成人双侧同时植入人工耳蜗后静噪效应的发展

Development of a Squelch Effect in Adult Patients After Simultaneous Bilateral Cochlear Implantation.

作者信息

Kraaijenga Véronique J C, van Zon Alice, Smulders Yvette E, Ramakers Geerte G J, Van Zanten Gijsbert A, Stokroos Robert J, Huinck Wendy J, Frijns Johan H M, Free Rolien H, Grolman Wilko

机构信息

*Department of Otorhinolaryngology-Head and Neck Surgery †Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands ‡Department of Otorhinolaryngology-Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands §Department of Otorhinolaryngology-Head and Neck Surgery ||Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands ¶Department of Otorhinolaryngology-Head and Neck Surgery **Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands ††Department of Otorhinolaryngology and Graduate School of Medical Sciences, Research School of Behavioral and Cognitive Neurosciences, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Otol Neurotol. 2016 Oct;37(9):1300-6. doi: 10.1097/MAO.0000000000001185.

DOI:10.1097/MAO.0000000000001185

PMID:27579836

Abstract

OBJECTIVES

To investigate whether a squelch effect occurs in the first 3 years after simultaneous bilateral cochlear implantation and to investigate whether this effect increases during follow-up.

STUDY DESIGN

Prospective study as part of a multicenter randomized controlled trial that compares simultaneous bilateral cochlear implantation to sequential and unilateral cochlear implantation.

SETTING

Tertiary referral center.

PATIENTS

Nineteen postlingually deafened adults.

INTERVENTION

Simultaneous bilateral cochlear implantation.

MAIN OUTCOME MEASURE

The squelch effect, measured yearly with a speech-intelligibility-in-noise test with spatially separated sources. Bilateral results were compared to unilateral results in which the cochlear implant at the noise side was turned off. The squelch effect was investigated for the patients' best performing ear and for the left and right ears separately.

RESULTS

In 13 individual patients, a squelch effect was present after 1 year. This number increased during follow-up years. On group level, a squelch effect was present in patients' best performing ear after 2 and 3 years (1.9 dB). A squelch effect was present in both ears after 3 years (AS: 1.7 dB, AD: 1.3 dB).

CONCLUSION

Patients who underwent simultaneous bilateral cochlear implantation developed a measurable benefit from the squelch effect after 2 years in their best performing ear and after 3 years in both ears. These observations suggest that the brain learns to use interaural differences to segregate sound from noise after simultaneous bilateral cochlear implantation. The squelch effect increased over time which suggests a growth in cortical integration and differentiation of inputs from bilateral CIs due to brain plasticity.