Davies Camron, Bergman Jenna, Misztal Carly, Ramchandran Renuka, Mittal Jeenu, Bulut Erdogan, Shah Viraj, Mittal Rahul, Eshraghi Adrien A
Cochlear Implant and Hearing Research Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
J Clin Med. 2021 Jun 29;10(13):2915. doi: 10.3390/jcm10132915.
To systematically appraise the implementation of cochlear implantation (CI) in Usher Syndrome (USH) Types 1, 2, and 3 patients, and analyze who would benefit from CI.
A comprehensive search of PubMed, Embase, CINAHL, and Cochrane Library electronic databases from inception through June 2020 was performed. There were no language restrictions.
The PRISMA strategy was followed. Included studies discuss USH patients who underwent CI regardless of age, nationality, or clinical subtype. All included studies report post-implantation functional, cognitive, or quality of life outcomes. Only reviews were excluded.
Fifteen studies met the inclusion criteria. USH patients experienced improvements in PTA and speech perception and expression outcomes after CI, as well as improvements in phonological memory and quality of life measures. Overall, patients implanted at younger ages outperformed older patients in audiological testing. Similarly, patients with prolonged auditory deprivation had relatively poor performance outcomes in sentence recognition and speech detection following CI.
Most USH patients benefit from CI. USH patients who undergo CI at younger ages generally achieve better hearing, speech, and cognitive outcomes. CI at older ages can still prove beneficial if appropriate auditory amplification is started at the right time. Further research is warranted to fill the gap in understanding regarding the gene mutations underlying the pathophysiology of USH that have favorable CI outcomes as well as the optimal time to perform CI.
系统评估1型、2型和3型Usher综合征(USH)患者人工耳蜗植入(CI)的实施情况,并分析哪些患者将从CI中获益。
对PubMed、Embase、CINAHL和Cochrane图书馆电子数据库从创建至2020年6月进行全面检索。无语言限制。
遵循PRISMA策略。纳入的研究讨论了接受CI的USH患者,无论其年龄、国籍或临床亚型如何。所有纳入的研究均报告了植入后的功能、认知或生活质量结果。仅排除综述。
15项研究符合纳入标准。USH患者在CI后纯音平均听阈(PTA)、言语感知和表达结果方面有所改善,语音记忆和生活质量指标也有所改善。总体而言,年龄较小接受植入的患者在听力测试中的表现优于年龄较大的患者。同样,听觉剥夺时间较长的患者在CI后的句子识别和言语检测方面的表现相对较差。
大多数USH患者从CI中获益。年龄较小接受CI的USH患者通常在听力、言语和认知方面取得更好的结果。如果在适当的时候开始进行适当的听觉放大,年龄较大时进行CI仍然有益。有必要进一步研究,以填补在理解USH病理生理学基础上具有良好CI结果的基因突变以及进行CI的最佳时间方面的空白。