Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University of Würzburg.
Otol Neurotol. 2020 Jul;41(6):727-735. doi: 10.1097/MAO.0000000000002618.
To implement a unified testing framework into clinical routine that can be used by adults with single-sided deafness (SSD) to assess alternative treatment options before cochlear implantation.
Retrospective data analysis.
Tertiary referral center with a large CI program.
Thirty four participants underwent the new implemented testing procedure, including a test trial with contralateral routing of the signal (CROS) hearing aids and bone conduction devices (BCD) on a headband, before deciding whether to proceed with cochlear implantation. A test battery was used to assess speech in noise, binaural effects (head shadow, squelch, summation, spatial release from masking), sound localization, and quality of life. For participants that chose a CI, the same test battery was repeated during the 6 and 12 months follow-up appointments.
Of the 34 participants involved in the study, 11 were implanted with a CI and finished their 12 month evaluation. Sixteen participants decided to stop after the CROS/BCD trial. In the CI-recipient group, a significant head shadow effect of 5.1 to 7.1 dB was achieved with the CI. Recipients in this group received only a limited benefit with either CROS or BCD before implantation. In the non-CI-recipient group, a significant difference between the CROS and BCD, in favor for the CROS device, was found calculating the head shadow and squelch effect. Localization abilities with the CI improved significantly in the CI-recipient group, even between the 6- and 12-month follow-up appointments. In the non-CI-recipient group, localization was significantly better with the BCD during the trial period. Higher scores were obtained from the speech and spatial categories of the Speech, Spatial, and Qualities of Hearing (SSQ) questionnaire with the CI. No subjective difference could be determined in the non-CI-recipient group.
Implementing the unified testing framework into a clinical routine was challenging but provided helpful insight into the best treatment option for each individual.
在临床常规中实施一个统一的测试框架，供单侧聋（SSD）成年人在接受人工耳蜗植入前评估替代治疗方案。
回顾性数据分析。
拥有大型人工耳蜗项目的三级转诊中心。
34 名参与者接受了新实施的测试程序，包括在头带式骨导设备和对侧信号转导（CROS）助听器上进行测试试验，然后再决定是否进行人工耳蜗植入。使用测试电池评估噪声下的言语、双耳效应（头部阴影、抑制、总和、掩蔽释放）、声音定位和生活质量。对于选择人工耳蜗的参与者，在 6 个月和 12 个月的随访预约中重复使用相同的测试电池。
在参与研究的 34 名参与者中，有 11 名植入了人工耳蜗并完成了 12 个月的评估。16 名参与者在 CROS/BCD 试验后决定停止。在人工耳蜗植入组中，人工耳蜗可获得 5.1 至 7.1dB 的显著头部阴影效应。在植入前，该组中的接受者仅从 CROS 或 BCD 中获得有限的益处。在非人工耳蜗植入组中，发现 CROS 和 BCD 之间存在显著差异，CROS 设备更有利，头部阴影和抑制效果的计算结果显示如此。在人工耳蜗植入组中，随着时间的推移，定位能力显著提高，即使在 6 个月和 12 个月的随访预约之间。在非人工耳蜗植入组中，在测试期间，BCD 的定位明显更好。在言语、空间和听力质量（SSQ）问卷的言语和空间类别中，人工耳蜗获得了更高的分数。在非人工耳蜗植入组中，无法确定主观差异。
将统一的测试框架纳入临床常规是具有挑战性的，但为每个个体提供了最佳治疗方案的有价值的见解。
