Factors That Influence Second-side Cochlear Implant Speech Recognition Outcomes.
Factors That Influence Second-side Cochlear Implant Speech Recognition Outcomes.
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影响第二侧人工耳蜗语音识别结果的因素。
DOI：
10.1097/mao.0000000000002947
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
McRackan,TheodoreR
中科院分区：
文献类型：
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作者：
Dornhoffer,James;Liu,YuanF;Zhao,EliseE;Camposeo,ElizabethL;Meyer,TedA;McRackan,TheodoreR
目的：评估患者、听力和人工耳蜗植入（CI）相关因素与双侧植入成人的第二侧CI语音识别结果之间的关系。研究设计：前瞻性维护CI数据库的回顾性审查。设置：三级学术中心。患者：102名接受双侧顺序或同时CI的成人。结果测量：≥ 12个月时的植入后辅音-核-辅音（CNC）单词和AzBio句子评分。结果：在患者、听力和CI特异性中，仅检查第一CI的植入后语音识别评分的因素在多变量回归分析中与第二CI的语音识别性能独立相关（CNC：AzBio：λ = 0.602 [0.417，0.769]）。第一侧术后CNC评分解释了第二次CI术后CNC评分变异的24.3%，而第一次CI AzBio评分的变化解释了第二次CI AzBio评分变异的40.3%。基于已确定的95%置信区间，75.2%（CNC）和65.9%（AzBio）的患者第二个CI的评分等于或优于第一个CI。年龄在植入，听力损失的持续时间，同时与顺序CI接收，和术前残余听力（测量纯音平均和辅助语音识别分数）与12个月的语音识别分数在12 months.Conclusions：语音识别的改善程度，从第一CI可以预测语音识别与第二CI。这为考虑第二次CI的患者提供了初步的循证预期。考虑到结果中剩余的无法解释的可变性，应谨慎进行咨询。尽管如此，这些数据可能有助于决策时，考虑第二CI与继续使用助听器为unimplanted ear.Level的证据：IIICoconstrar植入已成为标准的护理个人与双边中度至深度感音神经性听力损失。然而，成功单侧植入后，语音识别困难可能会持续存在[1]。通过恢复双耳听力，双侧人工耳蜗植入已被认为是单侧人工耳蜗（CI）用户面临的缺陷的一种可能的解决方案。数据还显示，从单侧人工耳蜗植入到双侧人工耳蜗植入（CI）的患者在声音定位、噪声中的语音识别和生活质量方面都有实质性改善（2-6）。
Objective:Assess relationships between patient, hearing, and cochlear implant (CI)-related factors and second-side CI speech recognition outcomes in adults who are bilaterally implanted.Study Design:Retrospective review of a prospectively maintained CI database.Setting:Tertiary academic center.Patients:One hundred two adults receiving bilateral sequential or simultaneous CIs.Outcome Measures:Postimplantation consonant-nucleus-consonant (CNC) word and AzBio sentence scores at≥ 12 months.Results:Of patient, hearing and CI-specific, factors examined only postimplantation speech recognition scores of the first CI were independently associated with speech recognition performance of the second CI on multivariable regression analysis (CNC: ß= 0.471 [0.298, 0.644]; AzBio: ß= 0.602 [0.417, 0.769]). First-side postoperative CNC scores explained 24.3% of variation in second CI postoperative CNC scores, while change in first CI AzBio scores explained 40.3% of variation in second CI AzBio scores. Based on established 95% confidence intervals, 75.2%(CNC) and 65.9%(AzBio) of patients score equivalent or better with their second CI compared to first CI performance. Age at implantation, duration of hearing loss, receiving simultaneous versus sequential CIs, and preoperative residual hearing (measured by pure-tone average and aided speech recognition scores) were not associated with 12 month speech recognition scores at 12 months.Conclusions:The degree of improvement in speech recognition from first CI may predict speech recognition with a second CI. This provides preliminary evidence-based expectations for patients considering a second CI. Counseling should be guarded given the remaining unexplained variability in outcomes. Nonetheless, these data may assist decision making when considering a second CI versus continued use of a hearing aid for an unimplanted ear.Level of Evidence:IIICochlear implantation has become the standard of care for individuals with bilateral moderate-to-profound sensorineural hearing loss. However, difficulty with speech recognition may persist after successful unilateral implantation (1). Bilateral cochlear implantation, by restoring binaural hearing, has been posited as one possible solution for deficits faced by unilateral cochlear implant (CI) users. Data also show substantial improvement in sound localization, speech recognition in noise, and quality of life in patients going from unilateral to bilateral cochlear implants (CIs)(2–6).