Peters Jeroen P M, Smit Adriana L, Stegeman Inge, Grolman Wilko
Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Laryngoscope. 2015 Jan;125(1):218-26. doi: 10.1002/lary.24865. Epub 2014 Aug 14.
OBJECTIVES/HYPOTHESIS: Systematically review the literature on the clinical outcome of bone conduction devices (BCD) and contralateral routing of sound systems (CROSS) for patients with single-sided deafness (SSD).
PubMed, Embase, Cochrane Library, and CINAHL databases were searched up to April 7, 2014.
All studies investigating BCD and CROSS for patients with SSD on speech perception in noise, sound localization, or quality of life were selected and critically appraised.
In total, 46 articles were retrieved, of which six satisfied the eligibility criteria. Critical appraisal showed that five studies (n = 91) carried a moderate to high directness of evidence and a low to moderate risk of bias. Subsequently, study characteristics and outcome measurements were extracted. Due to large heterogeneity between studies, pooling of data was not feasible. Studies did not show a clear advantage of BCD or CROSS on speech perception in noise. BCD and CROSS lead to the same sound localization ability as the unaided condition. Quality of life did not differ significantly between conditions; however, subjective speech communication did improve.
No high level of evidence studies compare BCD and CROSS in patients with SSD. Literature showed no beneficial effect of BCD or CROSS regarding speech perception in noise and sound localization. Subjective speech communication demonstrated a moderate improvement with BCD and CROSS. High evidence studies comparing all treatment options for single-sided deafness should be conducted.
目的/假设:系统回顾关于骨传导装置(BCD)和对侧声音路由系统(CROSS)用于单侧耳聋(SSD)患者临床结局的文献。
检索了截至2014年4月7日的PubMed、Embase、Cochrane图书馆和CINAHL数据库。
选择并严格评价所有针对SSD患者使用BCD和CROSS进行噪声中言语感知、声音定位或生活质量研究的文章。
总共检索到46篇文章,其中6篇符合纳入标准。严格评价显示,5项研究(n = 91)具有中等到高度的证据直接性和低到中度的偏倚风险。随后,提取了研究特征和结局测量指标。由于研究之间存在较大异质性,数据合并不可行。研究未显示BCD或CROSS在噪声中言语感知方面有明显优势。BCD和CROSS导致的声音定位能力与未使用辅助设备的情况相同。不同条件下生活质量无显著差异;然而,主观言语交流确实有所改善。
没有高水平证据的研究比较SSD患者使用BCD和CROSS的情况。文献表明,BCD或CROSS在噪声中言语感知和声音定位方面没有有益效果。主观言语交流在使用BCD和CROSS时有适度改善。应开展比较单侧耳聋所有治疗方案的高证据研究。