Franke-Trieger Annett, Hocke Thomas, Zahnert Thomas, Lailach Susen
Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Saxony, Germany.
Cochlear Deutschland GmbH&Co.KG, Hanover, Germany.
HNO. 2025 Jun 2. doi: 10.1007/s00106-025-01585-5.
Persons whose speech recognition with hearing aids at 65 dB, WRS(HA), is inadequate but whose maximum monosyllabic word recognition score (WRS) is still measurable may benefit from a cochlear implant (CI). Using a validated prediction model, one can estimate word recognition with a CI, WRS(CI), for these patients. The aim of this study was to investigate the relationship between electrically evoked compound action potentials (ECAP) and stimulation parameters of the CI system.
In this prospective study, 37 patients were included. The WRS(CI) was determined after 6 and 12 months and compared with the predicted WRS(CI). The correlation of minimum and maximum electrical stimulation with the ECAP was investigated.
All patients showed a significantly better WRS(CI) after 12 months compared with the preoperatively determined WRS(HA). The proportion of patients whose WRS(CI) fell short of the predicted value by more than 20 percentage points was 19% after 6 months and 5% after 12 months. In the patient population, there was a closer correlation of the ECAP thresholds with the maximum than with the minimum electrical stimulation.
For patients whose speech understanding with hearing aids is inadequate-even with a very high preoperative WRS in moderately severe hearing loss-CI fitting appears to be a promising treatment option. The predictive model enables individual treatment planning. Its application contributed to a quality of care that was higher than was found in an earlier retrospective study. The correlation found between stimulation intensity and ECAP in a cohort of patients with achieved predicted values supports the hypothesis that a fitting procedure based on ECAP and audiometry is a promising approach.
对于在65分贝时使用助听器的言语识别率[WRS(HA)]不足，但最大单音节词识别分数（WRS）仍可测量的患者，人工耳蜗植入（CI）可能有益。使用经过验证的预测模型，可以估计这些患者人工耳蜗植入后的言语识别率[WRS(CI)]。本研究的目的是探讨电诱发复合动作电位（ECAP）与CI系统刺激参数之间的关系。
在这项前瞻性研究中，纳入了37例患者。在6个月和12个月后确定WRS(CI)，并与预测的WRS(CI)进行比较。研究了最小和最大电刺激与ECAP的相关性。
与术前确定的WRS(HA)相比，所有患者在12个月后的WRS(CI)均有显著改善。WRS(CI)低于预测值20个百分点以上的患者比例在6个月后为19%，在12个月后为5%。在患者群体中，ECAP阈值与最大电刺激的相关性比与最小电刺激的相关性更密切。
对于助听器言语理解不足的患者——即使在中度重度听力损失中术前WRS非常高——CI植入似乎是一种有前景的治疗选择。该预测模型能够进行个性化治疗规划。其应用有助于提高护理质量，高于早期回顾性研究中的水平。在一组达到预测值的患者中发现的刺激强度与ECAP之间的相关性支持了基于ECAP和听力测定的适配程序是一种有前景的方法这一假设。
