Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
Otol Neurotol. 2021 Mar 1;42(3):e279-e285. doi: 10.1097/MAO.0000000000002947.
Assess relationships between patient, hearing, and cochlear implant (CI)-related factors and second-side CI speech recognition outcomes in adults who are bilaterally implanted.
Retrospective review of a prospectively maintained CI database.
Tertiary academic center.
One hundred two adults receiving bilateral sequential or simultaneous CIs.
Postimplantation consonant-nucleus-consonant (CNC) word and AzBio sentence scores at ≥12 months.
Of patient, hearing and CI-specific, factors examined only postimplantation speech recognition scores of the first CI were independently associated with speech recognition performance of the second CI on multivariable regression analysis (CNC: ß = 0.471[0.298, 0.644]; AzBio: ß = 0.602[0.417, 0.769]). First-side postoperative CNC scores explained 24.3% of variation in second CI postoperative CNC scores, while change in first CI AzBio scores explained 40.3% of variation in second CI AzBio scores. Based on established 95% confidence intervals, 75.2% (CNC) and 65.9% (AzBio) of patients score equivalent or better with their second CI compared to first CI performance. Age at implantation, duration of hearing loss, receiving simultaneous versus sequential CIs, and preoperative residual hearing (measured by pure-tone average and aided speech recognition scores) were not associated with 12 month speech recognition scores at 12 months.
The degree of improvement in speech recognition from first CI may predict speech recognition with a second CI. This provides preliminary evidence-based expectations for patients considering a second CI. Counseling should be guarded given the remaining unexplained variability in outcomes. Nonetheless, these data may assist decision making when considering a second CI versus continued use of a hearing aid for an unimplanted ear.
III.
评估患者、听力和人工耳蜗（CI）相关因素与双侧植入成人的第二侧 CI 言语识别结果之间的关系。
对前瞻性维护的 CI 数据库进行回顾性审查。
三级学术中心。
102 名接受双侧顺序或同时 CI 的成年人。
至少 12 个月时植入后的辅音-核-辅音（CNC）词和 AzBio 句子得分。
在检查的患者、听力和 CI 特异性因素中，只有植入后的言语识别得分与多变量回归分析中的第二侧 CI 的言语识别表现独立相关（CNC：β=0.471[0.298, 0.644]；AzBio：β=0.602[0.417, 0.769]）。第一侧手术后的 CNC 分数解释了第二侧手术后 CNC 分数变化的 24.3%，而第一侧 CI 的 AzBio 分数变化解释了第二侧 CI 的 AzBio 分数变化的 40.3%。根据既定的 95%置信区间，75.2%（CNC）和 65.9%（AzBio）的患者在第二 CI 方面的得分与第一 CI 表现相当或更好。植入年龄、听力损失持续时间、同时接受 CI 与顺序接受 CI 以及术前残余听力（通过纯音平均和助听听觉识别得分测量）与 12 个月时的言语识别得分无关。
第一 CI 的言语识别改善程度可能预测第二 CI 的言语识别。这为考虑第二 CI 的患者提供了初步的基于证据的预期。考虑到结果仍然存在无法解释的可变性，咨询应持谨慎态度。尽管如此，当考虑第二 CI 与继续使用未植入耳朵的助听器相比，这些数据可能有助于决策。
III。
