双侧人工耳蜗同期与分期植入对听障儿童生存质量的差异化影响研究

Differential impact of simultaneous versus staged bilateral cochlear implantation on quality of life in children with hearing impairment

摘要:

目的 探讨双侧人工耳蜗同期植入与分期植入对听障儿童生存质量的影响，为临床治疗方案的制定提供参考依据。方法 回顾性选取2023年1月—2025年1月在上海市儿童医院耳鼻咽喉头颈外科接受双侧人工耳蜗植入(BCI)的听障患儿140例，根据植入方式分为同期植入组和分期植入组，每组各70例。采用一般情况调查表收集患儿及监护人的基本信息，使用听障儿童生存质量测定量表(DCQOL)评估患儿的生存质量。结果 同期植入组患儿在生理功能、情感功能、社会功能、残疾儿童共性模块、听障儿童特异性模块及DCQOL总分方面均显著高于分期植入组(P<0.05)，两组角色功能评分差异无统计学意义(P>0.05)。年龄分段显示，两组5~7岁患儿仅在听障儿童特异性模块与总分上存在组间差异，≥8岁患儿同期植入组所有维度均显著优于分期植入组(P均<0.05)。结论 双侧人工耳蜗同期植入改善听障儿童生存质量的总体效果优于分期植入，尤其在≥8岁儿童中同期植入获益更全面。临床可优先选择同期植入，并重视术后系统化的康复训练。

Abstract:

Objective To explore the differential impact of simultaneous versus staged bilateral cochlear implantation on the quality of life of hearing-impaired children, aiming to provide a basis for formulating clinical treatment strategies. Methods A retrospective study was conducted on 140 hearing-impaired children who underwent BCI at the Department of Otolaryngology Head and Neck Surgery, Shanghai Children’s Hospital, between January 2023 and January 2025. According to the implantation methods, they were divided into the simultaneous implantation group and the staged implantation group, with 70 cases in each group. Basic information about the children and their parents was collected using a general information questionnaire. The children’s quality of life was assessed using the deaf children’s quality of life scale (DCQOL). Results The scores in physiological function, emotional function, social function, the common module for disabled children, the specific module for hearing-impaired children, and the total DCQOL score of the simultaneous implantation group were significantly higher than those of the staged implantation group (P<0.05). No significant difference was observed between the two groups in the role function dimension (P>0.05). Age segmentation showed that there was only an intergroup difference in the specific module and total score for hearing-impaired children between the two groups of 5-7 children. Children aged ≥ 8 who underwent simultaneous implantation in all dimensions were significantly better than those who underwent staged implantation (P<0.05). Conclusions Simultaneous BCI is generally superior to staged BCI in improving the quality of life of hearing-impaired children, with particularly comprehensive benefits observed in children aged 8 years and above. Clinically, BCI can be given priority, and systematic postoperative rehabilitation training should be emphasized.