附加残疾儿童人工耳蜗植入后的听觉结果：内耳畸形的分级评估

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-07-14 DOI:10.1016/j.ijporl.2025.112490

Shujiro Minami , Chieko Enomoto , Hidetoshi Kato , Natsumi Tachibana , Motoko Ihara , Masae Shiroma , Kimitaka Kaga

{"title":"附加残疾儿童人工耳蜗植入后的听觉结果：内耳畸形的分级评估","authors":"Shujiro Minami , Chieko Enomoto , Hidetoshi Kato , Natsumi Tachibana , Motoko Ihara , Masae Shiroma , Kimitaka Kaga","doi":"10.1016/j.ijporl.2025.112490","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate auditory and speech outcomes after cochlear implantation (CI) in children with additional disabilities (ADs), including autism spectrum disorder (ASD), with a particular focus on the impact of inner ear malformation (IEM) grading based on modiolus and cochlear nerve integrity.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 58 children with bilateral severe-to-profound sensorineural hearing loss and at least one AD who underwent CI between 2007 and 2022 at a national cochlear implant center. ADs included ASD, intellectual disability (ID), and attention-deficit/hyperactivity disorder (ADHD). IEMs were classified into Grades 0–III based on radiological evaluation. Auditory outcomes were assessed using the Revised Categories of Auditory Performance (R-CAP) and Speech Intelligibility Rating (SIR) scales. Statistical analyses included non-parametric tests and multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among the 58 children, 60 % had ASD and 83 % had ID. IEMs of Grade II or higher were observed in 26 %. Median age at implantation was 29.5 months, and median age at evaluation was 86.5 months. R-CAP scores were significantly higher in children with Grade 0– I IEM than in those with Grade ≥ II (median 8 vs. 2, <em>p</em> < 0.01). R-CAP ≥8, indicating conversational speech understanding, was achieved by 60 % of Grade 0– I cases but only 13 % of those with more severe IEMs. Multivariable analysis showed that mild ID and severe IEMs were independent negative predictors of achieving R-CAP ≥8, while age at assessment was positively associated with better outcomes.</div></div><div><h3>Conclusion</h3><div>CI can provide meaningful auditory development for children with ADs, but outcomes vary by cognitive and anatomical factors. Early implantation remains essential despite challenges in diagnosing conditions like ASD before surgery, supporting the need for ongoing developmental surveillance and individualized habilitation planning.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112490"},"PeriodicalIF":1.3000,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Auditory outcomes after cochlear implantation in children with additional disabilities: A grading-based evaluation of inner ear malformations\",\"authors\":\"Shujiro Minami , Chieko Enomoto , Hidetoshi Kato , Natsumi Tachibana , Motoko Ihara , Masae Shiroma , Kimitaka Kaga\",\"doi\":\"10.1016/j.ijporl.2025.112490\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>This study aimed to evaluate auditory and speech outcomes after cochlear implantation (CI) in children with additional disabilities (ADs), including autism spectrum disorder (ASD), with a particular focus on the impact of inner ear malformation (IEM) grading based on modiolus and cochlear nerve integrity.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 58 children with bilateral severe-to-profound sensorineural hearing loss and at least one AD who underwent CI between 2007 and 2022 at a national cochlear implant center. ADs included ASD, intellectual disability (ID), and attention-deficit/hyperactivity disorder (ADHD). IEMs were classified into Grades 0–III based on radiological evaluation. Auditory outcomes were assessed using the Revised Categories of Auditory Performance (R-CAP) and Speech Intelligibility Rating (SIR) scales. Statistical analyses included non-parametric tests and multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among the 58 children, 60 % had ASD and 83 % had ID. IEMs of Grade II or higher were observed in 26 %. Median age at implantation was 29.5 months, and median age at evaluation was 86.5 months. R-CAP scores were significantly higher in children with Grade 0– I IEM than in those with Grade ≥ II (median 8 vs. 2, <em>p</em> < 0.01). R-CAP ≥8, indicating conversational speech understanding, was achieved by 60 % of Grade 0– I cases but only 13 % of those with more severe IEMs. Multivariable analysis showed that mild ID and severe IEMs were independent negative predictors of achieving R-CAP ≥8, while age at assessment was positively associated with better outcomes.</div></div><div><h3>Conclusion</h3><div>CI can provide meaningful auditory development for children with ADs, but outcomes vary by cognitive and anatomical factors. Early implantation remains essential despite challenges in diagnosing conditions like ASD before surgery, supporting the need for ongoing developmental surveillance and individualized habilitation planning.</div></div>\",\"PeriodicalId\":14388,\"journal\":{\"name\":\"International journal of pediatric otorhinolaryngology\",\"volume\":\"196 \",\"pages\":\"Article 112490\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-07-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of pediatric otorhinolaryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0165587625002770\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of pediatric otorhinolaryngology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165587625002770","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的本研究旨在评估包括自闭症谱系障碍（ASD）在内的附加残疾（ADs）儿童人工耳蜗植入术（CI）后的听觉和言语预后，特别关注基于耳蜗神经完整性和耳蜗神经完整性的内耳畸形（IEM）评分的影响。方法回顾性分析了2007年至2022年间在国家人工耳蜗中心接受CI治疗的58例双侧重度至重度感音神经性听力损失和至少1例AD患儿。ad包括ASD、智力残疾（ID）和注意力缺陷/多动障碍（ADHD）。根据放射学评价将IEMs分为0-III级。使用修订后的听觉表现分类（R-CAP）和语音清晰度评级（SIR）量表评估听觉结果。统计分析包括非参数检验和多变量逻辑回归。结果58名儿童中，60%患有ASD， 83%患有ID。II级及以上的IEMs占26%。植入时中位年龄为29.5个月，评估时中位年龄为86.5个月。0 - I级IEM患儿的R-CAP评分显著高于≥II级IEM患儿(中位数8比2，p <；0.01)。R-CAP≥8（表明会话语音理解）在0 - I级患者中达到60%，但在更严重的IEMs患者中只有13%。多变量分析显示，轻度ID和重度IEMs是R-CAP≥8的独立负向预测因子，而评估年龄与较好的预后呈正相关。结论ci可为ad患儿提供有意义的听觉发展，但结果受认知和解剖学因素的影响。尽管在术前诊断ASD等疾病方面存在挑战，但早期植入仍然至关重要，这支持了持续发育监测和个性化康复计划的需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Auditory outcomes after cochlear implantation in children with additional disabilities: A grading-based evaluation of inner ear malformations

