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人工耳蜗植入患者对侧使用助听器:双模式获益的多中心研究

Contralateral hearing aid use in cochlear implanted patients: multicenter study of bimodal benefit.

作者信息

Morera Constantino, Cavalle Laura, Manrique Manuel, Huarte Alicia, Angel Ramos, Osorio Angel, Garcia-Ibañez Luis, Estrada Elisabeth, Morera-Ballester Constantino

机构信息

Hospital Universitario 'La Fe', Valencia, Spain.

出版信息

Acta Otolaryngol. 2012 Oct;132(10):1084-94. doi: 10.3109/00016489.2012.677546. Epub 2012 Jun 5.

Abstract

CONCLUSION

The use of a hearing aid (HA) in combination with a cochlear implant (CI) significantly improved performance for speech perception in quiet, in noise, and for localization compared with monaural conditions. No significant differences in functional performance were observed following optimization of HA fitting.

OBJECTIVES

To evaluate the binaural benefits derived from using a contralateral HA in conjunction with a CI in subjects with significant functional hearing in the nonimplanted ear and the effects of HA fitting optimization.

METHODS

Fifteen adult CI users, intra-subject controls, were enrolled in a prospective repeated-measure multicenter study. Evaluation of performance for speech understanding, localization, and subjective impressions was conducted before and following HA fitting optimization for CI alone, HA alone, and CI + HA.

RESULTS

For speech testing in quiet, bimodal scores were significantly better than for HA alone and CI alone conditions (p < 0.01). For speech and noise (S0N0) at 0° azimuth the scores were significantly better in the bimodal condition than for CI alone (p = 0.01), indicating binaural summation. When noise was presented to the HA side (S0NHA) bimodal scores were significantly better than for CI alone (p < 0.01 and p < 0.05, respectively), suggesting a significant binaural squelch effect. Sound localization ability was significantly improved in the bimodal condition compared with the CI alone condition (p = 0.002).

摘要

结论

与单耳佩戴情况相比,助听器(HA)与人工耳蜗(CI)联合使用在安静环境、噪声环境下的言语感知以及定位方面显著改善了表现。在优化HA适配后,未观察到功能表现上的显著差异。

目的

评估在非植入耳具有显著功能性听力的受试者中,对侧HA与CI联合使用所带来的双耳效益以及HA适配优化的效果。

方法

15名成年CI使用者作为自身对照,参与了一项前瞻性重复测量多中心研究。在单独CI、单独HA以及CI + HA的HA适配优化前后,对言语理解、定位及主观感受的表现进行了评估。

结果

对于安静环境下的言语测试,双耳模式得分显著优于单独使用HA和单独使用CI的情况(p < 0.01)。对于0°方位角的言语加噪声(S0N0),双耳模式下的得分显著优于单独使用CI的情况(p = 0.01),表明存在双耳累加效应。当噪声呈现给HA一侧(S0NHA)时,双耳模式得分显著优于单独使用CI的情况(分别为p < 0.01和p < 0.05),提示存在显著的双耳静噪效应。与单独使用CI的情况相比,双耳模式下的声音定位能力显著提高(p = 0.002)。

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