健保給付人工電子耳時代的評估利器（言語感知評估）兼論國、內外兒童人工電子耳植入的適應症

在1980年代第一代人工電子耳上市後，經過40年的技術演進，現今人工電子耳的技術日漸成熟。隨著植入體及外部語音處理器的更新，人工電子耳能使植入者有更佳的語音辨識能力，大幅改善聽力損失者的生活。因此也越來越多聽力損失者在助聽器等傳統方式效益不佳時，會選擇人工電子耳植入為解決方案，人工電子耳候選人的適用標準也逐漸放寬。然而，人工電子耳並非萬靈丹，在開刀植入之外，也要藉由專業人員提供術前諮詢和術後調頻與復健的服務，加上聽力損失者、家庭成員與不同專業人員角色間的相互合作，才能夠使人工電子耳達到最佳成效。近來聽力損失兒童植入人工電子耳的益處被廣為討論，研究發現植入人工電子耳兒童在接受適當療育後，能有接近正常兒童的學習表現，但人工電子耳仍舊有其限制，需在多方考量後才能手術植入。因此本文將會回顧國內、外兒童植入人工電子耳的影響因子與植入標準，並進一步探討電子耳的植入與成效的評估利器—言語感知評估。

關鍵字

言語感知評估測驗；人工電子耳

並列摘要

Since the 1980s, cochlear implants offer people with profound hearing loss opportunities to restore hearing. In the past forty years, the technology of cochlear implants has been advanced with slimmer electrode arrays and multifunctional processors. Cochlear implant users therefore perform better in speech perception in various listening conditions. In addition, the candidacy criteria have also become flexible in recent years. However, cochlear implants may not be the best solution for everyone. In fact, careful and comprehensive evaluation before implantation and ongoing dedicated rehabilitation after are two crucial factors successful outcome. Teamwork includes not only the transdisciplinary professionals and the cochlear implant user, but also the family members. Moreover, the benefits of cochlear implantation for children with hearing loss have also been widely discussed. Studies indicated that children with hearing loss who are supported by proper intervention can achieve comparable performance to their normal hearing peers. However, there are still many limitations of cochlear implants, and many considerations are necessary before implantation. This article reviews the influencing factors and candidacy criteria of cochlear implants for children, as well as discusses speech perception assessments, critical tools for evaluating cochlear implant prognosis.

並列關鍵字

Speech audiometry ； Cochlear implants

參考文獻

楊惠美、吳俊良（2005）。學齡前兒童中文語彙毗鄰測驗的編製與驗證。台灣耳鼻喉頭頸外科雜誌，40，1-12。doi:10.6286/2005.40.1.1

De Raeve, L., & Wouters, A. (2013). Accessibility to cochlear implants in Belgium: State of the art on selection, reimbursement, habilitation, and outcomes in children and adults. Cochlear Implants International, 14(Suppl. 1), S18-S25. doi:10.1179/1467010013Z.00000000078

Entwisle, L. K., Warren, S. E., & Messersmith, J. J. (2018). Cochlear implantation for children and adults with severe-to-profound hearing loss. Seminars in Hearing, 39, 390-404. doi:10.1055/s-0038-1670705

Hogan, S., Stokes, J., White, C., Tyszkiewicz, E., & Woolgar, A. (2008). An evaluation of auditory verbal therapy using the rate of early language development as an outcome measure. Deafness & Education International, 10, 143-167. doi:10.1179/146431508790559760

Kirk, K. I., Pisoni, D. B., & Osberger, M. J. (1995). Lexical effects on spoken word recognition by pediatric cochlear implant users. Ear and Hearing, 16, 470-481. doi:10.1097/00003446-199510000-00004

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健保給付人工電子耳時代的評估利器（言語感知評估）兼論國、內外兒童人工電子耳植入的適應症

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