Objectives: To study an effects on hearing ability and speech performance of the patients with auditory neuropathy (AN) after cochlear implantation (CI). Methods: Thirty-five AN patients (26 males and 9 females) after CI in our center since 2007 were chosen, including 5 postlingual patients (implanted age from 14.3 to 38.6 years old) and 30 prelingual patients (implanted age from 1.1 to 13.7 years old). Hearing sensitivity and speech performance were estimated via following methods: (1) implanted hearing thresholds by sound field audiometry; (2) speech audiometry, including monosyllable, disyllable and sentences recognition test by computer-controlled software and sentence recognition test under noise condition (signal to noise ratio=+ 10dB); (3) Mandarin Early Speech Perception test (MESP), Mandarin Pediatric Speech Intelligibility test (MPSI), MAIS, or IT-MAIS for prelingual AN implantees. Results: The average implanted hearing threshold (250-4 000 Hz) was (41.1±11.7) dBHL in 22 AN implantees, while those prelingual implantees was (39.1±10.9) dBHL, and (44.9±12.3) dBHL in postlingual implantees. Speech audiometry were implemented in four of 5 postlingual AN implantees, the results showed increasing tendency in monosyllable recognition scores, dramatic individual variation in computer-controlled disyllable and sentences recognition test, and poor scores (<30%) in speech recognition test in noise condition. Four of 30 prelingual implantees reconstruct their speech recognition ability within 1-3 years after switch-on, characterized as recognition scores (>60%) in monosyllable, disyllable and sentences. The one of prelingual implantee gained recognition scores of speech in noise within 1 year after switch-on. MAIS or IT-MAIS were implemented in twenty-five prelingual implantees, the average score in these patients was 28.6±11.7. Conclusion: Cochlear implant can improve the hearing thresholds of AN patients, however, the improvement in speech performance presented significant variations among the implanted individuals.
目的： 分析听神经病患者人工耳蜗植入后的听觉言语康复效果，为更好地应用人工耳蜗治疗听神经病提供临床参考。 方法： 回顾性分析2007年以来在解放军总医院确诊为听神经病并行人工耳蜗植入手术的35例患者的临床资料，其中男26例，女9例；语后聋5例(植入年龄14.3～38.6岁)、语前聋30例(植入年龄1.1～13.7岁)。术后听觉言语评估方法包括：①声场助听听阈测试；②言语识别测试，包括单音节、双音节和句子识别率测试，以及噪声条件下(信噪比为＋10 dB)句子识别率测试；③普通话早期言语感知测试(Mandarin Early Speech Perception test, MESP)、普通话儿童言语理解力测试(Mandarin Pediatric Speech Intelligibility test, MPSI)以及有意义听觉整合量表(Meaningful Auditory Integration Scale, MAIS)和婴幼儿有意义听觉整合量表(Infant Toddler － Meaningful Auditory Integration Scale, IT－MAIS)问卷评估。 结果： 22例受试者声场下250～4 000 Hz纯音平均助听听阈为(41.1±11.7)dB HL，其中语前聋患者平均为(39.1±10.9)dB HL，语后聋患者平均为(44.9±12.3)dB HL。4例语后聋听神经病患者进行了多次言语识别测试，其单音节识别率呈现逐渐提高趋势，而双音节和句子识别得分变异较大，噪声条件下句子识别得分低于30%。30例语前聋听神经病植入者中，4例在开机1～3年后获得了言语识别能力，单音节、双音节和句子识别得分均超过60%，其中1例患者在开机1年后获得噪声条件下句子识别得分。25例语前聋患者MAIS(IT－MAIS)的平均得分为(28.6±11.7)分，但个体变异度较大。 结论： 人工耳蜗植入可明确改善听神经病患者的纯音听阈，但对语前聋患者言语识别能力的补偿效果并不像听阈所反映的那样乐观，个体差异较大。.
Keywords: Auditory neuropathy; Cochlear implantation; Speech discrimination tests.