Department of Otorhinolaryngology, Head and Neck Surgery, Charité - University Medical Center Berlin, Campus Virchow-Klinikum, Berlin.
Department of Otorhinolaryngology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.
Otol Neurotol. 2020 Jun;41(5):e563-e574. doi: 10.1097/MAO.0000000000002590.
To determine and compare the benefit of binaural hearing rehabilitation via cochlear implantation (CI) on speech perception, assessment of auditory abilities, tinnitus distress, health-related quality of life (HRQoL) and psychological comorbidities in patients suffering from asymmetric hearing loss (AHL) as well as bilaterally-deafened and sequentially bilaterally-implanted patients.
53 patients were implanted between 2011 and 2016. 24 AHL patients were implanted unilaterally, using a hearing aid on the other side. 29 bilaterally-deafened patients were sequentially implanted bilaterally. Speech perception, subjective hearing quality, HRQoL, tinnitus distress, anxiety, depressiveness, perceived stress level and coping abilities were evaluated before implantation, as well as 6 and 24 months postoperatively.
Before CI, AHL and bilaterally-deaf patients showed significant differences regarding assessment of auditory abilities, speech discrimination, tinnitus distress and HRQoL. 24 months after CI both groups significantly improved in those scales. We could not find a significant difference between the groups after 2 years. Tinnitus distress significantly decreased 6 and 24 months postoperatively in both groups.
This study demonstrates the long-term benefit of binaural hearing rehabilitation in AHL and bilaterally-deaf patients not only regarding speech perception but also HRQoL, tinnitus distress and subjective hearing quality. Bilaterally-deafened patients present lower scores preoperatively, but they did not differ from AHL patients 2 years after CI. Up to now, this is the first study evaluating the outcome of CI in AHL patients compared to bilaterally-implanted patients and demonstrating the benefit of binaural hearing rehabilitation in these specific groups.
确定并比较双侧植入人工耳蜗对单侧听力损失（AHL）、双侧耳聋及序贯双侧植入患者的言语感知、听觉能力评估、耳鸣困扰、健康相关生活质量（HRQoL）和心理共病的益处。
2011 年至 2016 年共植入 53 例患者。24 例 AHL 患者单侧植入，对侧使用助听器。29 例双侧耳聋患者序贯双侧植入。在植入前、术后 6 个月和 24 个月评估言语感知、主观听力质量、HRQoL、耳鸣困扰、焦虑、抑郁、感知压力水平和应对能力。
在植入人工耳蜗前，AHL 和双侧耳聋患者在听觉能力评估、言语辨别、耳鸣困扰和 HRQoL 方面存在显著差异。植入后 24 个月，两组在这些量表上均有显著改善。2 年后两组间无显著差异。两组患者术后 6 个月和 24 个月耳鸣困扰均显著减轻。
本研究表明，双侧听觉康复不仅在言语感知方面，而且在 HRQoL、耳鸣困扰和主观听力质量方面，对 AHL 和双侧耳聋患者均具有长期益处。双侧耳聋患者术前评分较低，但在植入后 2 年与 AHL 患者无差异。到目前为止，这是第一项比较 AHL 患者和双侧植入患者的人工耳蜗植入后结果的研究，并证明了在这些特定患者群体中双侧听觉康复的益处。
