Buss Emily, Pillsbury Harold C, Buchman Craig A, Pillsbury Carol H, Clark Marcia S, Haynes David S, Labadie Robert F, Amberg Susan, Roland Peter S, Kruger Pamela, Novak Michael A, Wirth Julie A, Black Jennifer M, Peters Robert, Lake Jennifer, Wackym P Ashley, Firszt Jill B, Wilson Blake S, Lawson Dewey T, Schatzer Reinhold, D'Haese Patrick S C, Barco Amy L
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599, USA.
Ear Hear. 2008 Jan;29(1):20-32. doi: 10.1097/AUD.0b013e31815d7467.
Binaural hearing has been shown to support better speech perception in normal-hearing listeners than can be achieved with monaural stimulus presentation, particularly under noisy listening conditions. The purpose of this study was to evaluate whether bilateral electrical stimulation could confer similar benefits for cochlear implant listeners.
A total of 26 postlingually deafened adult patients with short duration of deafness were implanted at five centers and followed up for 1 yr. Subjects received MED-EL COMBI 40+ devices bilaterally; in all but one case, implantation was performed in a single-stage surgery. Speech perception testing included CNC words in quiet and CUNY sentences in noise. Target speech was presented at the midline (0 degrees), and masking noise, when present, was presented at one of three simulated source locations along the azimuth (-90, 0, and +90 degrees).
Benefits of bilateral electrical stimulation were observed under conditions in which the speech and masker were spatially coincident and conditions in which they were spatially separated. Both the "head shadow" and "summation" effects were evident from the outset. Benefits consistent with "binaural squelch" were not reliably observed until 1 yr after implantation.
These results support a growing consensus that bilateral implantation provides functional benefits beyond those of unilateral implantation. Longitudinal data suggest that some aspects of binaural processing continue to develop up to 1 yr after implantation. The squelch effect, often reported as absent or rare in previous studies of bilateral cochlear implantation, was present for most subjects at the 1 yr measurement interval.
与单耳刺激呈现相比，双耳听力已被证明能让听力正常的聆听者获得更好的言语感知，尤其是在嘈杂的聆听环境中。本研究的目的是评估双侧电刺激是否能为人工耳蜗植入者带来类似的益处。
共有26名耳聋时间较短的成年语后聋患者在五个中心接受了植入手术，并随访1年。受试者双侧植入MED-EL COMBI 40+设备；除1例以外，所有植入均在一期手术中完成。言语感知测试包括安静环境下的CNC单词和噪声环境下的纽约城市大学句子。目标言语在中线（0度）呈现，掩蔽噪声（若有）则在沿方位角的三个模拟声源位置之一（-90度、0度和+90度）呈现。
在言语和掩蔽声空间重合以及空间分离的条件下均观察到了双侧电刺激的益处。“头影”和“叠加”效应从一开始就很明显。直到植入后1年才可靠地观察到与“双耳静噪”一致的益处。
这些结果支持了一种越来越多的共识，即双侧植入比单侧植入能带来更多功能益处。纵向数据表明，双耳处理的某些方面在植入后长达1年仍在持续发展。在之前的双侧人工耳蜗植入研究中经常报告不存在或罕见的静噪效应，在1年测量间隔时大多数受试者都出现了。