Objective

This study aimed to evaluate auditory and speech outcomes after cochlear implantation (CI) in children with additional disabilities (ADs), including autism spectrum disorder (ASD), with a particular focus on the impact of inner ear malformation (IEM) grading based on modiolus and cochlear nerve integrity.

Methods

We retrospectively reviewed 58 children with bilateral severe-to-profound sensorineural hearing loss and at least one AD who underwent CI between 2007 and 2022 at a national cochlear implant center. ADs included ASD, intellectual disability (ID), and attention-deficit/hyperactivity disorder (ADHD). IEMs were classified into Grades 0–III based on radiological evaluation. Auditory outcomes were assessed using the Revised Categories of Auditory Performance (R-CAP) and Speech Intelligibility Rating (SIR) scales. Statistical analyses included non-parametric tests and multivariable logistic regression.

Results

Among the 58 children, 60 % had ASD and 83 % had ID. IEMs of Grade II or higher were observed in 26 %. Median age at implantation was 29.5 months, and median age at evaluation was 86.5 months. R-CAP scores were significantly higher in children with Grade 0– I IEM than in those with Grade ≥ II (median 8 vs. 2, p < 0.01). R-CAP ≥8, indicating conversational speech understanding, was achieved by 60 % of Grade 0– I cases but only 13 % of those with more severe IEMs. Multivariable analysis showed that mild ID and severe IEMs were independent negative predictors of achieving R-CAP ≥8, while age at assessment was positively associated with better outcomes.

Conclusion

CI can provide meaningful auditory development for children with ADs, but outcomes vary by cognitive and anatomical factors. Early implantation remains essential despite challenges in diagnosing conditions like ASD before surgery, supporting the need for ongoing developmental surveillance and individualized habilitation planning.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.