DU Haoliang, Jiang Yaofeng, Yang Ye, Gao Junyan, Lu Ling, Zhang Xiaoli, Chen Jie, Gao Xia
Department of Otolaryngology Head and Neck Surgery,Affiliated Drum Tower Hospital of Nanjing University Medical School,Jiangsu Provincial Key Medical Discipline(Laboratory),Research Institute of Otolaryngology,Nanjing,210008,China.
Department of Technical Counseling,Jiangsu Children's Rehabilitation Research Center.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Mar;37(3):201-205. doi: 10.13201/j.issn.2096-7993.2023.03.009.
To investigate speech recognition among children with a unilateral cochlear implant(CI), bilateral CI, and bimodal hearing and identify the benefits of binaural hearing. A total of 67 children with severe sensorineural hearing loss who received bilateral CI, bimodal hearing, and unilateral CI from 2012 to 2021 were recruited, including 23 cases with unilateral CI, 25 cases of bimodal hearing, and 19 cases of bilateral CI. The aided hearing threshold at 250-4000 Hz and speech recognition performance of two-syllable words and short sentences in quiet and noisy environments were tested, respectively. There was no significant difference in the hearing threshold results of the bilateral CI group, the bimodal hearing group, and the unilateral CI group by ANOVA(>0.05). According to the paired -test within the group, the speech recognition of disyllabic words and short sentences in quiet and noisy environments were significantly different among the three groups(<0.05). There was no significant difference in the speech recognition rates of disyllabic words and short sentences among the three groups in a quiet environment(>0.05), but there was a statistically significant difference in a noisy environment(<0.05). Additional multiple linear regression analysis showed no significant difference in the recognition rates of disyllabic words and short sentences between the bimodal group and the bilateral CI group in quiet and noisy environments(=-0.567, >0.05; =-0.643, >0.05). There was a statistically significant difference in speech recognition of disyllabic words and short sentences between the bimodal group and the unilateral CI group in the noise environment(=-0.124, <0.05), but the difference was not statistically significant in a quiet environment(=-0.671, >0.05); there was a statistically significant difference in the recognition rate of disyllabic words and short sentences between the bilateral CI group and the unilateral CI group in the noise environment(=-0.226, <0.05), but the difference was not statistically significant in a quiet environment(=-0.341, >0.05). Clinicians and guardians are encouraged to provide the most comprehensive audiological evaluation for children with hearing loss. Bilateral CI and bimodal hearing have demonstrated enormous advantages over unilateral CI regarding speech recognition in noise. Bimodal hearing deems a strong recommendation if the contralateral ear has sufficient speech recognition capability. Bilateral CI should be warranted if hearing aids deemed to be ineffective.
为研究单侧人工耳蜗植入(CI)、双侧CI及双耳混合听力儿童的言语识别能力,并确定双耳听力的益处。招募了2012年至2021年期间接受双侧CI、双耳混合听力及单侧CI的67例重度感音神经性听力损失儿童,其中单侧CI 23例,双耳混合听力25例,双侧CI 19例。分别测试了250 - 4000Hz的助听听阈以及安静和嘈杂环境中双音节词和短句的言语识别表现。经方差分析,双侧CI组、双耳混合听力组和单侧CI组的听阈结果无显著差异(>0.05)。根据组内配对检验,三组在安静和嘈杂环境中双音节词和短句的言语识别存在显著差异(<0.05)。三组在安静环境中双音节词和短句的言语识别率无显著差异(>0.05),但在嘈杂环境中有统计学显著差异(<0.05)。额外的多元线性回归分析显示,双耳混合组与双侧CI组在安静和嘈杂环境中双音节词和短句的识别率无显著差异(=-0.567,>0.05;=-0.643,>0.05)。在噪声环境中,双耳混合组与单侧CI组双音节词和短句的言语识别有统计学显著差异(=-0.124,<0.05),但在安静环境中差异无统计学意义(=-0.671,>0.05);在噪声环境中,双侧CI组与单侧CI组双音节词和短句的识别率有统计学显著差异(=-0.226,<0.05),但在安静环境中差异无统计学意义(=-0.341,>0.05)。鼓励临床医生和监护人对听力损失儿童进行最全面的听力学评估。在噪声中的言语识别方面,双侧CI和双耳混合听力比单侧CI显示出巨大优势。如果对侧耳有足够的言语识别能力,强烈推荐双耳混合听力。如果助听器被认为无效,则应采用双侧CI。