Centre for Language Sciences, Macquarie University, Sydney, New South Wales, Australia.
Ear Hear. 2011 Nov-Dec;32(6):758-66. doi: 10.1097/AUD.0b013e3182234c45.
Making evidence-based recommendations to prospective unilateral cochlear implant recipients on the potential benefits of implanting one or the other ear is challenging for cochlear implant teams. This particularly occurs in cases where a hearing aid has only been used in one ear for many years (referred to here as the "hearing ear"), and the contralateral ear has, in essence, been sound-deprived. In such cases, research to date is inconclusive, and little anecdotal evidence exists to inform the debate and support best clinical practice.
Retrospective data on speech recognition outcomes of 16 adult participants who received a cochlear implant in an ear deprived of sound for a minimum of 15 yr were analyzed. All subjects were implanted through the Quebec Cochlear Implant Program and were provided with personalized intensive rehabilitation services. Data obtained from clinical records included demographic data and speech recognition scores measured after implantation with the sentences of a multimedia auditory test battery in the auditory-only condition. Speech recognition outcomes were compared with the duration of auditory deprivation in the implanted ear, bilateral significant hearing loss, and auditory stimulation before bilateral significant hearing loss.
Using nonparametric correlation analyses, a strong negative correlation was demonstrated between speech recognition scores and the duration of bilateral significant hearing loss and with the duration of auditory stimulation before bilateral significant hearing loss. No significant correlation with the duration of auditory deprivation or with the duration of prior auditory stimulation in the implanted ear was found.
These findings suggest that functional outcomes of cochlear implantation for unilateral sound deprivation may be more strongly influenced by central processes than peripheral effects stemming from the deprivation per se. This indicates the relevance of considering the client's history of binaural hearing rather than the hearing in each ear individually when discussing possible outcomes with a cochlear implant.
为单侧人工耳蜗植入的潜在获益向潜在受术者提供循证推荐意见，这对人工耳蜗团队来说是一项挑战。当一只耳朵已多年仅使用助听器（以下简称“助听耳”），而对侧耳实质上处于失聪状态时，这种情况尤其会出现。在这种情况下，目前的研究尚无定论，并且几乎没有轶事证据来支持该争论并为最佳临床实践提供信息。
对 16 名成年参与者的言语识别结果的回顾性数据分析，这些参与者在至少 15 年的时间内一侧耳朵失聪，然后在该侧耳朵接受了人工耳蜗植入。所有参与者均通过魁北克人工耳蜗计划植入，并接受了个性化的强化康复服务。从临床记录中获得的数据包括人口统计学数据和言语识别分数，这些分数是在仅听觉条件下使用多媒体听觉测试电池获得的。言语识别结果与植入耳的双侧显著听力损失时间、双侧显著听力损失前的听觉刺激时间进行了比较。
使用非参数相关分析，发现言语识别分数与双侧显著听力损失时间以及双侧显著听力损失前的听觉刺激时间之间呈强负相关。而与双侧失聪时间或植入耳的先前听觉刺激时间均无显著相关性。
这些发现表明，单侧失聪患者人工耳蜗植入的功能结果可能更多地受到中枢过程的影响，而不是失聪本身引起的外周影响。这表明在与单侧人工耳蜗植入受术者讨论可能的结果时，考虑患者的双耳听力史而非每只耳朵的听力更为重要。
