Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University Health Systems, Richmond, Virginia.
Otol Neurotol. 2018 Sep;39(8):979-986. doi: 10.1097/MAO.0000000000001885.
To study postoperative hearing outcomes in older adult cochlear implant recipients who did not meet Medicare candidacy criteria by sentence testing in quiet.
Case Control Series.
University Based Tertiary Referral Cochlear Implant Center.
Fifty-four patients age 60 or greater with bilateral moderate to profound sensorineural hearing loss who underwent cochlear implantation. Patients were divided into three groups by preoperative testing scores: 1) sentence recognition in quiet and monosyllabic word recognition scores ≤40%, 2) sentence recognition in quiet scores >40% and sentence recognition in noise scores ≤40%, and 3) sentence recognition in quiet scores >40% and monosyllabic word recognition scores ≤40% in the ear to be implanted.
INTERVENTION(S): Cochlear implantation.
MAIN OUTCOME MEASURE(S): Pre- versus postoperative sentence and word recognition scores.
All three groups received a statistically significant benefit from their cochlear implant as measured by both postoperative sentence and word recognition. When comparing postoperative sentence recognition scores between groups, there were no statistically significant differences (Group 1: mean 83.1%, SD ± 17.4%; Group 2: mean 90.1%, SD ± 8.0%; Group 3: mean 90.6%, SD ± 6.9%). When comparing postoperative monosyllabic word recognition scores, there were no statistically significant differences between groups (Group 1: mean 60.3%, SD ± 19.6%; Group 2: mean 66.8%, SD ± 20.0%; Group 3: mean 70.0%, SD ± 18.8%).
Results of this study demonstrate that older patients who do not meet current Medicare candidacy criteria derive significant long-term benefit from cochlear implantation when either sentence in noise or monosyllabic word recognition in quiet ≤40% is used to determine candidacy. Further research and greater numbers are needed to better characterize the role of monosyllabic word recognition in cochlear implant candidacy.
通过安静环境下的句子测试，研究未达到医疗保险资格标准的老年人工耳蜗植入患者的术后听力结果。
病例对照系列。
基于大学的三级转诊人工耳蜗植入中心。
54 名年龄在 60 岁及以上的双侧中度至重度感音神经性听力损失患者，行人工耳蜗植入术。患者根据术前测试评分分为三组：1）安静环境下的句子识别和单音节词识别得分≤40%，2）安静环境下的句子识别得分>40%且安静环境下的句子识别得分≤40%，以及 3）植入耳的安静环境下的句子识别得分>40%和单音节词识别得分≤40%。
人工耳蜗植入。
术前与术后句子和单词识别得分。
所有三组患者的人工耳蜗植入均有显著获益，术后句子和单词识别均有统计学意义。当比较组间术后句子识别得分时，无统计学差异（组 1：平均 83.1%，标准差±17.4%；组 2：平均 90.1%，标准差±8.0%；组 3：平均 90.6%，标准差±6.9%）。当比较术后单音节词识别得分时，组间无统计学差异（组 1：平均 60.3%，标准差±19.6%；组 2：平均 66.8%，标准差±20.0%；组 3：平均 70.0%，标准差±18.8%）。
本研究结果表明，当使用噪声环境下的句子识别或安静环境下的单音节词识别≤40%来确定资格时，不符合当前医疗保险资格标准的老年患者可从人工耳蜗植入中获得长期显著获益。需要进一步研究和更多数据来更好地描述单音节词识别在人工耳蜗植入资格中的作用。
