电声刺激患者听力保留的长期随访

Long-term follow-up of hearing preservation in electric-acoustic stimulation patients.

作者信息

Mertens Griet, Punte Andrea Kleine, Cochet Ellen, De Bodt Marc, Van de Heyning Paul

机构信息

*University Department Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital; and †Antwerp University, Antwerp, Belgium.

出版信息

Otol Neurotol. 2014 Dec;35(10):1765-72. doi: 10.1097/MAO.0000000000000538.

DOI:10.1097/MAO.0000000000000538

PMID:25133472

Abstract

BACKGROUND

Hearing preservation (HP) surgery was initiated more than 10 years ago for combined electric and acoustic stimulation (EAS). Preserved residual low-frequency hearing has been demonstrated to improve speech perception in noise as well as music appreciation in EAS users up to 2 years. Multiple study groups aimed to evaluate initial loss of residual hearing (RH) as a consequence of HP surgery. However, after 1 year and 2 years of follow-up, further decline was reported. This study aimed to determine RH, speech perception, and the subjective benefits of EAS 10 years after HP surgery.

SUBJECTS AND METHODS

Nine postlingual EAS partially deaf patients who underwent HP surgery at Antwerp University Hospital were included in this study (11 implanted ears). Hearing preservation (0% = loss of hearing; >0%-25% = minimal HP; >25%-75% = partial HP; >75% = complete HP), speech perception and subjective benefits were evaluated preoperatively; at 3, 6, 12, 18, and 24 months postoperatively; and annually thereafter.

RESULTS

Complete HP was obtained in three of 11 ears; partial HP in five of 11 ears; and minimal HP in two of 11 ears, measured during their most recent follow-up. One subject lost his RH completely across time. The mean rate of HP was 48% (ranging from 6 months up to 10 years postoperatively). Speech perception analysis up to 10 years showed a continuous statistically significant improvement. The maximum subjective benefit was reached 3 months after implantation and subsequently remained statistically significant unchanged for the next 10 years.

CONCLUSION

Long-term HP in EAS users after HP surgery is feasible, although a small continuous decline of HP rate of 3% per year was observed (measured from first fitting up to 6 years postoperative). Nevertheless, a continuous improvement was found in the speech perception results of the EAS users across 10 years. Moreover, the positive subjective benefit, assessed 3 months postoperative, remained stable up to 10 years.

摘要

背景

听力保留（HP）手术于10多年前开始用于电声联合刺激（EAS）。已证实，保留的残余低频听力可改善EAS使用者在噪声中的言语感知以及音乐欣赏能力，长达2年。多个研究小组旨在评估HP手术导致的残余听力（RH）的初始损失。然而，在1年和2年的随访后，有报告称残余听力进一步下降。本研究旨在确定HP手术后10年的RH、言语感知以及EAS的主观益处。

受试者与方法

本研究纳入了9例在安特卫普大学医院接受HP手术的语后聋EAS部分失聪患者（11只植入耳）。术前、术后3、6、12、18和24个月以及此后每年评估听力保留情况（0% = 听力丧失；>0%-25% = 最小HP；>25%-75% = 部分HP；>75% = 完全HP）、言语感知和主观益处。

结果

在最近一次随访中测量，11只耳中有3只实现了完全HP；11只耳中有5只实现了部分HP；11只耳中有2只实现了最小HP。1名受试者的RH随时间完全丧失。HP的平均比例为48%（术后6个月至10年）。长达10年的言语感知分析显示有持续的统计学显著改善。最大主观益处出现在植入后3个月，随后在接下来的10年中保持统计学显著不变。