Casarella Antonio, Notaro Anna, Laria Carla, Serra Nicola, Genovese Elisabetta, Malesci Rita, Auletta Gennaro, Fetoni Anna Rita
Department of Neuroscience, Reproductive Sciences and Dentistry, Audiology Section, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy.
Department of Diagnostic, Clinical and Public Health Medicine, Audiology Program University of Modena and Reggio Emilia, Via Del Pozzo 71, 41124 Modena, Italy.
Audiol Res. 2024 Oct 16;14(5):914-927. doi: 10.3390/audiolres14050077.
BACKGROUND/OBJECTIVES: Bimodal stimulation (BS), which combines the use of a cochlear implant (CI) in one ear and a hearing aid (HA) in the opposite ear, is an established strategy to treat hearing loss by exploiting the unique capabilities of each device. CIs stimulate the auditory nerve by bypassing damaged hair cells, while HAs amplify sounds by requiring a functional hearing residual. The aim of this systematic review is to investigate the advantages and disadvantages of BS such as speech perception in noise.
We examined clinical studies published from October 2020 to July 2024, following the PRISMA guidelines, focusing on the advantages and disadvantages of BS on speech perception in noise in adulthood.
BS in adult patients significantly improves speech perception in quiet and noisy environments, especially for those with increased residual hearing. Unilateral CIs and BS perform similarly in quiet conditions, but BS significantly improves speech discrimination in noisy environments if loudness between the two devices is appropriately balanced.
Directional microphones and programming software are new technologies that succeed in reducing environmental noise and improving verbal perception outcomes, although their features in the literature are controversial. In addition, the individuals using BS may face temporal mismatches mainly due to differing device latencies, affecting sound localization. Compensating for these mismatches can enhance localization accuracy. However, modulated noise remains a significant obstacle to verbal perception in noise. Valuable assessment tools such as music tests provide further information on hearing performance and quality of life. More research is needed to define certain selection criteria.
背景/目的：双模式刺激（BS）是一种通过利用每种设备的独特功能来治疗听力损失的既定策略，它将一侧耳朵使用人工耳蜗（CI）与另一侧耳朵使用助听器（HA）相结合。人工耳蜗通过绕过受损的毛细胞来刺激听神经，而助听器则通过需要功能性听力残余来放大声音。本系统评价的目的是研究双模式刺激在噪声中语音感知等方面的优缺点。
我们按照PRISMA指南，审查了2020年10月至2024年7月发表的临床研究，重点关注双模式刺激对成人噪声中语音感知的优缺点。
成人患者的双模式刺激在安静和嘈杂环境中均能显著改善语音感知，尤其是对于残余听力增加的患者。单侧人工耳蜗和双模式刺激在安静条件下表现相似，但如果两个设备之间的响度适当平衡，双模式刺激在嘈杂环境中能显著提高语音辨别能力。
定向麦克风和编程软件是成功降低环境噪声并改善言语感知结果的新技术，尽管它们在文献中的特点存在争议。此外，使用双模式刺激的个体可能主要由于设备延迟不同而面临时间不匹配，影响声音定位。补偿这些不匹配可以提高定位准确性。然而，调制噪声仍然是噪声中言语感知的重大障碍。音乐测试等有价值的评估工具可提供有关听力表现和生活质量的更多信息。需要更多研究来确定某些选择标准。
