Ching T Y C, van Wanrooy E, Dillon H
National Acoustic Laboratories, Chatswood, New South Wales, Australia.
Trends Amplif. 2007 Sep;11(3):161-92. doi: 10.1177/1084713807304357.
There are now many recipients of unilateral cochlear implants who have usable residual hearing in the non-implanted ear. To avoid auditory deprivation and to provide binaural hearing, a hearing aid or a second cochlear implant can be fitted to that ear. This article addresses the question of whether better binaural hearing can be achieved with binaural/bimodal fitting (combining a cochlear implant and a hearing aid in opposite ears) or bilateral implantation. In the first part of this article, the rationale for providing binaural hearing is examined. In the second part, the literature on the relative efficacy of binaural/bimodal fitting and bilateral implantation is reviewed. Most studies on comparing either mode of bilateral stimulation with unilateral implantation reported some binaural benefits in some test conditions on average but revealed that some individuals benefited, whereas others did not. There were no controlled comparisons between binaural/bimodal fitting and bilateral implantation and no evidence to support the efficacy of one mode over the other. In the third part of the article, a crossover trial of two adults who had binaural/bimodal fitting and who subsequently received a second implant is reported. The findings at 6 and 12 months after they received their second implant indicated that binaural function developed over time, and the extent of benefit depended on which abilities were assessed for the individual. In the fourth and final parts of the article, clinical issues relating to candidacy for binaural/ bimodal fitting and strategies for bimodal fitting are discussed with implications for future research.
现在有许多单侧人工耳蜗植入者在未植入的耳朵中仍有可用的残余听力。为了避免听觉剥夺并提供双耳听力，可以为该耳佩戴助听器或植入第二个人工耳蜗。本文探讨了通过双耳/双模式适配（在双耳中分别植入人工耳蜗和佩戴助听器）或双侧植入是否能获得更好的双耳听力这一问题。在本文的第一部分，研究了提供双耳听力的基本原理。在第二部分，回顾了关于双耳/双模式适配和双侧植入相对疗效的文献。大多数比较双侧刺激的任何一种模式与单侧植入的研究平均报告了在某些测试条件下的一些双耳益处，但也表明一些个体受益，而另一些则没有。双耳/双模式适配和双侧植入之间没有对照比较，也没有证据支持一种模式比另一种模式更有效。在本文的第三部分，报告了一项对两名进行了双耳/双模式适配并随后接受了第二次植入的成年人的交叉试验。他们接受第二次植入后6个月和12个月的结果表明，双耳功能会随着时间发展，受益程度取决于对个体评估的能力。在本文的第四部分也是最后一部分，讨论了与双耳/双模式适配的候选资格相关的临床问题以及双模式适配策略，并对未来研究具有启示意义。
