Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center - University of Freiburg; Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Clinical Research International, Advanced Bionics GmbH, Hanover, Germany.
J Int Adv Otol. 2024 Jul 29;20(4):289-300. doi: 10.5152/iao.2024.231457.
People with single-sided deafness (SSD) or asymmetric hearing loss (AHL) have particular difficulty understanding speech in noisy listening situations and in sound localization. The objective of this multicenter study is to evaluate the effect of a cochlear implant (CI) in adults with single-sided deafness (SSD) or asymmetric hearing loss (AHL), particularly regarding sound localization and speech intelligibility with additional interest in electric-acoustic pitch matching. A prospective longitudinal study at 7 European tertiary referral centers was conducted including 19 SSD and 16 AHL subjects undergoing cochlear implantation. Sound localization accuracy was investigated in terms of root mean square error and signed bias before and after implantation. Speech recognition in quiet and speech reception thresholds in noise for several spatial configurations were assessed preoperatively and at several post-activation time points. Pitch perception with CI was tracked using pitch matching. Data up to 12 months post activation were collected. In both SSD and AHL subjects, CI significantly improved sound localization for sound sources on the implant side, and thus overall sound localization. Speech recognition in quiet with the implant ear improved significantly. In noise, a significant head shadow effect was found for SSD subjects only. However, the evaluation of AHL subjects was limited by the small sample size. No uniform development of pitch perception with the implant ear was observed. The benefits shown in this study confirm and expand the existing body of evidence for the effectiveness of CI in SSD and AHL. Particularly, improved localization was shown to result from increased localization accuracy on the implant side.
单侧聋（SSD）或非对称听力损失（AHL）患者在嘈杂的聆听环境和声音定位中理解言语特别困难。这项多中心研究的目的是评估人工耳蜗植入（CI）对单侧聋（SSD）或非对称听力损失（AHL）成人的影响，特别是对声音定位和言语可懂度的影响，并对电声音高匹配有额外的兴趣。在 7 个欧洲三级转诊中心进行了一项前瞻性纵向研究，共纳入 19 名 SSD 和 16 名 AHL 患者接受耳蜗植入。植入前后，通过均方根误差和符号偏差评估声音定位准确性。术前和术后几个激活时间点评估了几种空间配置下的安静言语识别和噪声中的言语接受阈。使用音高匹配跟踪 CI 中的音高感知。收集了激活后 12 个月的数据。在 SSD 和 AHL 患者中，CI 显著改善了植入侧声源的声音定位，从而整体改善了声音定位。植入耳的安静言语识别显著提高。在噪声中，仅 SSD 患者存在显著的头影效应。然而，AHL 患者的评估受到样本量小的限制。未观察到植入耳音高感知的统一发展。本研究显示的益处证实并扩展了 CI 在 SSD 和 AHL 中有效性的现有证据。特别是，植入侧定位准确性的提高导致了定位能力的改善。
