Wendrich Anne W, van Heteren Jan A A, Peters Jeroen P M, Cattani Guido, Stokroos Robert J, Versnel Huib, Smit Adriana L
Department of Otorhinolaryngology and Head & Neck Surgery University Medical Center Utrecht Utrecht Netherlands.
UMC Utrecht Brain Center University Medical Center Utrecht Utrecht Netherlands.
Laryngoscope Investig Otolaryngol. 2022 Dec 27;8(1):192-200. doi: 10.1002/lio2.1002. eCollection 2023 Feb.
Patients with single-sided deafness (SSD) may experience difficulties with speech perception in noise, sound localization, have tinnitus and experience a reduced quality of life (QoL). contralateral routing of sound hearing aids (CROS) or bone conduction devices (BCD) may partly improve subjective speech communication and QoL in SSD patients. A trial period with these devices can help in making a well-informed choice of treatment. Our aim was to evaluate factors influencing the choice of treatment made after a BCD and CROS trial period in adult SSD patients.
Patients were randomized in the: "first BCD, then CROS" or "first CROS, then BCD" trial period group. After the BCD on headband and CROS were tested for 6 weeks each, patients choose for BCD, CROS or no treatment. Primary outcome was the distribution of choice of treatment. Secondary outcomes included the association between the choice of treatment and patient characteristics, reasons for treatment acceptance or rejection, device usage during the trial periods, and disease-specific QoL outcomes.
Of 91 patients randomized, 84 completed both trial periods and made their choice of treatment: 25 (30%) BCD, 34 (40%) CROS, and 25 (30%) no treatment. No characteristics were found to be related to choice of treatment. Top three reasons for acceptance or rejection were: device (dis)comfort, sound quality and (dis)advantage of subjective hearing. Average daily device use during the trial periods was higher for CROS than for BCD. Choice of treatment was significantly related with both duration of device usage and greater improvement of QoL after the corresponding trial period.
The majority of SSD patients preferred BCD or CROS over no treatment. Evaluating device usage, discussing treatment (dis)advantages and disease-specific QoL outcomes after trial periods are to be considered during patient counseling and could facilitate whether to choose one of these treatments.
1B.
单侧耳聋（SSD）患者在噪声环境中言语感知、声音定位方面可能存在困难，伴有耳鸣，生活质量（QoL）下降。对侧声音传导助听器（CROS）或骨传导装置（BCD）可部分改善SSD患者的主观言语交流和生活质量。使用这些装置的试验期有助于做出明智的治疗选择。我们的目的是评估影响成年SSD患者在使用BCD和CROS试验期后治疗选择的因素。
患者被随机分为“先使用BCD，后使用CROS”或“先使用CROS，后使用BCD”试验期组。在分别对头戴式BCD和CROS进行6周测试后，患者选择使用BCD、CROS或不进行治疗。主要结局是治疗选择的分布情况。次要结局包括治疗选择与患者特征之间的关联、接受或拒绝治疗的原因、试验期内装置的使用情况以及疾病特异性生活质量结局。
91例随机分组的患者中，84例完成了两个试验期并做出治疗选择：25例（30%）选择BCD，34例（40%）选择CROS，25例（30%）选择不治疗。未发现与治疗选择相关的特征。接受或拒绝治疗的前三大原因是：装置（不）舒适、音质以及主观听力的（不）优势。试验期内CROS的平均每日装置使用时间高于BCD。治疗选择与装置使用时长以及相应试验期后生活质量的更大改善均显著相关。
大多数SSD患者选择BCD或CROS而非不治疗。在患者咨询过程中，应考虑评估装置使用情况、讨论治疗的（不）优点以及试验期后的疾病特异性生活质量结局，这有助于决定是否选择这些治疗方法之一。
1B。
