Cochlear implantation for prelinguistic deaf patients with central nervous system diseases

Abstract

Objective To investigate the preoperative evaluation methods of multi-channel cochlear implantation in prelinguistic deaf patients with central nervous system diseases,and explore the outcomes of speech rehabilitation.Methods Multi-channel cochlear implantation was conducted in 23 prelinguistic deaf patients with central nervous system diseases,admitted to our hospital from January 1996 to January 2009.Of the 23 patients,13 had white matter abnormalities,4 pallium dysplasia,2 hydrocephalus,2 congenital temporal lobe cyst,1 Tourette syndrome and 1 Down's syndrome.Another 30 prelinguistic deaf patients without central nervous diseases and performed cochlear implantation at the same period were chosen as control group.Preoperative hearing and imaging data,developmental assessments,implantation methods and postoperative outcomes of patients from these two groups were compared.Results These 23 patients were reconstructed hearing successfully after cochlear implantation without serious complications; postoperative mean thresholds in sound field 6 months after the surgery were (42.89±3.5) dBHL,which were significantly higher than those in control group ([32.4±4.5] dBHL,P＜0.05); the mean value of speech discrimination rate in close-set word list one year after the surgery was (65.18 ±3.1)％,which was significantly lower than that in control group ([81.63±3.7]％,P＜0.05).Outcomes of hearing-speech rehabilitation were good,but the patients with serious white matter abnormalities and pallium dysplasia had a lower hearing-speech rehabilitation rate than the other patients.Conclusion Cochlear implantation can be performed safely and effectively in patients with central nervous diseases after comprehensive pre-operative imaging and audiological evaluation are performed;type and severity of the central diseases can affect postoperative rehabilitation. Key words: Cochlear implantation; Central nervous disease; Rehabilitation