Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Int J Audiol. 2013 Jul;52(7):442-54. doi: 10.3109/14992027.2013.786190. Epub 2013 May 24.
Cochlear implantation (CI) is a standard treatment for severe-profound sensorineural hearing loss (SNHL). However, consensus has yet to be reached on its effectiveness for hearing loss caused by auditory neuropathy spectrum disorder (ANSD). This review aims to summarize and synthesize current evidence of the effectiveness of CI in improving speech recognition in children with ANSD.
Systematic review.
A total of 27 studies from an initial selection of 237.
All selected studies were observational in design, including case studies, cohort studies, and comparisons between children with ANSD and SNHL. Most children with ANSD achieved open-set speech recognition with their CI. Speech recognition ability was found to be equivalent in CI users (who previously performed poorly with hearing aids) and hearing-aid users. Outcomes following CI generally appeared similar in children with ANSD and SNHL. Assessment of study quality, however, suggested substantial methodological concerns, particularly in relation to issues of bias and confounding, limiting the robustness of any conclusions around effectiveness.
Currently available evidence is compatible with favourable outcomes from CI in children with ANSD. However, this evidence is weak. Stronger evidence is needed to support cost-effective clinical policy and practice in this area.
人工耳蜗植入 (CI) 是治疗重度-极重度感音神经性听力损失 (SNHL) 的标准方法。然而，对于听神经病谱系障碍 (ANSD) 引起的听力损失，其疗效尚未达成共识。本综述旨在总结和综合目前关于 CI 改善 ANSD 儿童言语识别效果的证据。
系统综述。
从最初的 237 项研究中选择了 27 项研究。
所有入选的研究均为观察性设计，包括病例研究、队列研究以及 ANSD 儿童与 SNHL 儿童的比较。大多数 ANSD 儿童在接受 CI 后实现了开放式言语识别。在 CI 用户（以前使用助听器效果不佳）和助听器用户中，言语识别能力相当。CI 后结局在 ANSD 和 SNHL 儿童中通常相似。然而，对研究质量的评估表明存在大量方法学问题，特别是在偏倚和混杂方面的问题，限制了任何关于有效性的结论的可靠性。
目前的证据与 ANSD 儿童接受 CI 后的有利结果相一致。然而，这些证据是薄弱的。需要更强有力的证据来支持这一领域的具有成本效益的临床政策和实践。
