Aminpour Nathan, Levin Laura, Finkbone Mary, Morikawa Michael, Blumgart Melissa, Kim H Jeffrey, Hoa Michael
Department of Otolaryngology, Georgetown University School of Medicine, Washington DC, USA.
Department of Otolaryngology, MedStar Georgetown University Hospital, Washington DC, USA.
Cureus. 2022 Feb 23;14(2):e22543. doi: 10.7759/cureus.22543. eCollection 2022 Feb.
The use of cochlear implantation to rehabilitate moderate to profound sensorineural hearing loss has become more widespread; however, the adult utilization rate of cochlear implant candidates is still very less. The study aims to examine the percentage of adult patients in a heterogeneous group of cochlear implant recipients at a nascent cochlear implant program who demonstrate improvements in speech outcomes.
Speech outcome scores were assessed preoperatively and postoperatively at three, six, and 12-month intervals using consonant-nucleus-consonant (CNC) words and AzBio sentences in quiet. Mean speech outcome scores at each time point and binomial distribution tables with 95% CI were used to assess individual improvement in speech understanding.
45 patients underwent a total of 49 cochlear implantation surgeries. The mean age at surgery was 62 years. The mean preoperative CNC score in the ear to be implanted was 18%±18, while the mean postoperative CNC score at three, six, and 12 months was 35%±21, 44%±23, and 45%±25, respectively. The mean preoperative AzBio score in the ear to be implanted was 22%±26 while the mean postoperative AzBio score at three, six, and 12 months was 50%±29, 56%±27, and 63%±26, respectively. Of the implantations, 74% (32 of 43) and 69% (22 of 32) showed significant improvement at six months or one year using AzBio and CNC binomial distribution tables, respectively.
Findings demonstrate significant improvements in speech perception following cochlear implantation for patients not benefiting from hearing aid aural rehabilitation. The study provides realistic expectations for new and emerging programs hoping to demonstrate cochlear implant utility for improving patients' speech outcomes.
使用人工耳蜗来恢复中度至重度感音神经性听力损失的情况已变得更为普遍；然而，人工耳蜗植入候选者的成人利用率仍然很低。本研究旨在调查在一个新开展的人工耳蜗植入项目中，不同类型人工耳蜗植入受者群体里，言语结果得到改善的成年患者的比例。
在安静环境下，术前以及术后三个月、六个月和十二个月，使用辅音-元音-辅音（CNC）单词和AzBio句子评估言语结果分数。利用每个时间点的平均言语结果分数以及带有95%置信区间的二项分布表，来评估个体在言语理解方面的改善情况。
45名患者共接受了49次人工耳蜗植入手术。手术时的平均年龄为62岁。拟植入耳术前CNC平均分数为18%±18，而术后三个月、六个月和十二个月的CNC平均分数分别为35%±21、44%±23和45%±25。拟植入耳术前AzBio平均分数为22%±26，而术后三个月、六个月和十二个月的AzBio平均分数分别为50%±29、56%±27和63%±26。在植入手术中，分别有74%（43例中的32例）和69%（32例中的22例）在六个月或一年时，使用AzBio和CNC二项分布表显示出显著改善。
研究结果表明，对于未从助听器听觉康复中获益的患者，人工耳蜗植入后言语感知有显著改善。该研究为希望证明人工耳蜗对改善患者言语结果有用性的新项目和新兴项目提供了现实的预期。
