双侧人工耳蜗植入与有残余听力患者的双耳模式听力：听力学表现和生活质量的自身对照比较。
Bilateral Cochlear Implantation Versus Bimodal Hearing in Patients With Functional Residual Hearing: A Within-subjects Comparison of Audiologic Performance and Quality of Life.
机构信息
Department of Otolaryngology.
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
出版信息
Otol Neurotol. 2018 Apr;39(4):422-427. doi: 10.1097/MAO.0000000000001750.
OBJECTIVE
Evaluate performance and quality of life changes after sequential bilateral cochlear implantation in patients with preoperative residual hearing functioning in a bimodal hearing configuration.
STUDY DESIGN
Retrospective analysis using within-subjects repeated measures design.
SETTING
Tertiary otologic center.
PATIENTS
Twenty-two adult patients with bilateral sensorineural hearing loss who used bimodal hearing before second cochlear implant (CI) meeting the following criteria: 1) preoperative residual hearing (≤80 dB HL at 250 Hz) in the ear to be implanted, 2) implantation with current CI technology (2013-2016), 3) consonant-nucleus-consonant (CNC) speech recognition testing in the bimodal condition preoperatively and bilateral CI condition postoperatively.
INTERVENTION
Cochlear implantation.
MAIN OUTCOME MEASURES
CNC and AzBio sentence scores in quiet and noise (+5 SNR). Subjective measures of communication difficulty and sound quality were also administered.
RESULTS
Twenty-two patients (mean 64 yr, 68% men) were included. At an average follow-up of 11.8 months, CNC scores in the bilateral CI condition (mean 63%, standard deviation [SD] = 22) were significantly better than preoperative bimodal scores with repeated measures analysis (mean 55%, SD = 22) (p = 0.03). AzBio scores in quiet were also higher with bilateral CI (mean 76%, SD = 24) compared with bimodal listening (mean 69%, SD = 29) (p = 0.0007). Global abbreviated profile of hearing aid benefit (APHAB) and overall speech, spatial, and qualities of hearing (SSQ) scores exhibited significant improvement following bilateral implantation (p = 0.006 for both analyses).
CONCLUSIONS
For patients using a bimodal hearing configuration with substantial residual hearing in the non-CI ear, bilateral cochlear implantation yields improved audiologic performance and better subjective quality of life, irrespective of the ability to preserve acoustic hearing during the second sided implantation.
目的
评估在双侧同时植入人工耳蜗的情况下，术前残留听力在双模式听力配置下的患者的表现和生活质量变化。
研究设计
使用受试者内重复测量设计的回顾性分析。
设置
三级耳科中心。
患者
22 名成人双侧感觉神经性听力损失患者，在第二次人工耳蜗植入（CI）前使用双模式听力，符合以下标准：1）待植入耳的术前残留听力（250Hz 时≤80dB HL），2）使用当前的 CI 技术进行植入（2013-2016 年），3）在术前双模式和术后双侧 CI 条件下进行辅音-核-辅音（CNC）言语识别测试。
干预
人工耳蜗植入。
主要观察指标
安静和噪声下的 CNC 和 AzBio 句子得分（+5 SNR）。还进行了沟通困难和音质的主观测量。
结果
22 名患者（平均年龄 64 岁，68%为男性）入选。在平均 11.8 个月的随访中，双侧 CI 条件下的 CNC 评分（平均 63%，标准差[SD] = 22）明显优于重复测量分析的术前双模式评分（平均 55%，SD = 22）（p = 0.03）。在安静时，双侧 CI 的 AzBio 评分也更高（平均 76%，SD = 24），与双模式听力相比（平均 69%，SD = 29）（p = 0.0007）。全球简化助听器受益量表（APHAB）和总体言语、空间和听力质量量表（SSQ）评分在双侧植入后均显著改善（两种分析均为 p = 0.006）。
结论
对于在非 CI 耳中具有大量残留听力的使用双模式听力配置的患者，双侧人工耳蜗植入可改善听力表现和更好的生活质量，无论在第二次植入时是否能够保留声学听力。
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