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当患者只有在存在背景噪声的情况下才符合植入人工耳蜗的条件时,他们是否能从中受益?

Do Patients Benefit From a Cochlear Implant When They Qualify Only in the Presence of Background Noise?

机构信息

Department of Speech-Language-Hearing Sciences, University of Colorado at Boulder, Boulder, Colorado.

UCHealth, Hearing and Balance Clinic, University of Colorado Hospital.

出版信息

Otol Neurotol. 2021 Feb 1;42(2):251-259. doi: 10.1097/MAO.0000000000002878.

DOI:10.1097/MAO.0000000000002878
PMID:33229878
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8075067/
Abstract

OBJECTIVE

To compare the difference in pre- to postoperative speech performance of patients qualifying for a cochlear implant (CI) in quiet, +10 dB signal-to-noise ratio (SNR), and +5 dB SNR.

STUDY DESIGN

Retrospective.

SETTING

Tertiary referral center.

PATIENTS

Fifty-eight post-lingually deafened, unilateral CI recipients from three Groups were included: 1) those who met CI candidacy criteria with AzBio sentences in quiet, 2) in noise at +10 dB SNR but not in quiet, 3) and in noise at +5 dB SNR but not in quiet or +10 dB SNR.

INTERVENTION

Unilateral CI.

MAIN OUTCOME MEASURES

Pre- and 1 year postoperative speech recognition scores.

RESULTS

Best-aided AzBio speech recognition of individuals in Group 1 improved significantly for all test conditions and improved significantly for Groups 2 and 3 in the +10 and +5 dB SNR test conditions postoperatively. When tested with their CI alone however, while AzBio speech recognition of individuals in Group 1 and Group 2 improved significantly in the quiet and +10 dB SNR conditions, speech recognition was not significantly changed postoperatively under any testing condition for individuals in Group 3.

CONCLUSIONS

While individuals qualifying for a CI only in the +5 dB SNR condition may derive significant benefit from implantation in best aided conditions, speech understanding outcomes can be more variable thus warranting additional counseling before implantation and case-by-case consideration of listening needs and goals.

摘要

目的

比较符合人工耳蜗植入(CI)适应证的患者在安静、+10dB 信噪比(SNR)和+5dB SNR 环境下术前至术后言语表现的差异。

研究设计

回顾性研究。

设置

三级转诊中心。

患者

58 名后天性聋的单侧 CI 接受者分为三组:1)在安静环境下满足 AzBio 句子 CI 候选标准的患者,2)在安静环境下不满足但在+10dB SNR 噪声环境下满足的患者,3)在安静环境下或+10dB SNR 噪声环境下不满足但在+5dB SNR 噪声环境下满足的患者。

干预

单侧 CI。

主要观察指标

术前和术后 1 年的言语识别分数。

结果

第 1 组患者在所有测试条件下的最佳辅助 AzBio 言语识别能力均显著提高,第 2 组和第 3 组患者在+10 和+5dB SNR 测试条件下术后也显著提高。然而,当单独使用 CI 测试时,第 1 组和第 2 组患者的 AzBio 言语识别在安静和+10dB SNR 条件下显著提高,但第 3 组患者在任何测试条件下术后言语识别均无显著变化。

结论

虽然仅在+5dB SNR 条件下符合 CI 适应证的患者在最佳辅助条件下可能会从植入中获得显著获益,但言语理解结果可能更为多变,因此在植入前需要进行额外的咨询,并根据患者的听力需求和目标进行个案考虑。