Department of Otolaryngology-Head and Neck Surgery.
Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
Otol Neurotol. 2018 Oct;39(9):e803-e809. doi: 10.1097/MAO.0000000000001963.
Patients with single-sided deafness (SSD) have great difficulties in listening situations which rely on binaural auditory processing. The purpose of this study was to examine to which extent a cochlear implant (CI) can improve speech perception outcomes in various noisy listening environments. Additionally, the ability to use interaural level differences for sound localization and subjective benefit with the CI were assessed.
Ten single-sided deaf patients with CI were tested in different loudspeaker configurations with and without the CI. A multi-source noise field (MSNF) with uncorrelated noise from four different directions was used in addition to a setup with the signal from the CI side and noise from the normal-hearing side (SCINNH, azimuth of ±45 degrees). Ten normal-hearing subjects were used as a control for the setup. Speech understanding was measured by an adaptive sentence test (Oldenburg Sentence Test, OLSA) in stationary speech shaped noise and temporally modulated noise to assess the benefit in each listening situation. Sensitivity to interaural level differences was measured in a lateralization experiment. Furthermore, patients completed the Bern Benefit in Single-Sided Deafness (BBSS) questionnaire to assess subjective benefit with the CI.
An overall average benefit in speech reception threshold (SRT) of 1.6 dB (±0.6 dB standard error of the mean [SEM]) was observed in the binaural listening condition (with CI) in all conditions. In the MSNF setup thresholds improved by 0.4 dB (±0.5 dB SEM) and in the SCINNH configuration by 2.7 dB (±0.7 dB SEM). The choice of masking noise effect also had a significant effect on the SRT outcome. The lateralization performance of the SSD users was on a par with the normal hearing group. BBSS scores reflect the overall benefit with the CI apparent in the speech test results.
Patients with single-sided deafness do benefit from a CI in difficult listening environments and are able to localize sound based on interaural level differences. Considering these outcomes, cochlear implantation represents a promising treatment option for patients with single-sided deafness.
单侧聋（SSD）患者在依赖双耳听觉处理的聆听环境中存在较大困难。本研究旨在探究人工耳蜗（CI）在各种嘈杂聆听环境中改善言语感知效果的程度。此外，评估了使用双侧强度差进行声音定位的能力和对 CI 的主观获益。
10 名单侧聋患者在有无 CI 的不同扬声器配置下接受了测试。除了信号来自 CI 侧且噪声来自正常听力侧的设置（SCINNH，±45 度的方位角）外，还使用了具有来自四个不同方向的不相关噪声的多声源噪声场（MSNF）。10 名正常听力受试者被用作该设置的对照组。言语理解通过自适应句子测试（Oldenburg Sentence Test，OLSA）在静止语音成形噪声和时变调制噪声中进行测量，以评估每种聆听环境下的获益。在侧化实验中测量了对双侧强度差的敏感性。此外，患者完成了 Bern Benefit in Single-Sided Deafness（BBSS）问卷，以评估对 CI 的主观获益。
在所有条件下，双侧聆听条件（带 CI）的言语接收阈值（SRT）的总体平均获益为 1.6dB（±0.6dB 均数标准误差[SEM]）。在 MSNF 设置中，阈值提高了 0.4dB（±0.5dB SEM），在 SCINNH 配置中提高了 2.7dB（±0.7dB SEM）。掩蔽噪声效应的选择对 SRT 结果也有显著影响。单侧聋患者的侧化表现与正常听力组相当。BBSS 评分反映了在言语测试结果中明显的 CI 总体获益。
单侧聋患者从 CI 中受益于困难的聆听环境，并能够基于双侧强度差进行声音定位。考虑到这些结果，人工耳蜗植入术代表了单侧聋患者的一种有前途的治疗选择。
