大龄语前聋患者双侧人工耳蜗植入与双模式干预效果分析

朱冰冰; 张利

doi:10.3969/j.issn.1672-4933.2026.04.017

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大龄语前聋患者双侧人工耳蜗植入与双模式干预效果分析

康复教育 | 更新时间：2026-09-22

- 大龄语前聋患者双侧人工耳蜗植入与双模式干预效果分析
- Analysis of the Effect of Bilateral Cochlear Implantation and Bimodal Stimulation in Later-implanted Patients with Prelingual Deafness
- 中国听力语言康复科学杂志 2026年24卷第4期页码：416-420
- 作者机构：
  
  合肥京东方医院耳鼻喉科合肥 230013
- 作者简介：
  
  朱冰冰本科主治医师；研究方向：耳显微外科，E-mail：1304216354@qq.com
- 基金信息：
- DOI：10.3969/j.issn.1672-4933.2026.04.017
  中图分类号： G762
- 收稿：2025-01-02，
  
  修回：2025-03-15，
  
  录用：2025-03-21，
  
  纸质出版：2026-07-15
- 稿件说明：
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朱冰冰,张利.大龄语前聋患者双侧人工耳蜗植入与双模式干预效果分析[J].中国听力语言康复科学杂志,2026,24(04):416-420.

ZHU Bing-bing,ZHANG Li.Analysis of the Effect of Bilateral Cochlear Implantation and Bimodal Stimulation in Later-implanted Patients with Prelingual Deafness[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(04):416-420.
朱冰冰,张利.大龄语前聋患者双侧人工耳蜗植入与双模式干预效果分析[J].中国听力语言康复科学杂志,2026,24(04):416-420. DOI： 10.3969/j.issn.1672-4933.2026.04.017.

ZHU Bing-bing,ZHANG Li.Analysis of the Effect of Bilateral Cochlear Implantation and Bimodal Stimulation in Later-implanted Patients with Prelingual Deafness[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(04):416-420. DOI： 10.3969/j.issn.1672-4933.2026.04.017.

摘要

目的

比较大龄语前聋患者双侧人工耳蜗植入与双模式干预后听觉言语能力及生活质量的康复效果，分析不同年龄段患者的干预效果差异。

方法

回顾性收集本院106例大龄语前聋患者，根据干预方式分为双侧人工耳蜗植入组（A组，56例）和双模式干预组（B组，50例），所有患者均于术前、术后1、3、6和12个月完成听觉行为分级量表（CAP）和言语可懂度量表（SIR），并于术后1年评估患者生活质量，比较两组患者评估结果。按照年龄将患者分为学龄组（7～13岁）和少年组+成人组（≥14岁），对2组干预效果进行分层比较。

结果

B组在术后1个月及3个月的CAP及SIR分级优于A组（

0.05），两组术后6个月、12个月CAP、SIR分级及术后1年生活质量无显著差异（

0.05）。年龄分层分析显示，学龄组患者双模式干预术后早期（1个月、3个月）听觉及言语能力改善具有明显优势（

0.05），术后1年部分生活质量维度表现出更好的改善效果；而在少年组及成人组患者中，两种干预方式在听觉言语能力及生活质量方面的改善效果差异不明显（

0.05）。

结论

双模式干预在大龄语前聋患者中具有良好的临床应用价值，其优势在学龄期患者中更明显。年龄因素可能影响干预效果的获益模式，在制订个体化听觉康复策略时应予以充分考虑。

Abstract

Objective

To compare the rehabilitation outcomes of auditory performance

speech intelligibility

and quality of life between bilateral cochlear implantation and bimodal intervention in older prelingually deaf patients

and to analyze differences in intervention effects across different age groups.

Methods

106 older prelingually deaf patients treated at our institution were retrospectively enrolled and divided according to the intervention strategy into Group A (bilateral cochlear implantation

=56) and group B (bimodal intervention

n=50). All the patients completed the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) assessments preoperatively and at 1

and 12 months postoperatively. Quality of life was evaluated at 1 year after surgery. The outcomes were compared between the two groups. Additionally

the patients were stratified by age into a school-age group (7-13 years) and an adolescent plus adult group (≥14 years) for

subgroup analysis of intervention effects.

