correlation between age at implantation and threshold.