使用国际功能、残疾和健康分类模型评估并报告的人工耳蜗植入适应症对结果的影响。
Impact of cochlear implant indications on outcome, assessed and reported using the international classification of functioning, disability and health model.
作者信息
Andries Ellen, Lorens Artur, Skarżyński Piotr Henryk, Skarżyński Henryk, Calvino Miryam, Gavilán Javier, Lassaletta Luis, Tavora-Vieira Dayse, Acharya Aanand, Kurz Anja, Hagen Rudolf, Anderson Ilona, Koinig Karin, Abdelsamad Yassin, Van de Heyning Paul, Van Rompaey Vincent, Mertens Griet
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.
Resonant Labs Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium.
出版信息
Eur Arch Otorhinolaryngol. 2025 Jun 3. doi: 10.1007/s00405-025-09454-1.
OBJECTIVES
To determine the impact of various Cochlear Implant (CI) indications on outcomes assessed using the International Classification of Functioning, disability and health (ICF)-based CI outcome assessment (CI-ICF) protocol.
METHODS
Data from a multicenter longitudinal cohort study was analyzed. A consecutive sample of adult CI users (N = 72), including unilateral (n = 22), bilateral (n = 2), electric acoustic stimulation (EAS) (n = 6), single-sided deafness (SSD) (n = 6), and bimodal (n = 36) CI users, were enrolled based on clinical indications for cochlear implantation. Participants were assessed preoperatively and six months postoperatively using the CI-ICF protocol, which comprises patient-reported outcome measures (PROMs), pure tone and speech audiometry and localization tests.
RESULTS
All CI indication groups showed benefits across most PROMs, pure tone and speech audiometry and localization. Differences were mainly observed in participants with SSD, who showed better baseline auditory abilities and less postoperative improvement compared to other groups for sound detection (PTA4) [e.g. PTA4 difference over time: SSD versus unilateral CI (p = 0.003)] and listening (HISQUI19) [e.g. HISQUI19 difference over time: SSD versus bimodal (p = 0.039)]. Participants with bimodal stimulation or SSD generally exhibited superior speech discrimination in noise abilities pre- and postoperatively, and demonstrated an equivalent amount of improvement for this category compared to EAS and unilateral CI users.
CONCLUSION
Various CI indication groups experienced improvements following cochlear implantation, highlighting its broad efficacy. Personalized CI strategies are essential to maximize individual outcomes. These findings support the comprehensive and readily interpretable assessment framework provided by the CI-ICF protocol in evaluating CI outcomes.
TRIAL REGISTRATION
Clinicaltrials.gov (NCT04611555), retrospectively registered on 2-Nov-2020.
目的
确定各种人工耳蜗（CI）适应证对使用基于国际功能、残疾和健康分类（ICF）的人工耳蜗结果评估（CI-ICF）方案所评估结果的影响。
方法
分析了一项多中心纵向队列研究的数据。根据人工耳蜗植入的临床适应证，纳入了连续样本的成年CI使用者（N = 72），包括单侧（n = 22）、双侧（n = 2）、电声刺激（EAS）（n = 6）、单侧耳聋（SSD）（n = 6）和双耳混合（n = 36）CI使用者。使用CI-ICF方案在术前和术后6个月对参与者进行评估，该方案包括患者报告的结局指标（PROMs）、纯音和言语听力测定以及定位测试。
结果
所有CI适应证组在大多数PROMs、纯音和言语听力测定以及定位方面均显示出益处。主要在SSD参与者中观察到差异，与其他组相比，他们在声音检测（PTA4）方面基线听觉能力更好且术后改善较少[例如，PTA4随时间的差异：SSD与单侧CI相比（p = 0.003）]以及听力（HISQUI19）方面[例如，HISQUI19随时间的差异：SSD与双耳混合相比（p = 0.039）]。双耳混合刺激或SSD的参与者在术前和术后通常表现出更好的噪声中言语辨别能力，并且与EAS和单侧CI使用者相比，在这一类别中表现出同等程度的改善。
结论
各种CI适应证组在人工耳蜗植入后均有改善，突出了其广泛的疗效。个性化的CI策略对于使个体结果最大化至关重要。这些发现支持了CI-ICF方案在评估CI结果时提供的全面且易于解释的评估框架。
试验注册
Clinicaltrials.gov（NCT04611555），于2020年11月2日追溯注册。
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