Stark T, Engel A, Borkowski G
Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie der Ruhr-Universität Bochum, Germany.
Laryngorhinootologie. 2004 Jan;83(1):20-2. doi: 10.1055/s-2004-814097.
The effectiveness of cochlear implants in profoundly deaf patients could be demonstrated in the last years. One of the problems of these patients is the decreased speech understanding in noise. Therefore bilateral cochlear implantation seems to be obvious. Another problem of unilateral cochlear implantation is to predict the better side for implantation concerning speech understanding. Only a few factors seem to help for the choice of the side for implantation. One of these is duration of deafness. In other studies short duration of deafness is a significant predictor of good word recognition. We present a case of a deaf patient with a time gap of 23 years for deafness between both ears. The patient underwent bilateral cochlear implantation (Med-el Combi 40+) as one stage procedure. After activation of the speech processor he shows better speech understanding on that ear, which is deaf for more than 25 years. In addition he has further improvement of speech understanding in noise by using both implants compared to one. In unilateral cochlear implantation selection of the side might still be difficult. In bilateral cochlear implantation the better side is always implanted, which is an other advantage of bilateral cochlear implantation.
近年来已证实人工耳蜗对极重度聋患者的有效性。这些患者面临的问题之一是在噪声环境中言语理解能力下降。因此，双侧人工耳蜗植入似乎是显而易见的选择。单侧人工耳蜗植入的另一个问题是，就言语理解而言，难以预测哪一侧植入效果更佳。似乎只有少数因素有助于选择植入侧。其中一个因素是耳聋持续时间。在其他研究中，耳聋持续时间短是单词识别良好的重要预测指标。我们报告一例双耳耳聋时间间隔为23年的聋患者。该患者作为一期手术接受了双侧人工耳蜗植入（Med-el Combi 40+）。在言语处理器开启后，他在耳聋超过25年的那只耳朵上表现出更好的言语理解能力。此外，与单侧植入相比，使用双侧植入时他在噪声环境中的言语理解能力有进一步提高。在单侧人工耳蜗植入中，选择植入侧可能仍然困难。在双侧人工耳蜗植入中，总是植入效果更佳的一侧，这也是双侧人工耳蜗植入的另一个优势。
