人工耳蜗植入术后的纵向语音识别变化：系统评价与荟萃分析。
Longitudinal Speech Recognition Changes After Cochlear Implant: Systematic Review and Meta-analysis.
作者信息
Ma Cheng, Fried Jacob, Nguyen Shaun A, Schvartz-Leyzac Kara C, Camposeo Elizabeth L, Meyer Ted A, Dubno Judy R, McRackan Theodore R
机构信息
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
出版信息
Laryngoscope. 2023 May;133(5):1014-1024. doi: 10.1002/lary.30354. Epub 2022 Aug 25.
OBJECTIVES
To examine patterns of change and plateau in speech recognition scores in postlingually hearing impaired adult cochlear implant recipients. The study also examines variations in change patterns for different speech materials and testing conditions.
STUDY DESIGN
Used systematic review with meta-analysis.
METHODS
Articles in English reporting speech recognition scores of adults with postlingual hearing loss at pre-implantation and at least two post-implantation time points were included. Statistically significant changes were determined by meta-analysis and the 95% confidence interval.
RESULTS
A total of 22 articles representing 1954 patients were included. Meta-analysis of mean difference demonstrated significant improvements in speech recognition score for words in quiet (37.4%; 95% confidence interval [34.7%, 40.7%]), sentences in quiet (49.4%; 95% confidence interval [44.9%, 53.9%]), and sentences in noise (30.8%; 95% confidence interval [25.2%, 36.4%]) from pre-op to 3 months. Scores continued to increase from 3 to 12 months but did not reach significance. Similarly, significant improvements from pre-op to 3 months were observed for consonant nucleus consonant (CNC) words in quiet (37.1%; 95% confidence interval [33.8%, 40.4%]), hearing in noise test (HINT) sentences in quiet (46.5%; 95% confidence interval [37.0%, 56.0%]), AzBio sentences in quiet (45.9%; 95% confidence interval [44.2%, 47.5%]), and AzBio sentences in noise (26.4%; 95% confidence interval [18.6%, 34.2%]). HINT sentences in noise demonstrated improvement from pre-op to 3 months (35.1%; 95% confidence interval [30.0%, 40.3%]) and from 3 to 12 months (15.5%; 95% confidence interval [7.2%, 23.8%]).
CONCLUSIONS
Mean speech recognition scores demonstrate significant improvement within the first 3 months, with no further statistically significant improvement after 3 months. However, large individual variation should be expected and future research is needed to explain the sources of these individual differences. Laryngoscope, 133:1014-1024, 2023.
目的
研究语后聋成年人工耳蜗植入受者言语识别分数的变化模式及平台期。本研究还考察了不同言语材料和测试条件下变化模式的差异。
研究设计
采用系统评价和荟萃分析。
方法
纳入以英文发表的报告语后聋成年人植入前及至少两个植入后时间点言语识别分数的文章。通过荟萃分析和95%置信区间确定具有统计学意义的变化。
结果
共纳入22篇文章，涉及1954例患者。平均差异的荟萃分析表明，从术前到3个月，安静环境下单词的言语识别分数有显著提高（37.4%；95%置信区间[34.7%，40.7%]），安静环境下句子的言语识别分数有显著提高（49.4%；95%置信区间[44.9%，53.9%]），噪声环境下句子的言语识别分数有显著提高（30.8%；95%置信区间[25.2%，36.4%]）。分数从3个月到12个月持续增加，但未达到显著水平。同样，从术前到3个月，安静环境下辅音-元音-辅音（CNC）单词（37.1%；95%置信区间[33.8%，40.4%]）、安静环境下噪声听力测试（HINT）句子（46.5%；95%置信区间[37.0%，56.0%]）、安静环境下AzBio句子（45.9%；95%置信区间[44.2%，47.5%]）以及噪声环境下AzBio句子（26.4%；95%置信区间[18.6%，34.2%]）均有显著改善。噪声环境下的HINT句子从术前到3个月有改善（35.1%；95%置信区间[30.0%，40.3%]），从3个月到12个月也有改善（15.5%；95%置信区间[7.2%，23.8%]）。
结论
平均言语识别分数在最初3个月内有显著提高，3个月后无进一步的统计学显著改善。然而，应预期存在较大的个体差异，未来需要开展研究以解释这些个体差异的来源。《喉镜》，133:1014 - 1024，2023年。
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