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单侧聋患者人工耳蜗植入对耳鸣困扰、健康相关生活质量及心理共病的改善作用。

Improvement in tinnitus distress, health-related quality of life and psychological comorbidities by cochlear implantation in single-sided deaf patients.

作者信息

Häußler S M, Knopke S, Dudka S, Gräbel S, Ketterer M C, Battmer R-D, Ernst A, Olze H

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Charité-University Medical Center Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.

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

出版信息

HNO. 2020 Jan;68(Suppl 1):1-10. doi: 10.1007/s00106-019-0705-8.

Abstract

BACKGROUND

Patients with single-sided deafness (SSD) lack the ability localize sound sources and have difficulty with speech-in-noise hearing. In addition, there is a high prevalence of tinnitus distress. These problems may result in reduced health-related quality of life (HRQoL) and psychological comorbidities. This study aimed to investigate the influence of treatment with a cochlear implant (CI) on HRQoL, tinnitus distress, psychological comorbidities, and audiological parameters in SSD patients.

METHODS

This retrospective study included 20 patients with postlingually acquired SSD (13 women, 7 men, mean age 57.0 years). Data on HRQoL were collected with the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the Medical Outcome Study Short Form 36 Survey (SF-36). Tinnitus distress was assessed with the Tinnitus Questionnaire (TQ), psychological comorbidities were evaluated with validated questionnaires, and speech perception and hearing ability were measured with validated speech tests.

RESULTS

Postoperatively, the mean total NCIQ score (p < 0.0001) and four subscores improved significantly, as did tinnitus distress (p < 0.05). Anxiety symptoms (Generalized Anxiety Disorder questionnaire, GAD-7) decreased significantly after CI. Speech perception improved significantly, particularly "hearing with background noise" (p < 0.05, Oldenburg Inventory, OI) and "localization" (p < 0.001, OI), as well as the Oldenburg Sentence Test (OlSa) scores for with vs. without CI when speech was presented from the SSD side and noise was presented from the normal hearing side (SN; p < 0.005).

CONCLUSION

CI in SSD patients is a powerful procedure to improve HRQoL, reduce tinnitus distress, and improve psychological comorbidities. Additionally, it is beneficial for hearing improvement, particularly in noise and for directional hearing.

摘要

背景

单侧耳聋(SSD)患者缺乏声源定位能力,在噪声环境中听语音有困难。此外,耳鸣困扰的患病率很高。这些问题可能导致健康相关生活质量(HRQoL)下降和心理合并症。本研究旨在调查人工耳蜗(CI)治疗对SSD患者HRQoL、耳鸣困扰、心理合并症和听力学参数的影响。

方法

这项回顾性研究纳入了20例语后获得性SSD患者(13名女性,7名男性,平均年龄57.0岁)。使用奈梅亨人工耳蜗问卷(NCIQ)和医学结局研究简表36调查(SF-36)收集HRQoL数据。用耳鸣问卷(TQ)评估耳鸣困扰,用经过验证的问卷评估心理合并症,并用经过验证的言语测试测量言语感知和听力能力。

结果

术后,NCIQ总平均分(p<0.0001)和四个子分数显著改善,耳鸣困扰也显著改善(p<0.05)。人工耳蜗植入后焦虑症状(广泛性焦虑障碍问卷,GAD-7)显著减轻。言语感知显著改善,尤其是“在背景噪声中听力”(p<0.05,奥尔登堡量表,OI)和“定位”(p<0.001,OI),以及当言语从SSD侧呈现且噪声从正常听力侧呈现时(SN;p<0.005)人工耳蜗植入前后的奥尔登堡句子测试(OlSa)分数。

结论

SSD患者植入人工耳蜗是改善HRQoL、减轻耳鸣困扰和改善心理合并症的有效方法。此外,它有利于听力改善,尤其是在噪声环境中和定向听力方面。

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本文引用的文献

1
The psychological and social consequences of single-sided deafness in adulthood.成年后单侧耳聋的心理和社会后果。
Int J Audiol. 2018 Jan;57(1):21-30. doi: 10.1080/14992027.2017.1398420. Epub 2017 Nov 13.
3
Etiology of single-sided deafness and asymmetrical hearing loss.单侧耳聋和不对称听力损失的病因
Acta Otolaryngol. 2017;137(sup565):S2-S7. doi: 10.1080/00016489.2017.1300321. Epub 2017 Apr 1.
8
Cochlear Implantation and Single-sided Deafness: A Systematic Review of the Literature.人工耳蜗植入与单侧耳聋:文献系统综述
Int Arch Otorhinolaryngol. 2016 Jan;20(1):69-75. doi: 10.1055/s-0035-1559586. Epub 2015 Jul 29.

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