Department of Audiology, Nova Southeastern University, Fort Lauderdale, FL.
Am J Audiol. 2021 Sep 10;30(3):777-789. doi: 10.1044/2021_AJA-20-00175. Epub 2021 Jul 23.
Objective The aim of this mini-systematic review was to evaluate the evidence reporting speech, language, and auditory behavioral outcome measures for children with a diagnosis of auditory neuropathy spectrum disorder (ANSD) who received cochlear implants (CIs) prior to 3 years of age. Method A mini-systematic review of the literature supporting evidence-based practices was performed. Two databases were searched utilizing a search strategy derived from the PICO (patient, intervention, comparison, outcome) framework. Peer-reviewed articles published between 2009 and 2019 evaluating children with a diagnosis of ANSD who were implanted prior to 3 years of age with a range of speech, language, and auditory behavioral outcomes were included. Four articles meeting inclusion criteria were critically appraised for reputable research design and risks of bias. Each of the four studies was assigned a level of evidence for effectiveness and quality assessment rating. Results Evidence supports cochlear implantation as an appropriate intervention for children with ANSD. Improvements in outcome performance were observed in all the included studies. Children with ANSD fit with CIs can achieve outcomes similar to children with sensorineural hearing loss and CIs, despite the heterogeneity of ANSD. Conclusion These findings have implications for clinical practice and for future research with current CI technology for facilitating parent education, counseling, and realistic expectations for children with ANSD and CIs.
本微型系统评价旨在评估在 3 岁之前接受人工耳蜗植入术 (CI) 的听神经病谱系障碍 (ANSD) 儿童的言语、语言和听觉行为结局的报告证据。
对支持循证实践的文献进行微型系统评价。利用源于 PICO(患者、干预、比较、结局)框架的搜索策略,对两个数据库进行了搜索。纳入了 2009 年至 2019 年期间发表的评估在 3 岁之前被诊断为 ANSD 且植入 CI 的儿童的研究,其研究范围为言语、语言和听觉行为结局。对符合纳入标准的 4 篇文章进行了批判性评估,以评估其研究设计的可信度和偏倚风险。对这 4 项研究均进行了有效性和质量评估评级的分级。
证据支持将 CI 作为 ANSD 儿童的一种适当干预措施。所有纳入的研究均观察到结局表现的改善。尽管 ANSD 存在异质性,但植入 CI 的 ANSD 儿童可以取得与感音神经性听力损失和 CI 儿童相似的结局。
这些发现对临床实践和使用当前 CI 技术开展未来研究具有启示意义,旨在为 ANSD 和 CI 儿童的家长教育、咨询和现实期望提供依据。