Moberly Aaron C, Vasil Kara, Baxter Jodi, Klamer Brett, Kline David, Ray Christin
Department of Otolaryngology - Head and Neck Surgery The Ohio State University Wexner Medical Center Columbus Ohio USA.
Department of Speech and Hearing Science The Ohio State University Columbus Ohio USA.
Laryngoscope Investig Otolaryngol. 2020 Sep 1;5(5):911-918. doi: 10.1002/lio2.442. eCollection 2020 Oct.
In the United States, most adults who receive cochlear implants (CIs) do not undergo a comprehensive auditory rehabilitation (CAR) approach, which may result in suboptimal outcomes. The objectives of this pilot study were to demonstrate that a CAR approach incorporating auditory training (AT) by a speech-language pathologist (SLP) is feasible in adults receiving CIs and to explore whether this approach results in improved outcomes.
Twenty-four postlingually deaf adult CI candidates were serially assigned to one of three groups: (a) a "CAR group" that received standard of care implantation, programming by an audiologist, an additional preoperative counseling session, and eight one-hour AT sessions; (b) a "passive control" standard-of-care group; and (c) an "active control" group that also received the extra preoperative counseling session. Participants were tested preoperatively and 1, 3, and 6 months after CI using measures of word and sentence recognition in quiet and in babble, as well as measures of quality of life (QOL).
The CAR approach was feasible, but this pilot study was underpowered to determine efficacy. Differential time courses of speech recognition improvement were seen for sentence and word recognition. All QOL measurements showed improvement from pre-CI to 1 month post-CI activation. Results revealed issues to consider for a larger-scale study of CAR revolving around participant selection, study measures, and sample size.
The CAR approach is feasible in new CI users. A larger trial is needed to investigate whether CAR leads to better outcomes or faster improvement in this clinical population.
在美国，大多数接受人工耳蜗植入（CI）的成年人未采用全面的听觉康复（CAR）方法，这可能导致效果欠佳。本试点研究的目的是证明由言语语言病理学家（SLP）实施的包含听觉训练（AT）的CAR方法在接受CI的成年人中是可行的，并探讨这种方法是否能带来更好的效果。
24名语后聋的成年CI候选者被依次分配到三组中的一组：（a）“CAR组”，接受标准护理植入、听力学家编程、额外的术前咨询以及八次一小时的AT训练；（b）“被动对照”标准护理组；（c）“主动对照”组，也接受额外的术前咨询。在术前以及CI术后1、3和6个月，使用安静和嘈杂环境下的单词和句子识别测试以及生活质量（QOL）测试对参与者进行检测。
CAR方法是可行的，但本试点研究的效能不足以确定疗效。句子和单词识别的言语识别改善时间进程存在差异。所有QOL测量结果均显示从CI术前到CI激活后1个月有所改善。结果揭示了围绕参与者选择、研究措施和样本量进行CAR大规模研究时需要考虑的问题。
CAR方法在新的CI使用者中是可行的。需要进行更大规模的试验来研究CAR是否能使该临床人群获得更好的效果或更快的改善。
2级。
