Department of Clinical and Experimental Audiology, Academic Medical Center, Amsterdam, The Netherlands.
Otol Neurotol. 2013 Feb;34(2):190-8. doi: 10.1097/mao.0b013e318278506d.
Assessment of the clinical effectiveness of bilateral cochlear implantation compared with unilateral cochlear implantation or bimodal stimulation, in adults with severe-to-profound hearing loss. In 2007, the National Institute for Health and Clinical Excellence (NICE) in the U.K. conducted a systematic review on cochlear implantation. This study forms an update of the adult part of the NICE review.
The electronic databases MEDLINE and Embase were searched for English language studies published between October 2006 and March 2011.
Studies were included that compared bilateral cochlear implantation with unilateral cochlear implantation and/or with bimodal stimulation, in adults with severe-to-profound sensorineural hearing loss. Speech perception in quiet and in noise, sound localization and lateralization, speech production, health-related quality of life, and functional outcomes were analyzed.
Data extraction forms were used to describe study characteristics and the level of evidence.
The effect size was calculated to compare different outcome measures.
Pooling of data was not possible because of the heterogeneity of the studies. As in the NICE review, the level of evidence of the included studies was low, although some of the additional studies showed less risk of bias. All studies showed a significant bilateral benefit in localization over unilateral cochlear implantation. Bilateral cochlear implants were beneficial for speech perception in noise under certain conditions and several self-reported measures. Most speech perception in quiet outcomes did not show a bilateral benefit. The current review provides additional evidence in favor of bilateral cochlear implantation, even in complex listening situations.
评估双侧人工耳蜗植入与单侧人工耳蜗植入或双模刺激在重度至极重度听力损失成人中的临床效果。2007 年，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。本研究是 NICE 成人部分综述的更新。
检索了 MEDLINE 和 Embase 电子数据库中 2006 年 10 月至 2011 年 3 月发表的英文研究。
纳入了比较双侧人工耳蜗植入与单侧人工耳蜗植入和/或双模刺激的研究，这些研究对象为重度至极重度感觉神经性听力损失的成人。分析了安静和噪声环境下的言语感知、声源定位和侧化、言语产生、健康相关生活质量和功能结果。
使用数据提取表描述研究特征和证据水平。
计算了效应量以比较不同的结果测量。
由于研究的异质性，无法进行数据合并。与 NICE 综述一样，纳入研究的证据水平较低，尽管一些额外的研究显示出较低的偏倚风险。所有研究均表明，在定位方面，双侧人工耳蜗植入优于单侧人工耳蜗植入。在某些条件下，双侧人工耳蜗植入对噪声环境下的言语感知以及几项自我报告的测量指标有益。在安静环境下的大多数言语感知结果并未显示出双侧获益。本综述提供了更多支持双侧人工耳蜗植入的证据，即使在复杂的听力环境下也是如此。
