Snapp Hillary A, Hoffer Michael E, Liu Xuezhong, Rajguru Suhrud M
*Department of Otolaryngology †Department of Biomedical Engineering, University of Miami Miller School of Medicine, Miami, Florida.
Otol Neurotol. 2017 Dec;38(10):1397-1404. doi: 10.1097/MAO.0000000000001614.
To compare the effectiveness of current contralateral routing of signal technology (CROS) to bone-anchored implants in experienced bone-anchored implant users with unilateral severe-profound sensorineural hearing loss.
Prospective, within-subject repeated-measures comparison study.
Tertiary referral center.
Adult, English-speaking patients (n = 12) with severe-profound unilateral sensorineural hearing loss implanted with a bone-anchored implant for the indication of single-sided deafness.
Subjects were fitted with contralateral routing of signal amplification and tested for speech in noise performance and localization error.
Speech perception in noise was assessed using the BKB-SIN test materials. Localization was assessed using narrow band noises centered at 500 and 4000 Hz, as well as a broadband speech stimulus presented at random to the front hemifield by 19 speakers spatially separated by 10 degrees.
There was no improvement in localization ability in the aided condition and no significant difference in performance with CROS versus bone-anchored implants (BAI). There was a significant improvement in speech in noise performance for monaural listeners in the aided condition for speech poorer ear/noise better ear, speech front/noise front, and speech front/noise back. No significant difference was observed on performance with CROS versus BAI subjects.
Contrary to earlier studies suggesting improved performance of BAIs over CROS, the current study found no difference in performance in BAI over CROS devices. Both CROS and BAI provide significant benefit for monaural listeners. The results suggest that noninvasive CROS solutions can successfully rehabilitate certain monaural listening deficits, provide improved hearing outcomes, and expand the reach of treatment in this population.
比较在有经验的单侧严重至极重度感音神经性听力损失的骨锚式植入物使用者中,当前对侧信号路由技术(CROS)与骨锚式植入物的有效性。
前瞻性、受试者自身重复测量比较研究。
三级转诊中心。
成年、说英语的患者(n = 12),患有严重至极重度单侧感音神经性听力损失,因单侧耳聋植入骨锚式植入物。
为受试者佩戴对侧信号路由放大装置,并测试其在噪声环境中的言语表现和定位误差。
使用BKB-SIN测试材料评估噪声环境下的言语感知。使用以500和4000赫兹为中心的窄带噪声以及由19个扬声器在空间上相隔10度随机呈现到前半视野的宽带言语刺激来评估定位。
在佩戴辅助装置的情况下,定位能力没有改善,CROS与骨锚式植入物(BAI)在表现上没有显著差异。对于单耳聆听者,在佩戴辅助装置的情况下,在言语较差耳/噪声较好耳、言语在前/噪声在前以及言语在前/噪声在后的条件下,噪声环境中的言语表现有显著改善。在CROS与BAI受试者的表现上未观察到显著差异。
与早期研究表明BAI比CROS表现更好相反,当前研究发现BAI与CROS设备在表现上没有差异。CROS和BAI对单耳聆听者都有显著益处。结果表明,非侵入性CROS解决方案可以成功改善某些单耳听力缺陷,提供更好的听力结果,并扩大该人群的治疗范围。