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前瞻性多中心单侧聋成人人工耳蜗植入随访研究:耳鸣及听力学结果。

Prospective Multicentric Follow-up Study of Cochlear Implantation in Adults With Single-Sided Deafness: Tinnitus and Audiological Outcomes.

机构信息

APHP, Rotschild Hospital, Otolaryngology, Otology and Auditory Implants Department, Paris.

Rennes Pontchaillou University Hospital, Otorhinolaryngology Department, Rennes.

出版信息

Otol Neurotol. 2020 Apr;41(4):458-466. doi: 10.1097/MAO.0000000000002564.

Abstract

OBJECTIVE

This study investigated the audiological and tinnitus outcomes of cochlear implantation (CI) in adults with single-sided deafness (SSD) and tinnitus.

STUDY DESIGN

Multicentered prospective, non-randomized intervention study.

SETTING

Six French CI centers.

PATIENTS

Twenty-six patients with SSD and incapacitating tinnitus (Tinnitus Handicap Inventory [THI] >58) underwent cochlear implantation.

INTERVENTIONS

First, CIs delivered only masking white noise stimulation for 1 month and then standard CI stimulation.

MAIN OUTCOME MEASURES

Before and after CI surgery, patients completed the THI, Tinnitus Reaction Questionnaire (TRQ), Subjective Tinnitus Severity Scale (STSS), and two visual analogue scales quantifying tinnitus loudness and annoyance. Speech perception in spatialized noise was tested at 13 months.

RESULTS

The first month of white noise stimulation triggered a significant improvement in THI scores (72 ± 9 to 55 ± 20, p < 0.05). No change was observed for the other measures. After 1 year of standard CI stimulation, 23 patients (92%) reported a significant improvement in tinnitus. This improvement started 1 to 2 months after CI and exceeded 40% improvement for 14 patients (54%). Average speech-in-noise perception after 1 year significantly improved for the 23 patients who completed these measures.

CONCLUSIONS

CI is efficacious to reduce the handicap of patient with SSD and incapacitating tinnitus, leading to a decrease in reported tinnitus and partial restoration of binaural hearing abilities.

摘要

目的

本研究旨在探讨单侧聋(SSD)伴耳鸣患者行人工耳蜗植入(CI)后的听力和耳鸣结局。

研究设计

多中心前瞻性、非随机干预研究。

设置

六家法国 CI 中心。

患者

26 例 SSD 伴致残性耳鸣(耳鸣残疾评估量表[THI]>58)患者接受了 CI 植入。

干预措施

首先,CI 仅提供掩蔽白噪声刺激 1 个月,然后提供标准 CI 刺激。

主要观察指标

在 CI 手术前后,患者完成了 THI、耳鸣反应问卷(TRQ)、主观耳鸣严重程度量表(STSS)以及两个视觉模拟量表,用于量化耳鸣响度和烦恼。13 个月时测试空间化噪声中的言语感知。

结果

白噪声刺激的第一个月,THI 评分显著改善(72±9 降至 55±20,p<0.05)。其他指标无变化。标准 CI 刺激 1 年后,23 例患者(92%)报告耳鸣显著改善。这种改善在 CI 后 1 至 2 个月开始,14 例患者(54%)的改善超过 40%。完成这些测量的 23 例患者的平均噪声中言语感知在 1 年后显著提高。

结论

CI 对于减轻 SSD 伴致残性耳鸣患者的残疾程度是有效的,可导致耳鸣报告减少和双耳听力能力部分恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eebf/7208276/4015ebfc2e22/mao-41-458-g001.jpg

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