Bo Duan, Huang Yue, Wang Bing, Lu Ping, Chen Wen-Xia, Xu Zheng-Min
Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China.
Ann Otol Rhinol Laryngol. 2023 Apr;132(4):371-380. doi: 10.1177/00034894221092201. Epub 2022 May 2.
The aim of this meta-analysis was to critically assess the effect of cochlear implantation on auditory and speech performance outcomes of children with auditory neuropathy spectrum disorder (ANSD).
A systematic literature search was conducted on PubMed, EMbase, and Web of Science. The outcomes included speech recognition score, Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR) score, and open-set speech perception. Results were expressed as standardized mean difference (SMD) or risk ratio (RR) with a 95% confidence interval (95% CI).
A total of 15 studies was included in this meta-analysis. Pooled data showed that, there were no significant differences between ANSD and sensorineural hearing loss (SNHL) groups in terms of speech recognition score (SMD = 0.01, 95% CI: -0.45, 0.47; = .959),CAP (SMD = 0.71, 95% CI: -0.13, 1.54; = .098), SIR score (SMD = -0.09, 95% CI: -0.49, 0.32; = .667), and open-set speech perception (RR = 0.85, 95% CI: 0.69, 1.05; = .142). Sensitivity analysis by removing individual studies one at a time showed that the overall estimate and level of heterogeneity did not change substantially.
The current evidence suggested that children with ANSD who underwent cochlear implants achieved comparable effects in auditory and speech performance as children with non-ANSD SNHL.
本荟萃分析旨在严格评估人工耳蜗植入对听神经病谱系障碍（ANSD）儿童听觉和言语表现结果的影响。
在PubMed、EMbase和Web of Science上进行了系统的文献检索。结果包括言语识别得分、听觉表现类别（CAP）、言语可懂度评分（SIR）得分和开放式言语感知。结果以标准化均数差（SMD）或风险比（RR）及95%置信区间（95%CI）表示。
本荟萃分析共纳入15项研究。汇总数据显示，ANSD组和感音神经性听力损失（SNHL）组在言语识别得分（SMD = 0.01，95%CI：-0.45，0.47；P = 0.959）、CAP（SMD = 0.71，95%CI：-0.13，1.54；P = 0.098）、SIR得分（SMD = -0.09，95%CI：-0.49，0.32；P = 0.667）和开放式言语感知（RR = 0.85，95%CI：0.69，1.05；P = 0.142）方面无显著差异。逐一剔除个别研究进行的敏感性分析表明，总体估计和异质性水平没有实质性变化。
目前的证据表明，接受人工耳蜗植入的ANSD儿童在听觉和言语表现方面与非ANSD的SNHL儿童取得了相当的效果。
