Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits
Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits
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DOI：
10.1159/000488023
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发表时间：
2017-01-01
影响因子：
1.6
通讯作者：
Brokx, Jan
中科院分区：
文献类型：
--
作者：
Debruyne, Joke;Janssen, Miranda;Brokx, Jan
目的：众所周知，早期聋人人工耳蜗术(CI)患者是一个表现非常不同的群体。为了更深入地了解这一群体，本研究调查了(1)基于各种结果测量的术后听觉表现随时间的变化，重点关注表现不佳的患者，(2)自我感知结果，(3)听觉和自我感知结果之间的关系，以及(4)植入前预测术后结果的因素。方法：对27例早聋、晚期植入脑梗塞患者植入后3年内的预后进行前瞻性评估。结果测量包括开放集合单词和句子识别、封闭集合单词识别、语音跟踪和关于自我感知结果的问卷。此外，通过线性回归分析评估了植入前8个因素对CI预后的相对影响。结果：在听觉表现测量和问卷的大部分领域都有显著的改善。对于表现不佳的一组人，封闭集单词测试、语音跟踪和问卷调查也发生了显著变化。听觉结果和自我感知结果之间的相关性很弱，且不显著。在多变量回归模型中，术前单词识别和术前听力阈值都是预测术后结果的重要因素，可解释63.5%的变异。结论：在这一人群中的结果测量应该根据患者的个人表现水平进行调整，并包括自我感知的利益。在这一组中，仍然需要更多关于CI预后预测因素的知识，但目前的研究表明，植入耳朵的术前表现是重要的。(C)2018年作者(S)由S.Karger AG，巴塞尔出版
Objectives: It is known that early-deafened cochlear implant (CI) users are a very heterogeneously performing group. To gain more insight into this population, this study investigated (1) postoperative changes in auditory performance over time based on various outcome measures, focusing on poor performers, (2) self-perceived outcomes, (3) relations between auditory and self-perceived outcomes, and (4) preimplantation factors predicting postoperative outcomes. Methods: Outcomes were assessed prospectively in a group of 27 early-deafened, late-implanted CI users, up to 3 years after implantation. Outcome measures included open-set word and sentence recognition, closed-set word recognition, speech tracking and a questionnaire on self-perceived outcomes. Additionally, the relative influence of 8 preimplantation factors on CI outcome was assessed with linear regression analyses. Results: Significant improvements were found for auditory performance measures and most of the questionnaire domains. Significant changes of the closed-set word test, speech tracking and questionnaire were also found for a subgroup of poor performers. Correlations between auditory and self-perceived outcomes were weak and nonsignificant. Preoperative word recognition and preoperative hearing thresholds, both for the implanted ear, were significant predictors of postoperative outcome in the multivariable regression model, explaining 63.5% of the variation. Conclusions: Outcome measurement in this population should be adjusted to the patients' individual performance level and include self-perceived benefit. There is still a need for more knowledge regarding predictors of CI outcomes in this group, but the current study suggests the importance of the preoperative performance of the ear to be implanted. (C) 2018 The Author(s) Published by S. Karger AG, Basel