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单中心经验及双侧聋成人植入第二侧人工耳蜗获益的实际考虑。

Single-centre experience and practical considerations of the benefit of a second cochlear implant in bilaterally deaf adults.

机构信息

Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

Department of Otorhinolaryngology, Kantonsspital Baselland, Liestal, Switzerland.

出版信息

Eur Arch Otorhinolaryngol. 2021 Jul;278(7):2289-2296. doi: 10.1007/s00405-020-06315-x. Epub 2020 Sep 5.

Abstract

PURPOSE

Bilateral cochlear implant (CI) implantation is increasingly used in the auditory rehabilitation of bilaterally deafened adults. However, after successful unilateral implantation, objective patient counselling is essential.

METHODS

We investigated the extra benefit of a second CI in adults in terms of health-related quality of life, tinnitus, stress, anxiety, depression, quality of hearing, and speech recognition. Hearing ability was assessed by using the Freiburg monosyllable speech discrimination test (FB MS) and the Oldenburg sentence test with azimuth variations. In a prospective patient cohort, we administered validated questionnaires before a CI, after a first CI and after a second CI implantation.

RESULTS

The study included 29 patients, made up of nine women and 20 men. The median time between the first and the second implantation was 23 months. The mean total NCIQ score and TQ before a CI improved significantly after both implantations. Stress, anxiety, and depression were stable over time and were not significantly affected by CI implantations. Speech recognition with noise significantly improved after the first and again after the second CI. Correlation analysis showed a strong connection between auditory performance and HRQoL.

CONCLUSION

We demonstrated that a unilateral CI benefitted many fields and that the second sequential CI leads again to additional improvement. Bilateral CI implantation should, therefore, be the standard form of auditory rehabilitation in deafened adults.

摘要

目的

双侧人工耳蜗植入术(CI)越来越多地应用于双侧聋患者的听觉康复。然而,在成功单侧植入后,对患者进行客观的咨询至关重要。

方法

我们研究了双侧聋成年人在健康相关生活质量、耳鸣、压力、焦虑、抑郁、听力质量和言语识别方面接受第二侧 CI 的额外益处。听力能力通过弗赖堡单音节言语辨别测试(FB MS)和具有方位变化的奥登堡句子测试进行评估。在一项前瞻性患者队列研究中,我们在植入 CI 之前、植入第一侧 CI 之后和植入第二侧 CI 之后使用经过验证的问卷进行调查。

结果

该研究纳入了 29 名患者,包括 9 名女性和 20 名男性。第一侧和第二侧植入之间的中位时间为 23 个月。植入 CI 前的平均 NCIQ 总分和 TQ 显著提高,植入后又进一步提高。压力、焦虑和抑郁随时间保持稳定,植入 CI 并未显著影响。噪声下言语识别在第一侧和第二侧植入后均显著改善。相关性分析表明,听觉表现与健康相关生活质量之间存在紧密联系。

结论

我们证明单侧 CI 受益于许多领域,并且第二侧序贯 CI 再次带来了额外的改善。双侧 CI 植入术应成为耳聋成年人听觉康复的标准形式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35f9/8165073/101973636efd/405_2020_6315_Fig1_HTML.jpg

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