Dornhoffer James R, Chidarala Shreya, Patel Terral, Khandalavala Karl R, Nguyen Shaun A, Schvartz-Leyzac Kara C, Dubno Judy R, Carlson Matthew L, Moberly Aaron C, McRackan Theodore R
Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, NY 55905, USA.
College of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA.
J Clin Med. 2024 Jan 11;13(2):400. doi: 10.3390/jcm13020400.
to review evidence on the efficacy of auditory training in adult cochlear implant recipients. PRISMA guidelines for a systematic review of the literature were followed. PubMed, Scopus, and CINAHL databases were queried on 29 June 2023 for terms involving cochlear implantation and auditory training. Studies were limited to the English language and adult patient populations. Three authors independently reviewed publications for inclusion in the review based on a priori inclusion and exclusion criteria. Inclusion criteria encompassed adult cochlear implant populations, an analysis of clinician- or patient-directed auditory training, and an analysis of one or more measures of speech recognition and/or patient-reported outcome. Exclusion criteria included studies with only pediatric implant populations, music or localization training in isolation, and single-sample case studies. The data were collected regarding study design, patient population, auditory training modality, auditory training timing, speech outcomes, and data on the durability of outcomes. A quality assessment of the literature was performed using a quality metric adapted from the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group guidelines. Data were qualitatively summarized for 23 studies. All but four studies demonstrated significant improvement in at least one measured or patient-reported outcome measure with training. For 11 studies with sufficient data reporting, pre-intervention and post-intervention pooled means of different outcome measures were compared for 132 patients using meta-analysis. Patient-direct training was associated with significant improvement in vowel-phoneme recognition and speech recognition in noise ( < 0.05 and < 0.001, respectively), and clinician-directed training showed significant improvement in sentence recognition in noise ( < 0.001). The literature on auditory training for adult cochlear implant recipients is limited and heterogeneous, including a small number of studies with limited levels of evidence and external validity. However, the current evidence suggests that auditory training can improve speech recognition in adult cochlear implant recipients.
回顾成人人工耳蜗植入受者听觉训练疗效的证据。遵循PRISMA文献系统综述指南。2023年6月29日在PubMed、Scopus和CINAHL数据库中查询了涉及人工耳蜗植入和听觉训练的术语。研究限于英语语言和成年患者群体。三位作者根据事先确定的纳入和排除标准独立审查出版物以纳入综述。纳入标准包括成人人工耳蜗植入人群、对临床医生指导或患者主导的听觉训练的分析，以及对一项或多项语音识别和/或患者报告结局指标的分析。排除标准包括仅涉及儿童植入人群的研究、单独的音乐或定位训练以及单样本病例研究。收集了有关研究设计、患者群体、听觉训练方式、听觉训练时间、语音结局以及结局持久性数据的资料。使用从推荐分级评估、制定和评价（GRADE）工作组指南改编的质量指标对文献进行质量评估。对23项研究的数据进行了定性总结。除四项研究外，所有研究均表明训练后至少一项测量指标或患者报告的结局指标有显著改善。对于11项有足够数据报告的研究，使用荟萃分析比较了132名患者不同结局指标的干预前和干预后合并均值。患者主导的训练与元音音素识别和噪声中语音识别的显著改善相关（分别为P<0.05和P<0.001），临床医生主导的训练在噪声中句子识别方面显示出显著改善（P<0.001）。关于成人人工耳蜗植入受者听觉训练的文献有限且存在异质性，包括少数证据水平和外部效度有限的研究。然而，目前的证据表明听觉训练可以改善成人人工耳蜗植入受者的语音识别。
