Czurda Ronja, Wesarg Thomas, Aschendorff Antje, Beck Rainer Linus, Hocke Thomas, Ketterer Manuel Christoph, Arndt Susan
Department of Otorhinolaryngology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79106 Freiburg, Germany.
Cochlear Deutschland GmbH & Co., KG, Mailänder Straße 4 a, 30539 Hannover, Germany.
J Clin Med. 2024 Jan 23;13(3):646. doi: 10.3390/jcm13030646.
The cochlear implant (CI) is an established treatment option for patients with inadequate speech understanding and insufficient aided scores. Nevertheless, reliable predictive models and specific therapy goals regarding achievable speech understanding are still lacking. In this retrospective study, 601 cases of CI fittings between 2005 and 2021 at the University Medical Center Freiburg were analyzed. We investigated the preoperative unaided maximum word recognition score (mWRS) as a minimum predictor for post-interventional scores at 65 dB SPL, WRS(CI). The WRS(CI) was compared with the preoperative-aided WRS, and a previously published prediction model for the WRS(CI) was reviewed. Furthermore, the effect of duration of hearing loss, duration of HA fitting, and etiology on WRS(CI) were investigated. In 95.5% of the cases, a significant improvement in word recognition was observed after CI. WRS(CI) achieved or exceeded mWRS in 97% of cases. Etiology had a significant impact on WRS(CI). The predicted score was missed by more than 20 percentage points in 12.8% of cases. Our results confirmed the minimum prediction via mWRS. A more precise prediction of the expected WRS(CI) is possible. The etiology of hearing loss should be considered in the indication and postoperative care to achieve optimal results.
人工耳蜗（CI）是针对言语理解能力不足且助听得分不理想的患者的一种既定治疗选择。然而，关于可实现的言语理解，仍然缺乏可靠的预测模型和具体的治疗目标。在这项回顾性研究中，分析了2005年至2021年在弗莱堡大学医学中心进行的601例人工耳蜗植入病例。我们将术前未助听时的最大单词识别得分（mWRS）作为65 dB SPL时干预后得分即人工耳蜗单词识别得分（WRS(CI)）的最低预测指标进行研究。将WRS(CI)与术前助听后的WRS进行比较，并对之前发表的WRS(CI)预测模型进行了回顾。此外，还研究了听力损失持续时间、助听器佩戴时间和病因对WRS(CI)的影响。在95.5%的病例中，人工耳蜗植入后单词识别能力有显著提高。在97%的病例中，WRS(CI)达到或超过了mWRS。病因对WRS(CI)有显著影响。在12.8%的病例中，预测得分相差超过20个百分点。我们的结果证实了通过mWRS进行的最低预测。对预期的WRS(CI)进行更精确的预测是可能实现的。在适应证选择和术后护理中应考虑听力损失的病因，以取得最佳效果。
