老年听障患者人工耳蜗植入临床问题探讨（Ⅱ）——术后早期管理与开机调试策略

林以鹏; 高珊仙; 张丽娜; 刘天翊; 梁爽; 梁巍; 银力

doi:10.3969/j.issn.1672-4933.2026.05.021

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老年听障患者人工耳蜗植入临床问题探讨（Ⅱ）——术后早期管理与开机调试策略

继续教育 | 更新时间：2026-10-08

- 老年听障患者人工耳蜗植入临床问题探讨（Ⅱ）——术后早期管理与开机调试策略
- Clinical Issues in Cochlear Implantation for Elderly Patients with Hearing Loss (Part Ⅱ): Early Postoperative Management and Individualized Mapping Strategies
- 中国听力语言康复科学杂志 2026年24卷第5期页码：555-560
- 作者机构：
  
  1.东南大学生物科学与医学工程学院南京 210000
  2.浙江诺尔康神经电子科技股份有限公司杭州 311100
  3.全省智能康复与神经电子转化重点实验室杭州 311100
  4.杭州市余杭区启航公益服务中心杭州 311100
  5.杭州未来科技城医院杭州 311100
  6.中国听力语言康复研究中心北京 100028
- 作者简介：
  
  林以鹏博士工程师；研究方向：人工耳蜗应用
  银力，E-mail：yinli@nurotron.com
- 基金信息：
  
  全省智能康复与神经电子转化重点实验室(2024E10108)
- DOI：10.3969/j.issn.1672-4933.2026.05.021
  中图分类号： R764.5
- 收稿：2026-06-29，
  
  修回：2026-07-28，
  
  录用：2026-08-15，
  
  纸质出版：2026-09-15
- 稿件说明：
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林以鹏,高珊仙,张丽娜等.老年听障患者人工耳蜗植入临床问题探讨（Ⅱ）——术后早期管理与开机调试策略[J].中国听力语言康复科学杂志,2026,24(05):555-560.

LIN Yi-peng,GAO Shan-xian,ZHANG Li-na,et al.Clinical Issues in Cochlear Implantation for Elderly Patients with Hearing Loss (Part Ⅱ): Early Postoperative Management and Individualized Mapping Strategies[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(05):555-560.
林以鹏,高珊仙,张丽娜等.老年听障患者人工耳蜗植入临床问题探讨（Ⅱ）——术后早期管理与开机调试策略[J].中国听力语言康复科学杂志,2026,24(05):555-560. DOI： 10.3969/j.issn.1672-4933.2026.05.021.

LIN Yi-peng,GAO Shan-xian,ZHANG Li-na,et al.Clinical Issues in Cochlear Implantation for Elderly Patients with Hearing Loss (Part Ⅱ): Early Postoperative Management and Individualized Mapping Strategies[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(05):555-560. DOI： 10.3969/j.issn.1672-4933.2026.05.021.

摘要

随着人口老龄化进程加快，老年语后聋患者人工耳蜗植入需求逐渐增加。对于老年患者而言，人工耳蜗植入后的早期管理是影响后续长期听觉获益和生活质量改善的重要环节。相较于儿童及中青年患者，老年人工耳蜗植入者常存在前庭代偿能力下降、耳鸣发生率高、听觉剥夺时间长、声音适应慢、合并基础疾病多、认知及操作能力减退、心理适应困难和康复依从性差异大等特点，使其术后早期管理更具复杂性。本文作为系列综述的中篇，结合临床实践与相关研究，围绕老年耳聋患者人工耳蜗植入后的术后早期管理、耳鸣评估、耳聋持续时间对康复预期的影响、开机调试策略及心理支持干预等问题进行系统梳理。术后眩晕与平衡障碍可影响患者早期康复并增加跌倒风险，应重视风险评估、早期识别和前庭康复干预；耳鸣是老年听力损失患者常见伴随症状，人工耳蜗植入后多数患者耳鸣困扰可能获得一定缓解，但仍需避免将其简单视为耳鸣治疗手段；耳聋持续时间是影响术后言语识别康复信心的重要因素，应纳入康复目标设定和预期管理；开机调试应遵循个体化、循序渐进和动态优化原则，在保证舒适佩戴的基础上逐步提高听觉输入质量；心理支持和同伴交流有助于缓解患者焦虑、失望和康复信心不足。本文旨在为老年人工耳蜗植入者术后早期管理和听觉康复提供参考。

Abstract

With the acceleration of aging population

the demand for cochlear implantation in elderly patients with postlingual deafness is gradually increasing. For elderly patients

early postoperative management after cochlear implantation is a critical factor influencing long-term auditory benefit and quality of life. Compared with children and younger adults

elderly cochlear implant users often present with reduced vestibular compensation

a higher prevalence of tinnitus

a longer duration of auditory deprivation

slower adaptation to electrical hearing

multiple comorbidities

decreased cognitive and operational abilities

psychological adjustment difficulties

and variable rehabilitation adherence

making early postoperative management more complex. As Part Ⅱ of this review series

this article systematically summarizes key clinical issues in early postoperative management after cochlear implantation in elderly patients with hearing loss

including postoperative dizziness and balance disorders

tinnitus assessment

the impact of duration of deafness on rehabilitation prognosis and expectation management

initial activation and mapping strategies

and psychological support interventions. This review indicates that postoperative dizziness and balance disorders may affect early recovery and increase the risk of falls

highlighting the importance of risk assessment

early identification

and vestibular rehabilitation. Tinnitus is a common accompanying symptom in elderly patients with hearing loss

and tinnitus-related distress may be alleviated in many patients after cochlear implantation; however

cochlear implantation should not be simply presented as a specific treatment for tinnitus. The Duration of deafness is an important factor affecting postoperative speech recognition recovery and rehabilitation confidence

and should be incorporated into rehabilitation goal setting and expectation management. Initial activation and mapping should follow individualized

stepwise

and dynamic optimization principles

with gradual improvement of auditory input quality on the basis of comfortable device use. Psychological support and peer communication may help relieve anxiety

disappointment

and lack of rehabilitation confidence. This review aims to provide a practical reference for early postoperative management and initiation of auditory rehabilitation in elderly cochlear implant users.

关键词

Keywords

references

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