Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.
PLoS One. 2022 Jul 28;17(7):e0271497. doi: 10.1371/journal.pone.0271497. eCollection 2022.
To determine the benefit of sequential cochlear implantation after a long inter-implantation interval in children with bilateral deafness receiving their second implant between 5 and 18 years of age.
Prospective cohort-study.
Tertiary multicenter.
85 children with bilateral deafness and unilateral implantation receiving a contralateral cochlear implant at the age of 5 to 18 years.
The primary outcomes were speech recognition in quiet and noise (CVC) scores. The secondary outcomes were language outcomes and subjective hearing abilities, all measured before and 12 months after sequential bilateral cochlear implantation. Medians of the paired data were compared using the Wilcoxon signed-rank test. Univariable linear regression analyses was used to analyze associations between variables and performance outcomes.
A significant benefit was found for speech recognition in quiet (96% [89-98] vs 91% [85-96]; p < 0.01) and noise (65% [57-75] vs 54% [47-71]; p = 0.01) in the bilateral CI condition compared to unilateral (n = 75, excluded 10 non-users). No benefit was seen for language outcomes. The subjective sound quality score was statistically significant higher in bilateral compared to the unilateral CI condition. Pre-operative residual hearing level in the ear of the second implant, the inter-implant interval and age at time of second implantation was not significantly associated with performance scores.
After 12 months of use, sequential bilateral cochlear implantation showed improved speech perception in quiet and noise and improved subjective sound quality outcomes in children despite a great inter-implantation interval (median of 8 years [range 1-16 years]).
确定在 5 至 18 岁之间接受第二植入物的双侧耳聋儿童中，长时间植入间隔后进行顺序耳蜗植入的益处。
前瞻性队列研究。
三级多中心。
85 名双侧耳聋且单侧植入的儿童，在 5 至 18 岁时接受对侧耳蜗植入。
主要结局是在安静和噪声（CVC）下的语音识别评分。次要结局是语言结局和主观听力能力，所有这些均在顺序双侧耳蜗植入之前和之后 12 个月进行测量。使用 Wilcoxon 符号秩检验比较配对数据的中位数。使用单变量线性回归分析来分析变量与绩效结果之间的关联。
与单侧 CI 条件（n = 75，排除 10 名非使用者）相比，双侧 CI 条件下的安静（96%[89-98]与 91%[85-96]；p < 0.01）和噪声（65%[57-75]与 54%[47-71]；p = 0.01）的语音识别有明显提高。语言结果没有提高。双侧 CI 条件下的主观音质评分统计学上明显高于单侧 CI 条件。第二植入物耳的术前残余听力水平、植入间隔和第二次植入时间的年龄与绩效评分无显著相关性。
尽管植入间隔时间较长（中位数为 8 年[范围为 1-16 年]），但在 12 个月的使用后，顺序双侧耳蜗植入可改善安静和噪声下的语音感知，并改善主观音质结果。
