Cochlear Implantation: Vast Unmet Need to Address Deafness Globally.
Cochlear Implantation: Vast Unmet Need to Address Deafness Globally.
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人工耳蜗植入：全球解决耳聋问题的巨大未满足需求。
DOI：
10.1097/mao.0000000000001416
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Stankovic,KonstantinaM
中科院分区：
文献类型：
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作者：
Şahin,Mehmetİlhan;Sagers,JessicaE;Stankovic,KonstantinaM
感音神经性听力损失（SNHL）是最常见的听力损失类型。虽然新的治疗方法正在开发中，但目前的治疗仅限于辅助设备，如助听器和人工耳蜗（CI）。CI是有史以来最成功的神经假体，有助于重度至重度SNHL患者的功能性听力。然而，全球只有不到10%的CI候选人利用这项技术（1）。虽然有意识地尽早融入聋人文化为文化和语言发展提供了宝贵的机会，仍然是一个不应被忽视的选择，但我们提供了世界上CI候选人总数的计算，这是以前没有提出过的。结合10个人口最多的国家的报告数字，并将这一估计扩展到世界人口，我们计算出115，全世界有10000名新生儿经历了严重的HL（图1A）。从这个总数中可以减去患有耳疾病的婴儿，包括听神经病谱系障碍（1%）和内耳畸形（1%），每年有112，700名CI候选人出生。25%的世界人口年龄小于15岁，0.2%的儿童（360万）患有严重HL（2）。在这个年龄段，人工耳蜗植入最突出的禁忌症是智力低下，包括自闭症谱系障碍，影响2至7%的儿童（3，4）。各种其他禁止性残疾影响23%的重度HL儿童（3）。因此，在保守排除30%的重度HL儿童后，世界上仍有250万儿童为CI候选人。在全球范围内，0.2%至0.4%的成年人患有重度HL（2）。75%的人口年龄在15岁以上，其中60%（990万）的人由于噪音暴露和老年性耳聋等因素而经历过成人发作的HL（5）。这些人中的大多数都有资格接受植入。此外，65岁以上的人占世界人口的7.4%，其中0.9%患有重度HL（6）。如果我们从成人CI候选人中排除15%的老年人，以解释阿尔茨海默病（11%）和非阿尔茨海默病相关痴呆（3%）的患病率（7，8），我们假设大约有920万成年人仍然符合植入条件。
Sensorineural hearing loss (SNHL) is the most common type of hearing loss (HL). Though novel approaches to treatment are in development, current therapies are limited to assistive devices, such as hearing aids and cochlear implants (CIs). CIs are the most successful neural prostheses of all time and facilitate functional hearing for people with severe to profound SNHL. However, less than 10% of CI candidates worldwide take advantage of this technology (1). Although conscious, early integration into Deaf culture presents a valuable opportunity for cultural and linguistic development and remains an option that should not be discounted, we provide the calculation of total CI candidates in the world, which has not been previously presented.Combining reported figures from the 10 most populous countries and extending this estimate to the world population, we calculate that 115,000 newborns worldwide experience profound HL (Fig. 1A). Infants with otologic conditions for which implantation is contraindicated, including auditory neuropathy spectrum disorder (1%) and inner ear malformations (1%) can be subtracted from this total, leaving 112,700 CI candidates born each year. Twenty-five percent of the world population is younger than 15 years old, and 0.2% of children (3.6 million) experience profound HL (2). At this age, the most salient contraindication for cochlear implantation is mental retardation, including autism spectrum disorder, which affects 2 to 7% of children (3, 4). Various other prohibitive disabilities affect 23% of children with profound HL (3). Thus, after conservative elimination of 30% of children with profound HL, 2.5 million children in the world remain CI candidates. Globally, 0.2 to 0.4% of adults suffer from profound HL (2). 75% of the population is over 15 years old, and 60%(9.9 million) of these people have experienced adult-onset HL due to factors like noise exposure and presbycusis (5). Most of these individuals are eligible for implantation. Additionally, people over 65 years old make up 7.4% of the world population, of whom 0.9% suffer from profound HL (6). If we eliminate 15% of elderly people from the pool of adult CI candidates to account for the prevalence of Alzheimer’s disease (11%) and non-Alzheimer’s related dementia (3%)(7, 8), we assume that approximately 9.2 million adults remain eligible for implantation.