Department of Otolaryngology-Head & Neck Surgery, NYU School of Medicine, New York, New York.
Otol Neurotol. 2021 Mar 1;42(3):414-423. doi: 10.1097/MAO.0000000000002955.
To describe our experience with adults undergoing cochlear implantation (CI) for treatment of single-sided deafness (SSD).
Retrospective case review.
Tertiary referral center.
Fifty-three adults with SSD.
Unilateral CI.
Speech perception testing in quiet and noise, tinnitus suppression, and device usage from datalogs.
The mean age at CI was 53.2 years (SD 11.9). The mean duration of deafness was 4.0 years (SD 7.8). The most common etiology was idiopathic sudden SNHL (50%). Word recognition improved from 8.7% (SD 15) preoperatively to 61.8% (SD 20) at a mean follow-up of 3.3 years (SD 1.8) (p < 0.0001). Adaptive speech recognition testing in the "binaural with CI" condition (speech directed toward the front and noise toward the normal hearing ear) revealed a significant improvement by 2.6-dB SNR compared to the preoperative unaided condition (p = 0.0002) and by 3.6-dB SNR compared to when a device to route sound to the contralateral side was used (p < 0.0001). Tinnitus suppression was reported to be complete in 23 patients (43%) and improved in 20 patients (38%) while the device was on. The addition of the CI did not lead to a decrement in hearing performance in any spatial configuration. Device usage averaged 8.7 (SD 3.7) hours/day.
Cochlear implantation in adult SSD patients can suppress tinnitus and achieve speech perception outcomes comparable with CI in conventional candidates. Modest improvements in spatial hearing were also observed and primarily attributable to the head shadow effect. Careful patient selection and counseling regarding potential benefits are important to optimize outcomes.
描述我们在成人单侧聋（SSD）患者接受人工耳蜗植入（CI）治疗方面的经验。
回顾性病例研究。
三级转诊中心。
53 例 SSD 成人患者。
单侧 CI。
安静和噪声环境下的言语感知测试、耳鸣抑制以及数据日志中的设备使用情况。
CI 的平均年龄为 53.2 岁（SD 11.9）。耳聋的平均持续时间为 4.0 年（SD 7.8）。最常见的病因是特发性突发性单侧 SNHL（50%）。术前单词识别率为 8.7%（SD 15），平均随访 3.3 年（SD 1.8）后提高至 61.8%（SD 20）（p<0.0001）。在“双耳带 CI”条件下（言语朝向前方，噪声朝向健耳）进行自适应言语识别测试，与术前未助听条件相比，SNR 提高了 2.6dB（p=0.0002），与使用将声音路由到对侧设备时相比，SNR 提高了 3.6dB（p<0.0001）。有 23 例（43%）患者报告完全抑制耳鸣，20 例（38%）患者在设备开启时耳鸣改善。CI 的加入并没有导致任何空间配置下听力表现的下降。设备使用率平均为 8.7（SD 3.7）小时/天。
在 SSD 成年患者中进行 CI 可以抑制耳鸣并获得与传统 CI 候选者相当的言语感知结果。还观察到空间听觉的适度改善，主要归因于头部阴影效应。仔细选择患者并就潜在获益进行咨询对于优化结果很重要。
