台灣成人電子耳植入者之使用現況調查

A Questionnaire Survey on Adult Cochlear Implant Users in Taiwan

10.6143/JSLHAT.2009.01.02

劉樹玉(Shu-Yu Liu)；劉俊榮(Chun-Jung Liu)；王南梅(Nan-Mai Wang)；郭于靚(Yu-Ching Kuo)；黃國祐(Kuo-You Huang)

電子耳 ； 聽覺障礙 ； 成人 ； 聽力損失 ； 電子耳使用現況 ； Cochlear implantation ； Hearing impairment ； Adults ； Questionnaire ； Device usage

台灣聽力語言學會雜誌

22期（2009 / 01 / 01）

25 - 53

繁體中文

台灣自1990年左右引進電子耳植入術至今已18年，估計約有400位重度至極重度聽覺障礙的成人個案，但卻很少研究提及這些個案的使用狀況以及使用者對電子耳的主觀評價。故本研究的主要目的在於透過收集聽障成人電子耳植入者的個人背景、使用狀況、儀器操作與維護、補助金額與來源等，進行整理分析，以便瞭解其使用現況，同時對電子耳相關政策提出建言。研究工具為研究小組自行設計的電子耳使用狀況問卷，問卷發放有直接寄發與電子耳中心代為發放兩種方式，共發出223份問卷，回收61份，回收率為27.35%。個案年齡範圍為18至75歲，其中73.8%的填答者在40歲以下，23名在職(40.4%)，19名(33.3%)在學，14名(24.56%)無業。以下就CI使用情形、自覺聽覺困難的程度、使用口語溝通的百分比、以及植入CI是否正確等面向分別描述之。三分之二的人自述經常且持續的使用電子耳，每日使用時數超過8小時的也佔了75%；40名患者(70%)認為植入後沒有聽覺困難或僅有輕微困難；使用口語溝通的人數百分比從術前的34人(55.74%)增加至術後的44人(72.13%0；大多數(80%)的個案認為電子耳植入對他們而言是一項正確的決定，有2人(3.28%)則認為植入電子耳是非常不正確的決定。整體而言，大多數的成人植入者對於電子耳有正面的評價，唯個體間差異極大。本研究結果顯示電子耳植入者的自我陳述與使用狀況調查，不僅可提供聽障成人、醫師、聽覺專業人員第一手的寶貴資料，也可作為政府在擬定電子耳相關政策時的參考依據。

It is estimated about 400 adults with severe-to-profound hearing impairment in Taiwan have received cochlear implantation since 1990. However, few studies have been done on the daily use of cochlear implant (CI) and subjective evaluation by implantees. The aim of this study was to conduct a questionnaire survey on adult CI users so as to obtain crucial information including demographic data, device usage, maintenance and expense, funding, and comments on government policy of CI. Around 200 questionnaires were sent to CI recipients through several medical centers and 61 questionnaires were returned. The majority of these CI users (73.77%) are young adults, aged between 18 and 40. While 23 patients (40.4%) were employed and 19 (33.3%) were at school, 14 (24.56%) were unemployed. Two-third of them used their devices more than 8 hours every day. 40 patients (70%) reported that they had little or no hearing difficulty in daily listening situation. The percentage of using oral communication had increased from 55.7% to 72.1% after implantation. Most implant users stated that receiving a CI was a correct decision. In conclusion, the results showed that adult CI users perceived significant benefit from their implants. The results of self report by CI users also provided valuable information for those considering cochlear implantation, surgeons, hearing professionals, and the government policy makers.

