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不对称性听力损失以及人工耳蜗植入在言语感知、耳鸣负担和心理合并症方面的益处:一项前瞻性随访研究。

Asymmetric hearing loss and the benefit of cochlear implantation regarding speech perception, tinnitus burden and psychological comorbidities: a prospective follow-up study.

作者信息

Ketterer Manuel Christoph, Knopke Steffen, Häußler Sophia Marie, Hildenbrand Tanja, Becker Christoph, Gräbel Stefan, Olze Heidi

机构信息

Department of Otorhinolaryngology, Charité-Universitätsmedizin, Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.

Department of Otorhinolaryngology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2018 Nov;275(11):2683-2693. doi: 10.1007/s00405-018-5135-9. Epub 2018 Sep 18.

Abstract

OBJECTIVES

We determined the audiological outcome, the subjective and objective hearing quality in patients suffering from asymmetric hearing loss (AHL). Furthermore, we evaluated psychological comorbidities and tinnitus burden before and after cochlear implantation.

STUDY DESIGN

Prospective cohort study.

METHODS

44 AHL patients were unilaterally implanted with a multichannel cochlear implant between 2011 and 2016. Speech discrimination (Freiburg Monosyllable Word Test, Oldenburg Sentence Test) was measured before, 6 and 12 months after implantation. Subjective hearing quality, health-related quality of life (HRQoL), tinnitus burden, anxiety, depressiveness, perceived stress level and coping abilities were evaluated before implantation, 6 and 12 months postoperative using specific validated questionnaires (Oldenburg Inventory, Nijmegen Cochlear Implantation Questionnaire, Tinnitus Questionnaire, General Anxiety Disorder-7, Depression Scale, Perceived Stress Questionnaire and Cope Inventory).

RESULTS

Subjective and objective hearing quality, speech discrimination and health-related quality of life were significantly increased in AHL patients. Tinnitus burden significantly decreased over the 12 postoperative months. No significant alteration was observed for anxiety, depressiveness, coping abilities and stress level.

CONCLUSIONS

This study demonstrates that cochlear implantation achieves hearing rehabilitation, increases HRQoL and decreases tinnitus burden in patients suffering from AHL. Subjective hearing quality increased, while tinnitus burden significantly decreased 6 and 12 months after implantation. HRQoL in AHL patients is an important factor to focus on and is significantly increased postoperatively. In contrast, general anxiety, depressiveness, coping abilities and perceived stress level remained unaffected.

摘要

目的

我们确定了不对称听力损失(AHL)患者的听力学结果、主观和客观听力质量。此外,我们评估了人工耳蜗植入前后的心理合并症和耳鸣负担。

研究设计

前瞻性队列研究。

方法

2011年至2016年间,44例AHL患者单侧植入多通道人工耳蜗。在植入前、植入后6个月和12个月测量言语辨别能力(弗莱堡单音节词测试、奥尔登堡句子测试)。使用特定的经过验证的问卷(奥尔登堡量表、奈梅亨人工耳蜗植入问卷、耳鸣问卷、广泛性焦虑障碍-7、抑郁量表、感知压力问卷和应对量表)在植入前、术后6个月和12个月评估主观听力质量、健康相关生活质量(HRQoL)、耳鸣负担、焦虑、抑郁、感知压力水平和应对能力。

结果

AHL患者的主观和客观听力质量、言语辨别能力和健康相关生活质量显著提高。术后12个月内耳鸣负担显著降低。焦虑、抑郁、应对能力和压力水平未观察到显著变化。

结论

本研究表明,人工耳蜗植入可实现听力康复,提高AHL患者的HRQoL并减轻耳鸣负担。主观听力质量提高,而耳鸣负担在植入后6个月和12个月显著降低。AHL患者的HRQoL是一个需要关注的重要因素,术后显著提高。相比之下,一般焦虑、抑郁、应对能力和感知压力水平未受影响。

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