Results

Group B showed significantly higher CAP and SIR scores than Group A at 1 and 3 months postoperatively (all

0.05). However

no significant differences were observed between the two groups in CAP and SIR scores at 6 and 12 months postoperatively

nor in quality-of-life scores at 1 year (all

0.05). Age-stratified analysis revealed that in the school-age group

bimodal intervention was associated with more pronounced improvements in auditory and speech abilities during the early postoperative period (1 and 3 months; all

0.05) and better outcomes in selected quality-of-life domains at 1 year. In contrast

among adolescent and adult patients

no significant differences were observed between the two intervention strategies in terms of auditory performance

speech intelligibility

or quality of life (all

0.05).

Conclusion

Bimodal intervention demonstrates favorable clinical efficacy in older prelingually deaf patients

with more pronounced benefits observed in school-age individuals. Age may influence the pattern of benefit from auditory rehabilitation

and should be carefully considered when formulating individualized rehabilitation strategies.

关键词

Keywords

references

王硕 , 李永新 . 人工耳蜗植入治疗重度感音神经性耳聋的研究进展 [J ] . 中华耳科学杂志 , 2022 , 20 ( 4 ): 602 - 607 .

Gifford RH . Bilateral cochlear implants or bimodal hearing for patients with bilateral sensorineural hearing loss [J ] . Curr Opin Otolaryngol Head Neck Surg , 2021 , 29 ( 5 ): 387 - 392 .

中华医学会耳鼻咽喉头颈外科学分会 . 人工耳蜗植入工作指南(2013) [J ] . 中华耳鼻咽喉头颈外科杂志 , 2014 , 49 ( 2 ): 89 - 95 .

孙喜斌 , 于丽玫 , 曲成毅 , 等 . 中国听力残疾构成特点及康复对策 [J ] . 中国听力语言康复科学杂志 , 2008 , 6 ( 2 ): 21 - 24 .

陶仁霞 , 卫仁涛 , 李永勤 , 等 . 双耳双模式调试策略研究进展 [J ] . 中华耳科学杂志 , 2019 , 17 ( 6 ): 973 - 977 .

Lotfi Y , Hasanalifard M , Moossavi A , et al . Binaural hearing advantages for children with bimodal fitting [J ] . Int J Pediatr Otorhinolaryngol , 2019 , 121 : 58 - 63 .

Sturm JJ , Kuhlmey M , Alexiades G , et al . Comparison of speech performance in bimodal versus bilateral cochlear implant users [J ] . Laryngoscope , 2021 , 131 ( 4 ): E1322 - E1327 .

Long Y , Wang W , Liu J , et al . Comparison of sound localisation ability in bimodal versus bilateral cochlear implant users [J ] . J Laryngol Otol , 2025 , 139 ( 10 ): 918 - 922 .

Alfakhri M , Campbell N , Lineton B , et al . International survey of bimodal hearing and bilateral cochlear implant service provision [J ] . Cochlear Implants Int , 2024 , 25 ( 4 ): 260 - 274 .

贾慧 , 徐百成 , 边盼盼 , 等 . 双耳双模式聆听与双侧人工耳蜗植入研究进展 [J ] . 中华耳科学杂志 , 2021 , 19 ( 4 ): 658 - 661 .

Alfakhri M , Campbell N , Lineton B , et al . Integrated bimodal fitting and binaural streaming technology outcomes for unilateral cochlear implant users [J ] . Int J Audiol , 2025 , 64 ( 3 ): 243 - 252 .

Archbold S , Lutman ME , Marshall DH . Categories of Auditory Performance [J ] . Ann Otol Rhinol Laryngol Suppl , 1995 , 166 : 312 - 314 .

Allen MC , Nikolopoulos TP , O'Donoghue GM . Speech intelligibility in children after cochlear implantation [J ] . Am J Otol , 1998 , 19 ( 6 ): 742 - 746 .

瑞娟 , 刘博 , 彭晓霞 , 等 . Nijmegen人工耳蜗植入量表中文版信度和效度评价 [J ] . 中华耳鼻咽喉头颈外科杂志 , 2010 , 45 ( 10 ): 6 - 6 .

黄玮津 , 余乐茵 , 蔡颖琳 , 等 . 不同干预模式听觉言语康复效果比较 [J ] . 中国听力语言康复科学杂志 , 2021 , 19 ( 3 ): 215 - 218 .

