Cliniques universitaires Saint-Luc, Avenue Hippocrate 100, 1200, Brussels, Belgium.
Eargroup, Antwerpen-Deurne, Belgium.
Eur Arch Otorhinolaryngol. 2021 Dec;278(12):4671-4679. doi: 10.1007/s00405-020-06572-w. Epub 2021 Jan 3.
As a follow-up to the studies by Vaerenberg et al. (Sci World J 501738:1-12, 2014) and Browning et al. (Cochlear Implant Int 21(3):1-13, 2020), who used questionnaires, we determined whether there are between-centre variations in the fitting of cochlear implants by analysing the methodology, fitting parameters and hearing results of patients from four centres with real data. The purpose of this study is to highlight the lack of streamlined mapping guides and outcome measures with respect to cochlear implant (CI) fittings.
A retrospective study with ninety-seven post-lingual adults with a nucleus cochlear implant placed between 2003 and 2013 was included to ensure at least 5 years of follow-up. The studied data were as follows: the methodology, including the fitter's professional background, the method of activation, the sequence of fitting sessions, the objectives measures and hearing outcomes; and the fitting parameters, including the speech processors, programming strategy, stimulation mode, T and C levels, T-SPL and C-SPL, maxima, pulse width, loudness growth and hearing results.
This investigation highlights some common practices across professionals and CI centres: the activation of a CI is behavioural; impedances are systematically measured at each fitting; and some parameters are rarely modified. However, there are also differences, either between centres, such as the sequences of fitting sessions (p < 0.05) or their approach to spectral bands (p < 0.05), or even within centres, such as the policy regarding T and C levels at high frequencies compared to those at low and mid-frequencies.
There are important variations between and within centres that reflect a lack of CI-related policies and outcome measures in the fitting of CI.
NCT03700268.
作为 Vaerenberg 等人（Sci World J 501738:1-12, 2014）和 Browning 等人（Cochlear Implant Int 21(3):1-13, 2020）研究的后续工作，我们通过分析来自四个中心的患者的方法、拟合参数和听力结果，使用问卷确定人工耳蜗植入的中心之间是否存在差异。本研究的目的是强调在人工耳蜗（CI）适配方面缺乏流程化的映射指南和结果衡量标准。
纳入了一项回顾性研究，共 97 例后天性聋成人患者，于 2003 年至 2013 年期间接受了 Nucleus 耳蜗植入，以确保至少有 5 年的随访。研究数据如下：方法学，包括适配者的专业背景、激活方法、适配阶段的顺序、客观指标和听力结果；以及适配参数，包括言语处理器、编程策略、刺激模式、T 和 C 级别、T-SPL 和 C-SPL、最大值、脉冲宽度、响度增长和听力结果。
本研究强调了专业人员和 CI 中心之间的一些常见做法：CI 的激活是行为性的；在每次适配时都会系统地测量阻抗；并且很少修改某些参数。但是，也存在一些差异，包括中心之间的差异，如适配阶段的顺序（p < 0.05）或其对频谱带的处理方式（p < 0.05），甚至在中心内部，例如在高频时 T 和 C 级别的政策与低频和中频时的政策不同。
中心之间和中心内部存在重要的差异，这反映了在 CI 适配中缺乏与 CI 相关的政策和结果衡量标准。
NCT03700268。
