Cullington H E, Bele D, Brinton J C, Cooper S, Daft M, Harding J, Hatton N, Humphries J, Lutman M E, Maddocks J, Maggs J, Millward K, O'Donoghue G, Patel S, Rajput K, Salmon V, Sear T, Speers A, Wheeler A, Wilson K
a University of Southampton Auditory Implant Service , Highfield , Southampton SO17 1BJ , UK.
b St. Thomas' Hospital Hearing Implant Centre , London , UK.
Cochlear Implants Int. 2017 Jan;18(1):2-22. doi: 10.1080/14670100.2016.1265055. Epub 2016 Dec 23.
To assess longitudinal outcomes in a large and varied population of children receiving bilateral cochlear implants both simultaneously and sequentially.
This observational non-randomized service evaluation collected localization and speech recognition in noise data from simultaneously and sequentially implanted children at four time points: before bilateral cochlear implants or before the sequential implant, 1 year, 2 years, and 3 years after bilateral implants. No inclusion criteria were applied, so children with additional difficulties, cochleovestibular anomalies, varying educational placements, 23 different home languages, a full range of outcomes and varying device use were included.
1001 children were included: 465 implanted simultaneously and 536 sequentially, representing just over 50% of children receiving bilateral implants in the UK in this period. In simultaneously implanted children the median age at implant was 2.1 years; 7% were implanted at less than 1 year of age. In sequentially implanted children the interval between implants ranged from 0.1 to 14.5 years. Children with simultaneous bilateral implants localized better than those with one implant. On average children receiving a second (sequential) cochlear implant showed improvement in localization and listening in background noise after 1 year of bilateral listening. The interval between sequential implants had no effect on localization improvement although a smaller interval gave more improvement in speech recognition in noise. Children with sequential implants on average were able to use their second device to obtain spatial release from masking after 2 years of bilateral listening. Although ranges were large, bilateral cochlear implants on average offered an improvement in localization and speech perception in noise over unilateral implants.
These data represent the diverse population of children with bilateral cochlear implants in the UK from 2010 to 2012. Predictions of outcomes for individual patients are not possible from these data. However, there are no indications to preclude children with long inter-implant interval having the chance of a second cochlear implant.
评估大量不同儿童群体同时和序贯接受双侧人工耳蜗植入后的纵向结果。
这项观察性非随机服务评估收集了同时和序贯植入儿童在四个时间点的噪声中定位和言语识别数据：双侧人工耳蜗植入前或序贯植入前、双侧植入后1年、2年和3年。未应用纳入标准，因此纳入了有其他困难、耳蜗前庭异常、不同教育安置、23种不同母语、广泛结果以及不同设备使用情况的儿童。
纳入了1001名儿童：465名同时植入，536名序贯植入，占该时期英国接受双侧植入儿童的50%以上。同时植入儿童的植入中位年龄为2.1岁；7%在1岁以下植入。序贯植入儿童的植入间隔为0.1至14.5年。双侧同时植入儿童的定位优于单侧植入儿童。平均而言，接受第二次（序贯）人工耳蜗植入的儿童在双侧聆听1年后，定位和背景噪声中的听力有所改善。序贯植入间隔对定位改善没有影响，但较短的间隔在噪声中的言语识别方面改善更大。序贯植入儿童平均在双侧聆听2年后能够使用其第二个设备获得掩蔽下的空间解脱。尽管范围较大，但双侧人工耳蜗植入平均比单侧植入在定位和噪声中的言语感知方面有所改善。
这些数据代表了2010年至2012年英国双侧人工耳蜗植入儿童的多样化群体。这些数据无法对个体患者的结果进行预测。然而，没有迹象表明应排除植入间隔长的儿童接受第二次人工耳蜗植入的机会。
