目的:探讨使用心理物理测试及听觉行为分级、言语可懂度分级对语后聋多通道人工耳蜗植入患者听觉言语康复效果进行评估的意义,比较语前聋和语后聋患者术后康复效果。方法:1997-03-2007-06共植入人工耳蜗353例,选择语后聋植入者31例,语前聋植入者59例参加研究。对语后聋和语前聋受试者的纯音听阈、听觉行为分级标准(CAP)和言语可懂度分级标准(SIR)进行评估分析,并比较相同植入电极的语后聋和语前聋患者开机0.5年后的电听觉阈值、最大舒适强度和动态范围有无差异,用统计学方法加以分析。结果:所有受试者声场测试语言频率平均听阈(啭音)为25~45 dB(nHL)。植入同种电极(澳大利亚直电极、澳大利亚弯电极、奥地利Medel C40+)的语前聋和语后聋患者之间听觉阈值最大舒适强度和动态范围差异无统计学意义(P〉0.05)。语后聋患者的CAP和SIR得分高于语前聋患者。结论:CAP和SIR是一种对人工耳蜗植入者日常生活中听说能力的方便有效的评估方法。植入相同电极的语前聋和语后聋患者之间的纯音听阈、电听觉阈值、最大舒适强度、动态范围无明显差异,但语后聋患者听觉水平和言语可懂度效果好与语前聋患者。
Objective:To seek a convenient and effective method through subjective psychophysical measurements and CAP/SIR assessment.To compare the discrimination of rehabilitation between post-lingual and pre-lingual deafened patients.Method:Thirty-one post-lingual cochlear implantees and 59 pre-lingual cochlear implantees,the warble tone and CAP/SIR were assessed.The discrimination of threshold levels,comfortable levels and dynamic range between post-lingual and pre-lingual deafened patients in same electrodes were compared.Result:There was no statistic difference in warble tone,T-levels,C-levels and dynamic range in same electrodes implant after 6 months implant(P0.05).The score of CAP and SIR in post-lingual deafened patients were more prominent.Conclusion:CAP and SIR is a kind of convenient and effective method to assess the ability of aural and oral.There was no discrimination in warble tone,T-levels,C-levels and dynamic range in same electrodes implant,but the ability of aural and oral in post-lingual deafened patients were more prominent.