Sparreboom Marloes, Snik Ad F M, Mylanus Emmanuel A M
Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Otorhinolaryngology, Head and Neck Surgery, Nijmegen, The Netherlands.
Audiol Neurootol. 2011;16(4):203-13. doi: 10.1159/000320270. Epub 2010 Oct 27.
The advantages of sequential bilateral cochlear implantation were assessed in 29 children with a severe to profound hearing loss. The effect of age at second implantation and the effect of duration of bilateral implant use on the outcomes in speech perception and directional hearing were investigated. The children received their second cochlear implant at an age ranging from 2.8 to 8.5 years. Measurements were carried out preoperatively and postoperatively after 6, 12 and 24 months of bilateral implant use. A matched control group of 9 children with a unilateral implant were also measured over time and were compared with the study group after 12 and 24 months. Speech reception in both quiet and in noise and lateralization were measured. After 24 months, a minimum audible angle task was carried out. Bilateral advantages with regard to speech reception in quiet and in noise were already present after 6 months of bilateral implant use and improved thereafter. After 24 months, speech reception in noise had significantly improved with bilateral implants compared to that of children with a unilateral implant. The percentage of children that could accurately lateralize increased from 57% after 6 months to 83% after 24 months. With regard to the minimum audible angle task, loudspeakers were placed on average at ±42°. Age at second implantation did not have an influence on all outcomes. From the results it can be concluded that the advantages of bilateral hearing occur after sequential bilateral implantation and that age at second implantation does not influence the amount of bilateral advantage. Furthermore, it can be concluded that longer periods of bilateral implant use lead to greater bilateral advantages.
对29名重度至极重度听力损失儿童的序贯双侧人工耳蜗植入优势进行了评估。研究了第二次植入时的年龄以及双侧植入使用时长对言语感知和定向听力结果的影响。这些儿童在2.8至8.5岁之间接受了第二次人工耳蜗植入。在术前以及双侧植入使用6、12和24个月后进行了测量。还对9名单侧植入的儿童组成的匹配对照组进行了长期测量，并在12个月和24个月后与研究组进行了比较。测量了安静和噪声环境下的言语接受度以及声源定位。24个月后，进行了最小可听角任务。双侧植入使用6个月后，在安静和噪声环境下的言语接受度方面的双侧优势就已显现，并在此后得到改善。24个月后，与单侧植入儿童相比，双侧植入儿童在噪声环境下的言语接受度有显著改善。能够准确进行声源定位的儿童百分比从6个月后的57%增加到24个月后的83%。关于最小可听角任务，扬声器平均放置在±42°。第二次植入时的年龄对所有结果均无影响。从结果可以得出结论，序贯双侧植入后会出现双侧听力的优势，且第二次植入时的年龄不会影响双侧优势的程度。此外，可以得出结论，双侧植入使用时间越长，双侧优势越大。
