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人工耳蜗治疗单侧耳聋或不对称听力损失患者。

Cochlear implant treatment of patients with single-sided deafness or asymmetric hearing loss.

作者信息

Arndt S, Laszig R, Aschendorff A, Hassepass F, Beck R, Wesarg T

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Freiburg, Killianstraße 5, 79106, Freiburg, Germany.

出版信息

HNO. 2017 Aug;65(Suppl 2):98-108. doi: 10.1007/s00106-016-0297-5.

DOI:10.1007/s00106-016-0297-5
PMID:28188428
Abstract

BACKGROUND

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.

OBJECTIVE

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.

MATERIALS AND METHODS

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).

RESULTS AND DISCUSSION

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.

摘要

背景

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。

目的

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。

材料与方法

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。

结果与讨论

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。

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[Cochlear implant treatment of patients with single-sided deafness or asymmetric hearing loss. German version].[人工耳蜗治疗单侧耳聋或不对称听力损失患者。德文版]
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本文引用的文献

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Sound Source Localization and Speech Understanding in Complex Listening Environments by Single-sided Deaf Listeners After Cochlear Implantation.人工耳蜗植入后单侧聋患者在复杂聆听环境中的声源定位与言语理解
Otol Neurotol. 2015 Sep;36(9):1467-71. doi: 10.1097/MAO.0000000000000841.
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Identification and evaluation of cochlear implant candidates with asymmetrical hearing loss.不对称性听力损失的人工耳蜗植入候选者的识别与评估
Audiol Neurootol. 2015;20 Suppl 1:87-9. doi: 10.1159/000380754. Epub 2015 May 19.
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单侧耳聋患者人工耳蜗植入术后言语、空间及听力质量量表和耳鸣功能指数的改善情况
Laryngoscope Investig Otolaryngol. 2025 Apr 22;10(2):e70090. doi: 10.1002/lio2.70090. eCollection 2025 Apr.
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Comparing Bilateral and Single-Sided Deaf Cochlear Implant Recipients in a Novel Speech-in-Noise and Localization Task.在一项新颖的噪声环境下言语及定位任务中比较双侧和单侧聋人人工耳蜗植入受者
Otolaryngol Head Neck Surg. 2025 May;172(5):1725-1734. doi: 10.1002/ohn.1187. Epub 2025 Mar 10.
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Influence of cochlear coverage on speech perception in single sided deafness, bimodal, and bilateral implanted cochlear implant patients.耳蜗覆盖范围对单侧耳聋、双耳双模及双侧植入人工耳蜗患者言语感知的影响。
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):1853-1863. doi: 10.1007/s00405-024-09086-x. Epub 2024 Dec 17.
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Front Neurol. 2024 Oct 30;15:1477259. doi: 10.3389/fneur.2024.1477259. eCollection 2024.
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HNO. 2015 Mar;63(3):182-8. doi: 10.1007/s00106-014-2969-3.
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Otol Neurotol. 2015 Mar;36(3):430-6. doi: 10.1097/MAO.0000000000000707.
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Potential benefits from cochlear implantation of children with unilateral hearing loss.单侧听力损失儿童接受人工耳蜗植入的潜在益处。
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Review: Bone conduction devices and contralateral routing of sound systems in single-sided deafness.综述:单侧耳聋中的骨传导装置及对侧声音路由系统
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Otol Neurotol. 2013 Dec;34(9):1681-7. doi: 10.1097/MAO.0000000000000102.
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