Is Electric Acoustic Stimulation Better Than Conventional Cochlear Implantation for Speech Perception in Quiet?
Is Electric Acoustic Stimulation Better Than Conventional Cochlear Implantation for Speech Perception in Quiet?
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DOI：
10.1097/mao.0b013e3181d8d6fe
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发表时间：
2010-09-01
影响因子：
2.1
通讯作者：
Buchman, Craig A.
中科院分区：
文献类型：
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作者：
Adunka, Oliver F.;Pillsbury, Harold C.;Buchman, Craig A.
目的：为了评估联合电声刺激（EAS）是否比单独的同侧电刺激、单独的同侧声刺激或不保留听力的全长人工耳蜗植入术提供显著的安静听力优势。两组匹配的人工耳蜗植入（CI）患者，植入EAS或全人工耳蜗，干预：EAS人工耳蜗植入和听力保护（n = 10，EAS组）或传统CI（n = 10，常规Cl组）不保留听力。装配后3个月和6个月安静状态下的剩余听力和言语感知数据状态。术前，EAS组的平均辅助辅音核辅音词测试词得分为24.2 ± 8.3%，常规CI组为20.7 ± 11.36（p = 0.14）。在常规CI组中，所有受试者的听力在手术后均未保留，而EAS组中10例受试者中有9例听力保留。EAS组和传统CI组在单独使用电刺激激活后6个月的平均CNC单词评分分别为50.3 +/- 11.53%和53.8 +/- 17.32%（p = 0.81）。EAS受试者之间的条件间比较显示，联合刺激明显优于单独的电刺激或声刺激条件（p < 0.05）。当与常规CI组相比，EAS受试者的联合刺激再次优于上级（p < 0.05）。结论：当单独使用电刺激时，具有同侧听力保护的有限长度CI提供了与常规CI相当的言语感知性能结果。在保留残余听力的耳朵中添加同侧声刺激提供了超过单独电刺激的额外益处。
Objective: To assess whether combined electric acoustic stimulation (EAS) provides a significant hearing-in-quiet advantage over ipsilateral electrical stimulation alone, ipsilateral acoustic stimulation alone, or fill-length cochlear implantation without preserved hearing.Setting: Tertiary care academic referral center.Patients: Two matched groups of cochlear implant (CI) patients that were implanted with either an EAS or full-length device and use similar speech processing strategies.Intervention: EAS cochlear implantation and hearing preservation (n = 10, EAS group) or conventional CI (n = 10, conventional Cl group) without hearing preservation.Main Outcome Measures: Status of residual hearing and speech perception data in quiet at 3 and 6 months after fitting.Results: Preoperatively, the mean aided Consonant Nucleus Consonant Word Test word score was 24.2 +/- 8.3% for the EAS group and 20.7 +/- 11.36% for the conventional CI group (p = 0.14). In the conventional CI group, hearing was not preserved after surgery in any subject, whereas 9 of the 10 subjects in the EAS group had hearing preservation. Mean CNC word scores at 6 months after activation using electrical stimulation alone were 50.3 +/- 11.53% in the EAS group and 53.8 +/- 17.32% in the conventional CI group (p = 0.81). Between-condition comparisons among the EAS subjects revealed that combined stimulation was significantly better than either the electrical or acoustic stimulation condition alone (p < 0.05). When compared with the conventional CI group, combined stimulation in EAS subjects was again superior (p < 0.05).Conclusion: Limited length CI with ipsilateral hearing preservation provides comparable speech perception performance results to conventional CI when electric stimulation alone is used. The addition of ipsilateral acoustic stimulation in ears with preserved residual hearing provides an additional benefit over electrical stimulation alone.