Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
Otol Neurotol. 2010 Sep;31(7):1062-71. doi: 10.1097/MAO.0b013e3181e3d62c.
To assess the clinical effectiveness of bilateral cochlear implantation compared with unilateral cochlear implantation alone or with a contralateral hearing aid (bimodal stimulation), in children with severe-to-profound hearing loss. Recently, the National Institute for Health and Clinical Excellence (NICE) in the U.K. has conducted a systematic review on cochlear implantation. We decided to update the pediatric part of the NICE review.
The electronic databases MEDLINE and Embase were searched for European, North American, and Australasian studies published between October 2006 and June 2009. Reference lists of the included articles were also searched for relevant articles.
Studies were included if they comprised data on comparisons between bilateral cochlear implantation and unilateral cochlear implantation and/or bilateral cochlear implantation and bimodal stimulation, in children with severe-to-profound sensorineural hearing loss. The following outcome measures were analyzed: audiological, speech perception, speech production, functional capacities, health-related quality of life, and/or educational outcomes.
Characteristics of the participants, interventions, outcomes, and methodological comments were entered into data extraction forms and the level of evidence was assessed.
Results were standardized for each outcome measure by calculating a standardized mean difference (effect size).
Effect sizes could not be pooled because of the heterogeneity of the studies. Therefore, we presented the results qualitatively. Although the level of evidence was low, the advantages of bilateral cochlear implants corresponded with the primary benefits of bilateral hearing, that is, improved speech perception in quiet and noise. Localization results were less consistent. No data on audiologic, speech production, or educational outcomes were available.
评估双侧人工耳蜗植入与单侧人工耳蜗植入或对侧助听器（双模刺激）在重度至极重度听力损失儿童中的临床疗效。最近，英国国家卫生与临床优化研究所（NICE）对人工耳蜗植入进行了系统评价。我们决定更新 NICE 审查中的儿科部分。
在欧洲、北美和澳大拉西亚，搜索了 2006 年 10 月至 2009 年 6 月间发表的 MEDLINE 和 Embase 电子数据库。还对纳入文章的参考文献列表进行了搜索，以寻找相关文章。
如果研究包括比较双侧人工耳蜗植入与单侧人工耳蜗植入和/或双侧人工耳蜗植入与双模刺激的比较数据，且纳入的儿童患有重度至极重度感觉神经性听力损失，则将这些研究纳入。分析了以下结果测量：听力、言语感知、言语产生、功能能力、健康相关生活质量和/或教育结果。
将参与者、干预措施、结果和方法学评论的特征输入数据提取表，并评估证据水平。
通过计算标准化均数差（效应大小），对每个结果测量进行标准化。
由于研究的异质性，无法对效应大小进行汇总。因此，我们以定性的方式呈现结果。尽管证据水平较低，但双侧人工耳蜗植入的优势与双侧听力的主要益处相对应，即安静和噪声环境下言语感知能力的提高。定位结果则不太一致。没有关于听力、言语产生或教育结果的数据。
