Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, USA.
Ear Hear. 2023;44(5):955-968. doi: 10.1097/AUD.0000000000001353. Epub 2023 Mar 7.
Children with severe-to-profound unilateral hearing loss, including cases of single-sided deafness (SSD), lack access to binaural cues that support spatial hearing, such as recognizing speech in complex multisource environments and sound source localization. Listening in a monaural condition negatively impacts communication, learning, and quality of life for children with SSD. Cochlear implant (CI) use may restore binaural hearing abilities and improve outcomes as compared to alternative treatments or no treatment. This study investigated performance over 24 months of CI use in young children with SSD as compared to the better hearing ear alone and to children with bilateral normal hearing (NH).
Eighteen children with SSD who received a CI between the ages of 3.5 and 6.5 years as part of a prospective clinical trial completed assessments of word recognition in quiet, masked sentence recognition, and sound source localization at regular intervals out to 24-month postactivation. Eighteen peers with bilateral NH, matched by age at the group level, completed the same test battery. Performance at 24-month postactivation for the SSD group was compared to the performance of the NH group.
Children with SSD have significantly poorer speech recognition in quiet, masked sentence recognition, and localization both with and without the use of the CI than their peers with NH. The SSD group experienced significant benefits with the CI+NH versus the NH ear alone on measures of isolated word recognition, masked sentence recognition, and localization. These benefits were realized within the first 3 months of use and were maintained through the 24-month postactivation interval.
Young children with SSD who use a CI experience significant isolated word recognition and bilateral spatial hearing benefits, although their performance remains poorer than their peers with NH.
患有严重至极重度单侧听力损失的儿童，包括单侧聋（SSD）病例，无法获得支持空间听觉的双耳线索，例如在复杂多声源环境中识别语音和声源定位。SSD 儿童单耳聆听会对其交流、学习和生活质量产生负面影响。与替代治疗或不治疗相比，使用人工耳蜗（CI）可能会恢复双耳听力能力并改善结果。本研究调查了 18 名 SSD 儿童在使用 CI 后 24 个月的表现，与单耳听力较好的儿童以及双侧正常听力（NH）儿童进行了比较。
18 名 SSD 儿童在 3.5 至 6.5 岁之间接受 CI 治疗，作为前瞻性临床试验的一部分，他们定期接受安静环境下的单词识别、掩蔽句子识别和声源定位评估，直至激活后 24 个月。18 名年龄匹配的双侧 NH 同龄儿童完成了相同的测试。将 SSD 组在激活后 24 个月的表现与 NH 组进行比较。
与双侧 NH 同龄儿童相比，SSD 儿童在安静环境下、掩蔽句子识别和定位方面的言语识别能力明显较差。与仅使用 NH 耳相比，SSD 组在孤立单词识别、掩蔽句子识别和定位方面，CI+NH 比 NH 耳有显著获益。这些获益在使用后的前 3 个月内实现，并在激活后 24 个月的时间内保持。
使用 CI 的 SSD 儿童在孤立单词识别和双侧空间听觉方面会经历显著获益，尽管他们的表现仍逊于双侧 NH 同龄儿童。
