Asunto(s)
Implantes Cocleares , Trastornos Sordoceguera/terapia , Estimulación Encefálica Profunda/métodos , Distonía/terapia , Discapacidad Intelectual/terapia , Atrofia Óptica/terapia , Preescolar , Trastornos Sordoceguera/complicaciones , Trastornos Sordoceguera/diagnóstico , Trastornos Sordoceguera/genética , Distonía/complicaciones , Distonía/diagnóstico , Distonía/genética , Globo Pálido/fisiología , Humanos , Discapacidad Intelectual/complicaciones , Discapacidad Intelectual/diagnóstico , Discapacidad Intelectual/genética , Masculino , Proteínas de Transporte de Membrana/genética , Proteínas del Complejo de Importación de Proteínas Precursoras Mitocondriales , Atrofia Óptica/complicaciones , Atrofia Óptica/diagnóstico , Atrofia Óptica/genética , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVES: To assess a group of children who consecutively received implants more than 10 years after implantation with regard to speech perception, speech intelligibility, receptive language level, and academic/occupational status. STUDY DESIGN: A prospective longitudinal study. SETTING: Pediatric referral center for cochlear implantation. PATIENTS: Eighty-two prelingually deafened children received the Nucleus multichannel cochlear implant. INTERVENTIONS: Cochlear implantation with Cochlear Nucleus CI22 implant. MAIN OUTCOME MEASURES: The main outcome measures were open-set Phonetically Balanced Kindergarten word test, discrimination of sentences in noise, connective discourse tracking (CDT) using voice and telephone, speech intelligibility rating (SIR), vocabulary knowledge measured using the Peabody Picture Vocabulary Test (Revised), academic performance on French language, foreign language, and mathematics, and academic/occupational status. RESULTS: After 10 years of implant experience, 79 children (96%) reported that they always wear the device; 79% (65 of 82 children) could use the telephone. The mean scores were 72% for the Phonetically Balanced Kindergarten word test, 44% for word recognition in noise, 55.3 words per minute for the CDT, and 33 words per minute for the CDT via telephone. Thirty-three children (40%) developed speech intelligible to the average listener (SIR 5), and 22 (27%) developed speech intelligible to a listener with little experience of deaf person's speech (SIR 4). The measures of vocabulary showed that most (76%) of children who received implants scored below the median value of their normally hearing peers. The age at implantation was the most important factor that may influence the postimplant outcomes. Regarding educational/vocational status, 6 subjects attend universities, 3 already have a professional activity, 14 are currently at high school level, 32 are at junior high school level, 6 additional children are enrolled in a special unit for children with disability, and 3 children are still attending elementary schools. Seventeen are in further noncompulsory education studying a range of subjects at vocational level. CONCLUSION: This long-term report shows that many profoundly hearing-impaired children using cochlear implants can develop functional levels of speech perception and production, attain age-appropriate oral language, develop competency level in a language other than their primary language, and achieve satisfactory academic performance.
Asunto(s)
Logro , Implantes Cocleares , Pérdida Auditiva Sensorineural/rehabilitación , Percepción del Habla/fisiología , Adulto , Edad de Inicio , Niño , Escolaridad , Femenino , Estudios de Seguimiento , Pérdida Auditiva Sensorineural/epidemiología , Humanos , Lactante , Estudios Longitudinales , Masculino , Ocupaciones , Fonética , Pruebas de Discriminación del Habla , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
OBJECTIVE: The purpose of this study was to examine the speech perception skills of prelingually deafened French children with preoperative residual hearing who received multichannel cochlear implants. DESIGN: The design of the study incorporated a within-subject, repeated measures design for assessing speech perception skills. SETTING: Montpellier, Toulouse and Lyon Pediatric Cochlear Implant Centers. SUBJECTS: Seven prelingually deafened children demonstrating marginal benefit from conventional amplification prior to implantation with a Nucleus multichannel cochlear implant, served as subjects for the speech perception assessment (a speech recognition score less than 30% defines marginal benefit from acoustic amplification on open set materials). The mean age at implantation was 7 years, 9 months. OUTCOME MEASURES: Speech perception skills were assessed using open set materials and the MUSS and MAIS questionnaires. RESULTS: Open-set speech recognition averaged 21.4% before implantation, and 83.6% after 1 year's cochlear implant experience. All children demonstrated an open-set score over 60% after 12 months of CI use. MAIS test scores averaged 18.1/40 before implantation and 35.1/40 after 9 months of CI use. MUSS test scores averaged 24.4/40 before implantation and 34.1/40 after 9 months of CI use. CONCLUSIONS: Cochlear implantation should be considered for prelingually hearing impaired children demonstrating marginal benefit from hearing aids, with a speech recognition score less than 30% on open set materials, in order to improve their speech discrimination skills.