Arndt S, Laszig R, Aschendorff A, Hassepass F, Beck R, Wesarg T
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
HNO. 2017 Aug;65(Suppl 2):98-108. doi: 10.1007/s00106-016-0297-5.
The rehabilitation of patients with single-sided deafness (SSD) or asymmetric hearing loss can be achieved with conventional (Bi)CROS hearing aids ((Bi)CROS-HA, (Bi)CROS), bone conduction devices (BCI) or with cochlear implants (CI). Unfortunately, only small case series have been published on the treatment outcomes in SSD patients after CI surgery and there are only a few comparative studies evaluating rehabilitation outcomes.
The aim of this study was to provide evidence of successful treatment of SSD and asymmetric hearing loss with a CI compared to the untreated, monaural hearing condition and the therapy options of BCI and (Bi)CROS in a large number of patients.
In a single-centre study, 45 patients with SSD and 40 patients with asymmetric hearing loss were treated with a CI after careful evaluation for CI candidacy. Monaural speech comprehension in noise and localisation ability were examined with (Bi)CROS-HA and BCI devices (on a test rod) both preoperatively and at 12 months after CI switch-on. At the same intervals, subjective evaluation of hearing ability was conducted using the Speech, Spatial and Qualities of Hearing Scale (SSQ).
This report presents the first evidence of successful binaural rehabilitation with CI in a relatively large patient cohort and the advantages over (Bi)CROS and BCI in smaller subgroups, thus confirming the indication for CI treatment. Moreover, patients with long-term acquired deafness (>10 years) show a benefit from the CI comparable to that observed in patients with shorter-term deafness.
单侧耳聋(SSD)或不对称听力损失患者的康复可通过传统的(双)对侧信号互传助听器((双)对侧信号互传-HA,(双)对侧信号互传)、骨传导装置(BCI)或人工耳蜗(CI)来实现。遗憾的是,关于人工耳蜗植入术后SSD患者治疗效果的研究仅发表了少量病例系列,且仅有少数比较研究评估康复效果。
本研究旨在提供证据,证明在大量患者中,与未经治疗的单耳听力状况以及BCI和(双)对侧信号互传的治疗方案相比,人工耳蜗对SSD和不对称听力损失的治疗是成功的。
在一项单中心研究中,45例SSD患者和40例不对称听力损失患者在经过仔细评估符合人工耳蜗植入标准后接受了人工耳蜗植入。术前以及人工耳蜗开机后12个月,使用(双)对侧信号互传-HA和BCI装置(在测试杆上)检查单耳在噪声中的言语理解能力和定位能力。在相同时间间隔,使用言语、空间和听力质量量表(SSQ)对听力能力进行主观评估。
本报告首次提供了在相对较大的患者队列中人工耳蜗双耳康复成功的证据,以及在较小亚组中相对于(双)对侧信号互传和BCI的优势,从而证实了人工耳蜗治疗的适应证。此外,长期获得性耳聋(>10年)的患者从人工耳蜗中获得的益处与短期耳聋患者相当。