单侧聋人工耳蜗植入的生活质量影响：评估客观和主观测量的相互关系。

Quality of Life Impact of Cochlear Implantation for Single-Sided Deafness: Assessing the Interrelationship of Objective and Subjective Measures.

机构信息

Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland.

Department of Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.

出版信息

Otol Neurotol. 2023 Mar 1;44(3):e125-e132. doi: 10.1097/MAO.0000000000003783. Epub 2022 Dec 31.

DOI:10.1097/MAO.0000000000003783

PMID:36728614

Abstract

OBJECTIVE

To determine the effect on quality of life (QOL) of cochlear implantation (CI) for single-sided deafness (SSD) and asymmetric hearing loss (AHL) using the first psychometrically developed CI-specific QOL tool for English-speaking patients and to assess its relationship to objective perceptual measures.

STUDY DESIGN

Retrospective cohort study.

SETTING

Tertiary-care medical center.

PATIENTS

English-speaking adults with SSD or AHL.

INTERVENTIONS

Unilateral CI.

MAIN OUTCOME MEASURES

Cochlear Implant Quality of Life (CIQOL) score, CI-alone speech-in-quiet (SIQ) score (CNC and AzBio), binaural speech-in-noise (SIN) threshold, binaural azimuthal sound localization (SL) error.

RESULTS

At the most recent postoperative evaluation (median, 9.3 months postimplantation), 25 of 28 subjects (89%) had a CIQOL improvement, with the improvement considered clinically beneficial (>3 points) for 18 of 28 subjects (64%). Group-mean CIQOL improvement was observed at the first postoperative visit and did not change significantly thereafter. Objective perceptual measures (SL, SIQ, SIN) continued to improve over 12 months after implantation. Linear mixed-model regression analyses showed a moderate positive correlation between SIN and SIQ improvements (r = 0.50 to 0.59, p < 0.0001) and a strong positive correlation between the improvement in the two SIQ measures (r = 0.89, p < 0.0001). No significant relationships were observed ( p > 0.05) among QOL or the objective perceptual measures.

CONCLUSIONS

QOL improved for the majority of subjects implanted for SSD and AHL. Different time courses for improvement in QOL and audiologic tests, combined with the lack of significant relationships among them, suggest that QOL outcomes reflect different aspects of the CI experience than those captured by speech-understanding and localization measures. SIQ may substitute for SIN when clinical constraints exist.

摘要

目的

使用首个针对英语患者的具有心理测量学特性的人工耳蜗植入（CI）特异性生活质量（QOL）工具，确定单耳聋（SSD）和不对称性听力损失（AHL）患者接受 CI 对 QOL 的影响，并评估其与客观感知测量指标的关系。

研究设计

回顾性队列研究。

设置

三级医疗中心。

患者

有 SSD 或 AHL 的讲英语的成年人。

干预措施

单侧 CI。

主要观察指标

人工耳蜗植入生活质量量表（CIQOL）评分、CI 单耳安静言语识别（SIQ）评分（CNC 和 AzBio）、双耳噪声下言语识别阈、双耳方位声音定位（SL）误差。

结果

在最近的术后评估（中位数，植入后 9.3 个月）中，28 名受试者中的 25 名（89%）CIQOL 得到改善，28 名受试者中有 18 名（64%）的改善被认为具有临床意义（>3 分）。组平均 CIQOL 改善在术后首次就诊时即观察到，此后未发生显著变化。客观感知测量指标（SL、SIQ、SIN）在植入后 12 个月内持续改善。线性混合模型回归分析显示，SIN 与 SIQ 改善之间存在中度正相关（r = 0.50 至 0.59，p < 0.0001），且这两种 SIQ 测量值的改善之间存在很强的正相关（r = 0.89，p < 0.0001）。未观察到 QOL 或客观感知测量指标之间存在显著相关性（p > 0.05）。