Cohen Samuel M, Svirsky Mario A
a Department of Otolaryngology , New York University School of Medicine , New York , NY , USA.
Cochlear Implants Int. 2019 Mar;20(2):51-56. doi: 10.1080/14670100.2018.1550469. Epub 2018 Nov 28.
Examine the relationship between duration of unilateral deafness and speech perception outcomes after cochlear implantation in adults with single-sided deafness.
A systematic review of PubMed articles containing individual speech perception and duration of deafness data from single-sided deaf adults. Studies were selected for detailed review and duration of deafness and speech perception outcomes were extracted, with speech scores reported as percent correct. A linear regression as a function of study and length of deafness was performed.
A statistically significant negative effect of duration of unilateral deafness on speech perception was found, but there was substantial uncertainty regarding the strength of the effect.
Existing data make it difficult to either support or reject a hard 5- or 10-year unilateral auditory deprivation limit on cochlear implant (CI) candidacy for patients with single-sided deafness. This is because the totality of available data are consistent with a very small effect, perhaps negligible in practical terms, and just as consistent with a very large effect. Regardless of effect size, the present results have important basic implications. They suggest that unilateral sound deprivation may have a deleterious effect on auditory processing even though more central parts of the auditory system have continued to receive input from a contralateral normal ear.
Speech perception scores in SSD patients are negatively correlated with duration of deafness, but the limited amount of data from cochlear implant users with long-term single-sided deafness leads to substantial uncertainly, which in turn precludes any strong clinical recommendations. Further study of SSD CI users with long-term deafness will be necessary to generate evidence-based guidelines for implantation criteria in this population.
研究单侧耳聋持续时间与单侧耳聋成人人工耳蜗植入术后言语感知结果之间的关系。
对PubMed上的文章进行系统综述,这些文章包含来自单侧耳聋成人的个体言语感知和耳聋持续时间数据。选择研究进行详细综述,并提取耳聋持续时间和言语感知结果,言语分数以正确百分比报告。进行了作为研究和耳聋时长函数的线性回归。
发现单侧耳聋持续时间对言语感知有统计学上显著的负面影响,但关于该影响的强度存在很大的不确定性。
现有数据难以支持或拒绝为单侧耳聋患者设定5年或10年的严格单侧听觉剥夺限制作为人工耳蜗植入候选标准。这是因为现有数据总体上与非常小的影响一致,从实际角度来看可能微不足道,也与非常大的影响一致。无论效应大小如何,目前的结果都具有重要的基础意义。它们表明,即使听觉系统的更中枢部分继续从对侧正常耳接收输入,单侧声音剥夺可能对听觉处理产生有害影响。
单侧耳聋患者的言语感知分数与耳聋持续时间呈负相关,但来自长期单侧耳聋人工耳蜗使用者的有限数据导致很大的不确定性,这反过来又排除了任何强有力临床建议的可能性。有必要对长期耳聋的单侧耳聋人工耳蜗使用者进行进一步研究,以制定该人群植入标准的循证指南。