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目的:评价脑白质发育异常的极重度感音神经性聋患儿人工耳蜗植入术后的听觉言语康复效果与脑白质病变程度的关系。方法:回顾性分析35例行人工耳蜗植入术的脑白质发育异常患儿(实验组),并选取35例植入年龄匹配、耳蜗正常的极重度感音神经性聋患儿作为对照组。根据患儿术前MRI表现进行脑白质病变评测(Scheltens量表评分),术后6、12、24个月采用听觉行为(CAP)和言语可懂度(SIR)分级标准对两组患儿的听力及言语恢复水平分别评分。结果:经统计学分析,实验组术后6个月的CAP得分、SIR得分均低于对照组(P<0.05),术后12、24个月的CAP得分与对照组无明显差异,SIR得分低于对照组(P<0.05)。其中Scheltens分级越高的患儿,CAP和SIR得分越低。结论:脑白质发育异常的语前聋患儿人工耳蜗植入术后听觉感知及言语康复效果与脑白质病变程度有关,病变累及范围越广,听觉和言语康复水平越低,言语康复效果受脑白质病变程度影响更为显著。
OBJECTIVE: To evaluate the relationship between auditory speech rehabilitation after cochlear implantation and the severity of white matter lesions in children with severe sensorineural deafness of white matter development. Methods: A retrospective analysis of 35 cases of cochlear implants in children with abnormal white matter development (experimental group), and 35 cases of age-matched, normal cochlear impaired sensorineural hearing-impaired children as control group. According to the preoperative MRI findings of children with white matter lesions (Scheltens scale score), 6,12,24 months after the auditory behavior (CAP) and speech intelligibility (SIR) grading standards of two groups of children Listening and speech recovery levels were scored. Results: According to statistical analysis, CAP score and SIR score of experimental group at 6 months postoperatively were all lower than those of control group (P <0.05). There was no significant difference between CAP score 12 and 24 months after operation and control group Lower than the control group (P <0.05). The higher the Scheltens classification, the lower the CAP and SIR scores. Conclusion: The auditory perception and verbal rehabilitation after cochlear implantation in prelingual deaf children with abnormal white matter development are related to the degree of white matter lesions. The wider the range of lesion involvement, the lower the level of hearing and speech rehabilitation. The speech rehabilitation effect is affected by brain The degree of white matter lesions more significant impact.