1. Food and Drug Administration. (2007). US FDA/CDRH: Cochlear implants-benefits and risks of cochlear implants. Retrieved July 15, 2008, from http://www.fda.gov/cdrh/cochlear/riskbenefit.html
2. 臺北市政府社會局（2008）。97年度身心障礙者人工電子耳補助計畫。2008年7月12日，檢自http://www.dosw.tcg.gov.tw/dn.asp?uid=8727
3. National Institute on Deafness and Other Communication Disorders. (2007). Cochlear implants. Retrieved July 15, 2008, from http://www.nidcd.nih.gov/health/hearing/coch.asp
4. 教育部統計處（ 2007 ）。台灣地區教育程度別失業率。2008 年7 月15 日， 檢自 http://140.111.34.54/statistics/content.aspx?site_content_sn=8956
5. 行政院主計處（2007）。九十五年人力運用調查報告（表54受雇就業者每月主要工作之收入──按教育程度分）。上網日期：2008年7月15日，檢自http://pda.dgbas.gov.tw/ct.asp?xItem=16732&ctNode=3580
6. Malcolm, A. (2001). A Report from the STC Special Needs Committee: The nature of deafness. Retrieved December 4, 2008, from http://www.fda.gov/cdrh/cochlear/riskbenefit.html
7. 行政院勞工委員會（2005）。九十四年台灣地區身心障礙者勞動狀況調查。上網日期：2008年7月15日，檢自http://statdb.cla.gov.tw/html/svy94/9405001.xls
8. Faber, C. E.,Grontved, A. M.(2000).Cochlear implantation and change in quality of life.Acta Oto-Laryngologica,120(1),151-153.
9. Hawthorne, G.,Hogan, A.,Giles, E.,Stewart, M.,Kethel, L.,White, K.(2004).Evaluating the health-related quality of life effects of cochlear implants: A prospective study of an adult cochlear implant program.International Journal of Audiology,43(4),183-192.
10. Hinderink, J. B.,Krabbe, P. F.,van den Broek, P.(2000).Development and application of a health-related quality-of-life instrument for adults with cochlear implants: The Nijmegen cochlear implant questionnaire.Otolaryngology-Head and Neck Surgery,123(6),756-65.
11. Hogan, A.(1997).Implant outcomes: Towards a mixed methodology for evaluating the efficacy of adult cochlear implant programs.Disability and Rehabilitation,19(6),235-243.
12. Krueger, B.,Joseph, G.,Rost, U.,Strauß-Schier, A.,Lenarz, T.,Buechner, A.(2008).Performance groups in adult cochlear implant users: Speech perception results from 1984 until today.Otology and Neurotology,29,509-512.
13. Lin, F. R.,Niparko, J. K.(2006).Measuring health-related quality of life after pediatric cochlear implantation: A systematic review.International Journal of Pediatric Otorhinolaryngology,70,1695-1706.
14. Munson, B.,Donaldson, G. S.,Allen, S. L.,Collison, E. A.,Nielson, D. A.(2003).Patterns of phoneme perception errors by listeners with cochlear implants as a function of overall speech perception ability.Journal of the Acoustical Society of America,113,925-935.
15. Nichols, Joanna(1996)。實施「聽覺口語法」教導我的極重度聽障孩子的成效。特殊教育季刊，59，38-44。
16. O''Donoghue, G. M.,Nikolopoulos, T. P.,Archbold, S. M.(2000).Determinants of speech perception in children after cochlear implantation.The Lancet,356,466-468.
17. Plyler, P. N.,Bahng, J.,van Hapsburg, D.(2008).The acceptance of background noise in adult cochlear implant users.Journal of Speech, Language, and Hearing Research,51,502-515.
18. Proops, D. W.,Donaldson, I.,Cooper, H. R.,Thomas, J.,Burrell, S. P.,Stoddart, R. L.(1999).Outcomes from adult implantation: The first 100 patients.Journal of Laryngology and Otology,113,5-13.
19. Rabinowitz, W. M.,Eddington, D. K.,Delhorne, L. A.,Cuneo, P. A.(1992).Relations among different measures of speech reception in subjects using a cochlear implants.Journal of Acoustical Society of America,92,1869-1881.
20. Sadato, N.,Yamada, H.,Okada, T.,Yoshida, M.,Hasegawa, T.,Matsuki, K. I.(2004).Age-dependent plasticity in the superior temporal sulcus in deaf humans: A functional MRI study.BMC Neuroscience,5(56)
