van Zon Alice, Smulders Yvette E, Stegeman Inge, Ramakers Geerte G J, Kraaijenga Veronique J C, Koenraads Simone P C, Zanten Gijsbert A Van, Rinia Albert B, Stokroos Robert J, Free Rolien H, Frijns Johan H M, Huinck Wendy J, Mylanus Emmanuel A M, Tange Rinze A, Smit Adriana L, Thomeer Hans G X M, Topsakal Vedat, 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. 2017 May;127(5):1161-1168. doi: 10.1002/lary.26239. Epub 2016 Sep 26.
OBJECTIVES/HYPOTHESIS: To investigate hearing capabilities and self-reported benefits of simultaneous bilateral cochlear implantation (BiCI) compared with unilateral cochlear implantation (UCI) after a 2-year follow-up and to evaluate the learning effect of cochlear implantees over time.
Multicenter randomized controlled trial.
Thirty-eight postlingually deafened adults were included in this study and randomly allocated to either UCI or simultaneous BiCI. Our primary outcome was speech intelligibility in noise, with speech and noise coming from straight ahead (Utrecht-Sentence Test with Adaptive Randomized Roving levels). Secondary outcomes were speech intelligibility in noise with spatially separated sources, speech intelligibility in silence (Dutch phoneme test), localization capabilities and self-reported benefits assessed with different quality of hearing and quality of life (QoL) questionnaires. This article describes the results after 2 years of follow-up.
We found comparable results for the UCI and simultaneous BiCI group, when speech and noise were both presented from straight ahead. Patients in the BiCI group performed significantly better than patients in the UCI group, when speech and noise came from different directions (P = .01). Furthermore, their localization capabilities were significantly better. These results were consistent with patients' self-reported hearing capabilities, but not with the questionnaires regarding QoL. We found no significant differences on any of the subjective and objective reported outcomes between the 1-year and 2-year follow-up.
This study demonstrates important benefits of simultaneous BiCI compared with UCI that remain stable over time. Bilaterally implanted patients benefit significantly in difficult everyday listening situations such as when speech and noise come from different directions. Furthermore, bilaterally implanted patients are able to localize sounds, which is impossible for unilaterally implanted patients.
1b Laryngoscope, 127:1161-1168, 2017.
目的/假设：在2年随访后，研究双侧同期人工耳蜗植入（BiCI）与单侧人工耳蜗植入（UCI）相比的听力能力和自我报告的获益情况，并评估人工耳蜗植入者随时间推移的学习效果。
多中心随机对照试验。
38名语后聋成年人纳入本研究，并随机分为UCI组或双侧同期BiCI组。我们的主要结局指标是噪声环境下的言语清晰度，言语和噪声均来自正前方（采用自适应随机移动水平的乌得勒支句子测试）。次要结局指标包括声源空间分离时噪声环境下的言语清晰度、安静环境下的言语清晰度（荷兰音素测试）、定位能力以及使用不同听力质量和生活质量（QoL）问卷评估的自我报告获益情况。本文描述了2年随访后的结果。
当言语和噪声均从正前方呈现时，我们发现UCI组和双侧同期BiCI组的结果相当。当言语和噪声来自不同方向时，BiCI组患者的表现显著优于UCI组患者（P = .01）。此外，他们的定位能力明显更好。这些结果与患者自我报告的听力能力一致，但与QoL问卷结果不一致。我们发现在1年和2年随访的任何主观和客观报告结局上均无显著差异。
本研究表明，与UCI相比，双侧同期BiCI具有重要获益，且随时间保持稳定。双侧植入患者在日常困难聆听情境中（如言语和噪声来自不同方向时）获益显著。此外，双侧植入患者能够定位声音，而单侧植入患者则无法做到。
1b 《喉镜》，2017年，第127卷，第1161 - 1168页
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