外中耳畸形患者骨桥植入术后听觉言语康复效果分析

Analysis of auditory and speech rehabilitation effect of bonebridge implantation in patients with external and middle ear malformation

摘要:

目的 分析先天性外中耳畸形患者行骨桥植入术后听觉和言语识别能力的改善情况，评估骨桥植入的主观听觉获益。方法 回顾性分析行单侧骨桥植入的9例先天性外中耳畸形患者的术前裸耳及术后助听听阈、言语识别阈和言语识别率，并应用言语空间听觉质量量表—父母版(SSQ-P)问卷以及言语可懂度分级(SIR)标准问卷评估患者骨桥植入后主观获益情况。结果 9例患者在骨桥植入术后的助听听阈、言语识别阈和言语识别率较术前明显改善。助听听阈在主要频率0.25~8 kHz分别降低(31.1±12.7)、(43.9±21.5)、(53.3±14.1)、(45.0±12.2)、(45.0±15.2)、(42.2±19.1)dB，平均听阈下降(43.4±13.0)dB，言语识别阈平均下降(44.7±4.8)dB，单音节言语识别率平均提高(67.3±8.2)%，双音节言语识别率平均提高(68.1±8.4)%，安静环境下语句言语识别率平均提高(53.3±13.5)%，噪声环境下语句言语识别率平均提高(49.6±11.0)%。调查问卷结果显示，SSQ-P平均受益分数为(4.6±0.7)分，SIR平均受益分数为(1.4±0.4)分。结论 部分先天性外中耳畸形患者接受骨桥植入能获得明显听觉及言语能力改善，有效提升言语、空间和听觉的主观受益。

Abstract:

Objective To analyze the improvement of auditory and speech recognition in patients with congenital external and middle ear malformation after bonebridge implantation, and to evaluate the subjective auditory benefits of bonebridge implantation.Methods Clinical data of 9 patients with congenital external middle ear malformation who underwent unilateral bonebridge implantation were retrospectively analyzed. The analyzed data included preoperative and postoperative hearing threshold, speech recognition threshold, and speech recognition rate. The subjective benefit of the patients after bonebridge implantation was assessed by using the speech spatial hearing quality scale for parents (SSQ-P) questionnaire and the speech comprehensibility rating (SIR) questionnaire.Results The hearing aid threshold, speech recognition threshold and speech recognition rate of the 9 patients were significantly improved after bonebridge implantation. The hearing aid threshold in the main frequencies (0.25~8 kHz) decreased by (31.1±12.7) dB, (43.9±21.5) dB, (53.3±14.1) dB, (45.0±12.2) dB, (45.0±15.2) dB, (42.2±19.1) dB, respectively, with an average decrease of (43.4±13.0) dB. The average speech recognition threshold decreased by (44.7±4.8) dB, the average monosyllabic speech recognition rate increased by (67.3±8.2)%, the average two-syllable speech recognition rate increased by (68.1±8.4)%, the average sentence speech recognition rate in quiet environment increased by (53.3±13.5)%, and the average sentence speech recognition rate in noisy environment increased by (49.6±11.0)%. The questionnaire results showed that the mean benefit score of SSQ-P was (4.6±0.7) and that of SIR was (1.4±0.4).Conclusion Some patients with congenital external and middle ear malformation receiving bonebridge implantation can obtain significant improvement in auditory and speech ability, effectively improving the subjective benefits in terms of speech, space, and hearing.