[Long-term hearing outcomes of children with cochlear implant].

Objective:To investigate the long-term rehabilitation outcomes of children with cochlear implants（CI） and provide constructive guidance for clinical application. Methods:Fifteen children with unilateral CI over 5 years（CI group） were recruited. Ten children with normal hearing were recruited as the healthy control group. The project collected aided sound-field hearing thresholds and speech recognition scores using disyllabic words and C-HINT sentences with and without speech noise for 15 children with unilateral CI. In addition, children's guardians were requested to fill out the Mandarin Parental Perspectives questionnaire（MPP） in order to evaluate the hearing aspects of quality of life. MPP results from the 15 children were then compared with previous responses from 17 unilateral CI children whose overall CI wearing time was one year（CI control group）. Results:The aided pure-tone average（PTA） of the recruited children was below 35 dB HL, all children reached 80% for the speech recognition test in a quiet environment, yet their performance decreased in a noisy environment. Regarding the hearing aspects of the MPP questionnaire results, recruited children demonstrated better results than those from CI control group（P<0.05）. Speech noise had a significant impact on the recognition rate, and the CI group had higher recognition rate scores in the quiet environment than in the noise environment（two-syllable words t=18.81, P<0.001, short sentences t=16.48, P<0.001）. In the comparison of quality of life, in the dimension of "support for children", both the CI group and the CI control group can obtain better benefits, and there is no statistically significant difference between the groups（P>0.05）. The CI group benefited more significantly, and the scores were higher than those of the CI control group（P<0.05）. Conclusion:The long-term hearing outcome of children with CI is adequate for daily communication, but there is still a gap compared with hearing children of the same age, and they still need support from the entire society.

[Effect of cochlear implantation on speech recognition under different listening modes in children].

Objective:To investigate speech recognition among children with a unilateral cochlear implant（CI）, bilateral CI, and bimodal hearing and identify the benefits of binaural hearing. Methods:A total of 67 children with severe sensorineural hearing loss who received bilateral CI, bimodal hearing, and unilateral CI from 2012 to 2021 were recruited, including 23 cases with unilateral CI, 25 cases of bimodal hearing, and 19 cases of bilateral CI. The aided hearing threshold at 250-4000 Hz and speech recognition performance of two-syllable words and short sentences in quiet and noisy environments were tested, respectively. Results:There was no significant difference in the hearing threshold results of the bilateral CI group, the bimodal hearing group, and the unilateral CI group by ANOVA（P>0.05）. According to the paired t-test within the group, the speech recognition of disyllabic words and short sentences in quiet and noisy environments were significantly different among the three groups（P<0.05）. There was no significant difference in the speech recognition rates of disyllabic words and short sentences among the three groups in a quiet environment（P>0.05）, but there was a statistically significant difference in a noisy environment（P<0.05）. Additional multiple linear regression analysis showed no significant difference in the recognition rates of disyllabic words and short sentences between the bimodal group and the bilateral CI group in quiet and noisy environments（ß=-0.567, P>0.05; ß=-0.643, P>0.05）. There was a statistically significant difference in speech recognition of disyllabic words and short sentences between the bimodal group and the unilateral CI group in the noise environment（ß=-0.124, P<0.05）, but the difference was not statistically significant in a quiet environment（ß=-0.671, P>0.05）; there was a statistically significant difference in the recognition rate of disyllabic words and short sentences between the bilateral CI group and the unilateral CI group in the noise environment（ß=-0.226, P<0.05）, but the difference was not statistically significant in a quiet environment（ß=-0.341, P>0.05）. Conclusion:Clinicians and guardians are encouraged to provide the most comprehensive audiological evaluation for children with hearing loss. Bilateral CI and bimodal hearing have demonstrated enormous advantages over unilateral CI regarding speech recognition in noise. Bimodal hearing deems a strong recommendation if the contralateral ear has sufficient speech recognition capability. Bilateral CI should be warranted if hearing aids deemed to be ineffective.