Xu L , Luo J , Wang M , et al . Vocabulary Growth in Mandarin-Speaking Children With Bilateral Cochlear Implants, Bimodal Stimulation, or Unilateral Cochlear Implants During the First Year After Activation [J ] . J Speech Lang Hear Res , 2022 , 65 ( 4 ): 1630 - 1645 .

Gifford RH . Bilateral Cochlear Implants or Bimodal Hearing for Children with Bilateral Sensorineural Hearing Loss [J ] . Curr Otorhinolaryngol Rep , 2020 , 8 ( 4 ): 385 - 394 .

López-Torrijo M , Mengual-Andrés S , Estellés-Ferrer R . Clinical and logopaedic results of simultaneous and sequential bilateral implants in children with severe and/or profound bilateral sensorineural hearing loss: A literature review [J ] . Int J Pediatr Otorhinolaryngol , 2015 , 79 ( 6 ): 786 - 792 .

Deep NL , Green JE , Chen S , et al . From Bimodal Hearing to Sequential Bilateral Cochlear Implantation in Children-A Within-Subject Comparison [J ] . Otol Neurotol , 2020 , 41 ( 6 ): 767 - 774 .

Yawn RJ , O'Connell BP , Dwyer RT , et al . Bilateral Cochlear Implantation Versus Bimodal Hearing in Patients With Functional Residual Hearing: A Within-subjects Comparison of Audiologic Performance and Quality of Life [J ] . Otol Neurotol , 2018 , 39 ( 4 ): 422 - 427 .

Gifford RH , Driscoll CL , Davis TJ , et al . A Within-Subject Comparison of Bimodal Hearing, Bilateral Cochlear Implantation, and Bilateral Cochlear Implantation With Bilateral Hearing Preservation: High-Performing Patients [J ] . Otol Neurotol , 2015 , 36 ( 8 ): 1331 - 1337 .

Schafer EC , Amlani AM , Paiva D , et al . A meta-analysis to compare speech recognition in noise with bilateral cochlear implants and bimodal stimulation [J ] . Int J Audiol , 2011 , 50 ( 12 ): 871 - 880 .

Kokkinakis K , Pak N . Binaural advantages in users of bimodal and bilateral cochlear implant devices [J ] . J Acoust Soc Am , 2014 , 135 ( 1 ): El47 - 53 .

刘贤霖 , 冯永 , 陈红胜 , 等 . 大龄语前聋患者人工耳蜗植入术后长期康复效果分析 [J ] . 中华耳科学杂志 , 2018 , 16 ( 6 ): 791 - 796 .

吴海娟 , 李同利 , 李国栋 , 等 . 大龄语前聋患者人工耳蜗植入术后康复效果分析 [J ] . 临床耳鼻咽喉头颈外科杂志 , 2023 , 37 ( 6 ): 478 - 482 .

Gifford RH , Driscoll CL . Bimodal hearing and bilateral cochlear implantation:clinical considerations and outcomes [J ] . Curr Opin Otolaryngol Head Neck Surg , 2020 , 28 ( 5 ): 399 - 405 .

Yawn RJ , O'Connell BP , Dwyer RT , et al . Bilateral cochlear implantation versus bimodal hearing in patients with residual hearing [J ] . Otol Neurotol , 2021 , 42 ( 3 ): 356 - 363 .

Carlson ML , Driscoll CL , Gifford RH , et al . Implications of residual hearing in cochlear implantation [J ] . Laryngoscope Investigative Otolaryngology , 2021 , 6 ( 4 ): 708 - 716 .

Ching TYC , Dillon H , Hou S , et al . Factors influencing bimodal benefit in cochlear implant users [J ] . Ear Hear , 2021 , 42 ( 4 ): 889 - 902 .

Baron S , Blanchard M , Parodi M , et al . Sequential bilateral cochlear implants in children and adolescents: Outcomes and prognostic factors [J ] . Eur Ann Otorhinolaryngol Head Neck Dis , 2019 , 136 ( 2 ): 69 - 73 .

Peters BR , Wyss J , Manrique M . Worldwide trends in bilateral cochlear implantation [J ] . Laryngoscope , 2020 , 130 ( S2 ): S17 - S44 .

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