Vincent Christophe, Arndt Susan, Firszt Jill B, Fraysse Bernard, Kitterick Pádraig T, Papsin Blake C, Snik Ad, Van de Heyning Paul, Deguine Olivier, Marx Mathieu
Department of Otology and Neurotology, University Hospital of Lille, Lille, France.
Audiol Neurootol. 2015;20 Suppl 1:87-9. doi: 10.1159/000380754. Epub 2015 May 19.
Recommendation for cochlear implant (CI) treatment for individuals with severe to profound single-sided deafness (SSD) and asymmetrical hearing loss (AHL) is on the rise. This raises the need for greater consistency in the definition of CI candidacy for these cases and in the assessment methods of patient-related benefits to permit effective comparison and interpretation of the outcomes with both conventional and implantable options across studies.
During a dedicated seminar on implant treatment in AHL patients, the panellists of the closing round table reviewed the clinical experience presented with the aim to define clear audiometric characteristics for both AHL and SSD cases, as well as a common data set enabling consistent evaluation of hearing benefits in this population.
The panellists agreed on a clear differentiation between AHL and SSD CI candidates, defining average pure-tone thresholds up to 4 kHz for better and poorer ears. Agreement was reached on a minimum set of assessment procedures, and included the necessity of trials with conventional CROS/BICROS hearing aids and bone conduction devices before considering CI treatment. Objective assessment of sound localisation abilities was identified as the most relevant criterion to quantify performance before and after treatment. In parallel, subjective assessment of overall hearing ability was recommended via the Speech, Spatial and Qualities of hearing questionnaire. Longitudinal follow-up of these parameters and the hours of daily use were considered essential to reflect the potential treatment benefits for this population. The consistency in the data collection and its report will further support health authorities in their decision on acceptable gains from available hearing loss treatment options.
对于重度至极重度单侧耳聋（SSD）和不对称听力损失（AHL）患者，人工耳蜗（CI）治疗的推荐正在增加。这就需要在这些病例的CI候选资格定义以及患者相关获益的评估方法上更加一致，以便能够在各项研究中对传统和植入式选项的结果进行有效的比较和解读。
在一次关于AHL患者植入治疗的专门研讨会上，闭幕圆桌会议的小组成员回顾了所展示的临床经验，目的是为AHL和SSD病例定义明确的听力测定特征，以及一个能够对该人群的听力获益进行一致评估的通用数据集。
小组成员就AHL和SSD的CI候选者之间的明确区分达成一致，定义了较好耳和较差耳高达4kHz的平均纯音阈值。就一套最低限度的评估程序达成了一致，其中包括在考虑CI治疗之前使用传统CROS/BICROS助听器和骨传导装置进行试验的必要性。声音定位能力的客观评估被确定为量化治疗前后表现的最相关标准。同时，建议通过听力的言语、空间和质量问卷对整体听力能力进行主观评估。对这些参数和每日使用时长进行纵向随访被认为对于反映该人群的潜在治疗获益至关重要。数据收集及其报告的一致性将进一步支持卫生当局就现有听力损失治疗选项的可接受获益做出决策。