21. Sarant, J. Z.,Blamey, P. J.,Dowell, R. C.,Clark, G. M.,Gibson, W. P. R.(2001).Variation in speech perception scores among children with cochlear implants.Ear and Hearing,22,18-28.
22. Skinner, M. W.,Fourakis, M. S.,Holden, T. A.,Holden, L. K.,Demorest, M. E.(1999).Identification of speech by cochlear implant recipients with the Multipeak (MPEAK) and Spectral Peak (SPEAK) speech coding strategies II: Consonants.Ear and Hearing,20,443-460.
23. Skinner, M. W.,Fourakis, M. S.,Holden, T. A.,Holden, L. K.,Demorest, M. E.(1996).Identification of speech by cochlear implant recipients with the Multipeak (MPEAK) and Spectral Peak (SPEAK) speech coding strategies: I. Vowels.Ear and Hearing,17,182-197.
24. Tateya, T.,Funabiki, K.,Naito, Y.,Fujiki, N.,Morita, T.(2000).Factors influencing satisfaction of cochlear implant users: A questionnaire-based study.Journal of the Oto-Rhino-Laryngological Society of Japan,103(12),1272-1280.
25. Tye-Murray, N.,Tyler, R. S.,Woodworth, G. G.,Gantz, B. J.(1992).Performance over time with a Nucleus or Ineraid cochlear implants.Ear and Hearing,13,200-209.
26. Tyler, R. S.,Kelsay, D.(1990).Advantages and disadvantages reported by some of the better cochlear-implant patients.American Journal of Otology,11(4),282-289.
27. Tyler, R. S.,Moore, B. C. J.(1992).Consonant recognition by some of the better cochlear-implant patients.Journal of the Acoustical Society of America,92,3068-3077.
28. Tyler, R.(ed.)(1993).Cochlear implants: Audiological foundations.San Diego:Singular.
29. Välimaa, T. T.,Määttä, T. K.,Löppönen, H. J.,Sorri, M. J.(2002).Phoneme recognition and confusions with multichannel cochlear implants: Consonants.Journal of Speech, Language, and Hearing Research,45,1055-1069.
30. van Dijk, J. E.,van Olphen, A. F.,Langereis, M. C.,Mens, L. H.,Brokx, J. P.,Smoorenburg, G. F.(1999).Predictors of cochlear implant performance.Audiology,38(2),109-116.
31. van Wieringen, A.,Wouters, J.(1999).Natural vowel and consonant recognition by Laura cochlear implantees.Ear and Hearing,20,89-103.
32. Wilson, B. S.,Finley, C. C.,Lawson, D. T.,Wolford, R. D.,Eddington, D. K.,Rabinowitz, W. M.(1991).Better speech recognition with cochlear implants.Nature,352,236-238.
33. Zwolan, T. A.,Kileny, P. R.,Telian, S. A.(1996).Self-report of cochlear implant use and satisfaction by prelingually deafened adults.Ear and Hearing,17,198-210.
34. 王南梅、劉樹玉、詹妍玲、黃俊生(1998)。人工電子耳兒童之聽知覺能力研究。聽語會刊，13，1-13。
35. 江俊明(2003)。促進聽覺障礙者就業策略。就業安全，2(2)，94-100。
36. 沈惠貞(2005)。碩士論文(碩士論文)。新莊市，私立輔仁大學社會工作學系。
37. 林永松、彭淑貞、張顯達(2002)。人工耳蝸植入兒童之國語輔音發音與聽辨。中華民國耳鼻喉科醫學雜誌，37(4)，250-258。
38. 林永松、廖學儒、饒啟明、李國玲、陳小娟(1995)。多頻道人工電子耳植入狀況的X光攝影評估。中華民國耳鼻喉科醫學雜誌，30(3)，216-224。
39. 林慧娟(2007)。碩士論文(碩士論文)。彰化市，國立彰化師範大學復健諮商研究所。
40. 林寶貴、韓福榮(1997)。台灣地區聽覺障礙者接受人工電子耳植入術現況及溝通能力研究。特殊教育研究學刊，15，131-149。
41. 張簡培崙、林永松(1999)。人工電子耳植入術對病童急性中耳炎之影響。中華民國耳鼻喉科醫學雜誌，34(1)，12-16。
42. 陳小娟(2000)。人工電子耳孩童聽覺說話長期發展之研究。特殊教育學報，14，65-92。
43. 陳小娟(1997)。三至八歲聽覺障礙兒童語音聽知覺接受力研究。特殊教育與復健學報，7，51-78。
44. 陳盈霖、黃為賢、黃俊生(1995)。本國兒童植入核式人工電子耳之結果─病例報告。中華民國耳鼻喉科醫學雜誌，30(6)，574-578。
45. 陸義發、劉樹玉、黃為賢、黃俊生(1996)。兩側植入不同人工電子耳之比較─病例報告。中華民國耳鼻喉科醫學雜誌，31(2)，178-184。
46. 黃俊生(1998)。三歲至八歲人工電子耳之綜合研究。生命科學簡訊，12(5)，3-6。
47. 黃鵬成、林永松(1997)。疑似Mondini Dysplasia內耳畸型的多頻道人工電子耳植入手術─病例報告。中華民國耳鼻喉科醫學雜誌，32(4)，434-438。
48. 羅文政、徐蔚基、劉樹玉、黃為賢、黃俊生(1998)。人工電子耳再植入術─病例報告。中華民國耳鼻喉科醫學雜誌，33(4)，368-374。
49. 饒啟明、麥至輝、呂建達、陳博立、許淇卿、萬永亮(1995)。耳蝸內電子耳術後一般X光攝影評估。中華民國放射線醫學雜誌，20(2)，139-145。

1. 萬宗綸(2021)。電子耳與「聽」的展演：社會語言學的取徑。科技醫療與社會，33，167-193。