School of Medicine, Uniformed Services University of the Health Sciences.
Department of Otolaryngology Head and Neck Surgery, Walter Reed National Military Medical Center.
Otol Neurotol. 2022 Oct 1;43(9):e924-e935. doi: 10.1097/MAO.0000000000003653. Epub 2022 Aug 17.
To review studies evaluating clinically implemented image-guided cochlear implant programing (IGCIP) and to determine its effect on cochlear implant (CI) performance.
PubMed, EMBASE, and Google Scholar were searched for English language publications from inception to August 1, 2021.
Included studies prospectively compared intraindividual CI performance between an image-guided experimental map and a patient's preferred traditional map. Non-English studies, cadaveric studies, and studies where imaging did not directly inform programming were excluded.
Seven studies were identified for review, and five reported comparable components of audiological testing and follow-up times appropriate for meta-analysis. Demographic, speech, spectral modulation, pitch accuracy, and quality-of-life survey data were collected. Aggregate data were used when individual data were unavailable.
Audiological test outcomes were evaluated as standardized mean change (95% confidence interval) using random-effects meta-analysis with raw score standardization. Improvements in speech and quality-of-life measures using the IGCIP map demonstrated nominal effect sizes: consonant-nucleus-consonant words, 0.15 (-0.12 to 0.42); AzBio quiet, 0.09 (-0.05 to 0.22); AzBio +10 dB signal-noise ratio, 0.14 (-0.01 to 0.30); Bamford-Kowel-Bench sentence in noise, -0.11 (-0.35 to 0.12); Abbreviated Profile of Hearing Aid Benefit, -0.14 (-0.28 to 0.00); and Speech Spatial and Qualities of Hearing Scale, 0.13 (-0.02 to 0.28). Nevertheless, 79% of patients allowed to keep their IGCIP map opted for continued use after the investigational period.
IGCIP has potential to precisely guide CI programming. Nominal effect sizes for objective outcome measures fail to reflect subjective benefits fully given discordance with the percentage of patients who prefer to maintain their IGCIP map.
综述评估临床应用影像引导人工耳蜗编程（IGCIP）的研究，并确定其对人工耳蜗（CI）性能的影响。
从建库至 2021 年 8 月 1 日，通过 PubMed、EMBASE 和 Google Scholar 检索英文文献。
纳入研究前瞻性比较了影像引导的实验图和患者偏爱的传统图之间的个体 CI 性能。排除非英语研究、尸体研究以及影像学不能直接指导编程的研究。
共 7 项研究进行了综述，其中 5 项报告了适合荟萃分析的可比听力学测试和随访时间部分。收集了人口统计学、言语、频谱调制、音高准确性和生活质量调查数据。当个体数据不可用时，使用汇总数据。
使用随机效应荟萃分析对听力测试结果进行评估，采用原始分数标准化的标准化均数变化（95%置信区间）。使用 IGCIP 图改善言语和生活质量测量指标显示出名义效应大小：辅音-核-辅音词，0.15（-0.12 至 0.42）；AzBio 安静，0.09（-0.05 至 0.22）；AzBio+10 dB 信号噪声比，0.14（-0.01 至 0.30）；Bamford-Kowel-Bench 在噪声中的句子，-0.11（-0.35 至 0.12）；听力辅助设备简明受益量表，-0.14（-0.28 至 0.00）；言语空间和听觉质量量表，0.13（-0.02 至 0.28）。然而，79%的患者允许保留他们的 IGCIP 图，在研究期间过后，他们选择继续使用。
IGCIP 具有精确指导 CI 编程的潜力。客观结果测量的名义效应大小未能充分反映主观获益，因为与患者中更喜欢保留 IGCIP 图的比例存在差异。
