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单侧聋患者耳鸣的人工耳蜗植入治疗:系统评价和荟萃分析。

Cochlear Implantation for Treatment of Tinnitus in Single-sided Deafness: A Systematic Review and Meta-analysis.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.

出版信息

Otol Neurotol. 2020 Sep;41(8):e1004-e1012. doi: 10.1097/MAO.0000000000002711.

Abstract

OBJECTIVE

Quantify the benefit of cochlear implantation (CI) for tinnitus relief among individuals with single-sided deafness (SSD).

DATA SOURCES

PubMed, Scopus, and Cochrane databases were searched through July 10, 2019. Search strategies used a combination of subject headings (e.g., MeSH in PubMed) and keywords for the following three concepts: single-sided deafness, cochlear implantation, and tinnitus.

STUDY SELECTION

English articles that reported the preintervention (baseline) tinnitus-related patient-reported outcome measures (e.g., Tinnitus Handicap Inventory [THI] and Visual Analog Scale [VAS] for loudness) in patients with SSD that underwent CI were included.

DATA EXTRACTION

Number of patients, mean age, etiology of hearing loss, duration of deafness, baseline and follow-up THI and VAS scores.

DATA SYNTHESIS

A total of 17 studies met inclusion criteria encompassing 247 patients with SSD receiving a cochlear implant (mean age 50.2 yr, range 23-71). For THI, CI resulted in a mean difference of -35.4 points [95% CI -55.8 to -15.0, p < 0.001]. VAS decreased by -4.6 points [CI -6.0 to -3.3, p < 0.001]. A weighted proportion of 14.9% [CI 6.4-26.1] of patients experienced complete resolution of tinnitus, while 74.5% [CI 63.1-84.5] experienced partial improvement; 7.6% [CI 4.1-12.6] of patients had no change in severity, and 3.0% [CI 1.0-6.7] experienced worsening of their tinnitus.

CONCLUSIONS

On both THI and VAS, patients reported significant reduction in their scores, representing an overall improvement in tinnitus severity while wearing the cochlear implant. Most patients with SSD will experience partial improvement or complete resolution of tinnitus with a cochlear implant.

摘要

目的

量化单侧聋(SSD)患者植入人工耳蜗(CI)对耳鸣缓解的益处。

资料来源

检索了 2019 年 7 月 10 日之前的 PubMed、Scopus 和 Cochrane 数据库。检索策略使用了主题词(如 PubMed 中的 MeSH)和以下三个概念的关键词的组合:单侧聋、人工耳蜗植入和耳鸣。

研究选择

包括报告 SSD 患者接受 CI 前(基线)与耳鸣相关的患者报告结局测量(例如耳鸣残疾量表[THI]和响度视觉模拟量表[VAS])的英文文章。

数据提取

患者数量、平均年龄、听力损失病因、耳聋持续时间、基线和随访 THI 和 VAS 评分。

数据综合

共有 17 项研究符合纳入标准,共纳入 247 例 SSD 患者接受人工耳蜗植入(平均年龄 50.2 岁,范围 23-71 岁)。对于 THI,CI 导致平均差异为-35.4 分[95%CI-55.8 至-15.0,p<0.001]。VAS 降低了-4.6 分[CI-6.0 至-3.3,p<0.001]。14.9%[CI6.4-26.1]的患者完全缓解了耳鸣,74.5%[CI63.1-84.5]的患者部分改善;7.6%[CI4.1-12.6]的患者耳鸣严重程度无变化,3.0%[CI1.0-6.7]的患者耳鸣恶化。

结论

在 THI 和 VAS 上,患者报告的评分均显著降低,这代表佩戴人工耳蜗时耳鸣严重程度总体改善。大多数 SSD 患者将通过人工耳蜗植入获得耳鸣部分改善或完全缓解。

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