高龄并非中度至重度感音神经性听力损失成人人工耳蜗植入效果的预测因素。
Advanced age is not a predictor for cochlear implantation outcomes in adults with moderate to profound sensorineural hearing loss.
作者信息
Távora-Vieira Dayse, Wedekind Andre, Acharya Aanand, Kuthubutheen Jafri, Voola Marcus, Cavalheri Vinicius, Friedland Peter
机构信息
Fiona Stanley Fremantle Hospitals Group, Western Australia, Perth, Australia; The University of Western Australia, Medical School, Division of Surgery, Perth, Australia; Curtin University, School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Perth, Australia.
Fiona Stanley Fremantle Hospitals Group, Western Australia, Perth, Australia; The University of Western Australia, Medical School, Division of Surgery, Perth, Australia.
出版信息
Braz J Otorhinolaryngol. 2025 Mar 20;91(3):101571. doi: 10.1016/j.bjorl.2025.101571.
OBJECTIVE
Hearing impairment is a common disability in elderly people. With an ageing population, it is expected that the number of people with age-related hearing loss will grow, and a proportion are likely to become Cochlear Implant (CI) candidates. The aim of this study is to investigate whether the age at which a person receives a CI has an impact on their objective speech understanding outcomes and subjective, self-reported outcomes within the first 12-months of CI use.
METHODS
242 CI recipients participated in this study. Participants were divided into 3 groups according to age at implantation: 72 younger adults (18-60 years); 109 older adults (60-75 years); and 65 elderly adults (>75-years). Benefit of CI use was assessed via speech understanding and patient-reported measures. Speech understanding in quiet was assessed via the Consonant-Nucleus-Consonant words test. Speech understanding in noise was assessed via the Bamford-Kowal-Bench Adaptive speech-in-noise test. Self-perceived hearing ability was assessed via the short from of the Speech, Spatial and Qualities of Hearing scale. Tinnitus reduction, if applicable, was assessed via the Tinnitus Reaction Questionnaire. All 4 assessments were completed at 4 intervals: preoperatively, 3-, 6-, and 12-months of CI use.
RESULTS
For the entire cohort over time, significant improvements were found for speech understanding in quiet (p < 0.0001), and self-perceived hearing ability (p < 0.0001). Between the three groups, there were no significant differences in any postoperative (post-Op) assessment for all study outcomes.
CONCLUSION
Each age group had improved speech understanding and self-perceived hearing abilities after 12-months of CI use. No significant differences were found between groups at all post-Op test intervals. We therefore conclude that elderly people (>75-years) who are acceptable CI candidates should be offered the same opportunity to benefit from CI use as younger adult candidates.
LEVEL OF EVIDENCE
Level 3.
目的
听力障碍是老年人常见的残疾。随着人口老龄化，预计与年龄相关的听力损失人数将会增加，其中一部分人可能会成为人工耳蜗（CI）植入的候选者。本研究的目的是调查一个人接受CI植入的年龄是否会对其在CI使用的前12个月内的客观言语理解结果和主观的自我报告结果产生影响。
方法
242名CI接受者参与了本研究。参与者根据植入时的年龄分为3组：72名年轻人（18 - 60岁）；109名老年人（60 - 75岁）；65名高龄老年人（>75岁）。通过言语理解和患者报告的指标评估CI使用的益处。安静环境下的言语理解通过辅音-元音-辅音单词测试进行评估。噪声环境下的言语理解通过班福德-科瓦尔-本奇自适应噪声言语测试进行评估。自我感知听力能力通过听力言语、空间和质量量表的简版进行评估。如有耳鸣减轻情况，通过耳鸣反应问卷进行评估。所有4项评估在4个时间点完成：术前、CI使用3个月、6个月和12个月。
结果
对于整个队列随时间的变化，安静环境下的言语理解（p < 0.0001）和自我感知听力能力（p < 0.0001）有显著改善。在三组之间，所有研究结果的任何术后评估均无显著差异。
结论
各年龄组在CI使用12个月后言语理解和自我感知听力能力均有改善。术后所有测试时间点组间均未发现显著差异。因此，我们得出结论，对于可接受CI植入的高龄老年人（>75岁），应给予他们与年轻成年候选者相同的从CI使用中获益的机会。
证据水平
3级。
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