单侧耳聋及非对称性听力损失的人工耳蜗植入效果：生活质量、耳鸣及耳聋持续时间的影响
Outcomes of Cochlear Implantation for Single-Sided Deafness and Asymmetric Hearing Loss: Quality of Life, Tinnitus, and the Effect of Deafness Duration.
文献信息
| PMID | 42706939 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yujin Heo |
| 作者单位 | Department of Otorhinolaryngology--Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. |
| 期刊 | Clinical and experimental otorhinolaryngology |
| SCI 分区 | Q1 |
| IF | 2.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 评估成人单侧耳聋（SSD）或非对称性听力损失（AHL）患者接受人工耳蜗植入（CI）的多维度效果，并探讨耳聋持续时间如何影响言语感知、耳鸣严重程度及听力相关生活质量。
方法： 这项回顾性队列研究纳入124例在三级转诊中心接受单侧CI的SSD或AHL成人患者（2019年9月至2024年10月），术后随访至少12个月。主要结局为听力相关生活质量，采用言语、空间和听觉质量量表（SSQ）评估；次要结局包括老年听力障碍量表（HHIE）、耳鸣障碍量表（THI）、简明健康调查量表（SF-36）及开放式言语感知（n=61）。采用线性回归将耳聋持续时间作为连续预测变量，评估其与术后结局的关联。
结果： 术后SSQ言语域（+0.97；d=0.53；p<0.001）和空间域（+1.60；d=0.88；p<0.001）、HHIE（-13.0；d=0.50；p<0.001）、THI（-15.8；d=0.61；p<0.001）及SF-36（+4.2；d=0.27；p=0.031）均显著改善。仅CI条件下言语感知显著提高（单音节词d=1.98；双音节词d=2.92；句子识别d=3.59）。耳聋持续时间越长与THI改善越小显著相关（β=1.13分/年，95%CI 0.43-1.84；p=0.002；校正后β=0.98，95%CI 0.18-1.78；p=0.017），而生活质量及句子识别结局与耳聋持续时间无关联。
结论： 单侧CI可为SSD和AHL成人患者的听力相关生活质量、耳鸣严重程度、听力障碍及言语感知带来具有临床意义的改善。无论耳聋持续时间如何，生活质量和言语结局均得以保留，而耳鸣抑制效果随耳聋持续时间增加而下降。这些发现支持对伴有困扰性耳鸣的候选者更早进行CI。
英文摘要
OBJECTIVES.: To evaluate multidimensional outcomes of cochlear implantation (CI) in adults with single-sided deafness (SSD) or asymmetric hearing loss (AHL), and to examine how duration of deafness influences speech perception, tinnitus severity, and hearing-related quality of life.
METHODS.: This retrospective cohort study included 124 adults with SSD or AHL who underwent unilateral CI at a tertiary referral center (September 2019-October 2024) with at least 12 months of postoperative follow-up. The primary outcome, hearing-related quality of life, was assessed using the Speech, Spatial, and Qualities of Hearing Scale (SSQ); secondary outcomes included the Hearing Handicap Inventory for the Elderly (HHIE), Tinnitus Handicap Inventory (THI), Short Form-36 (SF-36), and open-set speech perception (n = 61). The association between duration of deafness and postoperative outcomes was evaluated using duration as a continuous predictor in linear regression.
RESULTS.: Significant postoperative improvements occurred in SSQ Speech (+0.97; d = 0.53; p < 0.001) and Spatial domains (+1.60; d = 0.88; p < 0.001), HHIE (- 13.0; d = 0.50; p < 0.001), THI (-15.8; d = 0.61; p < 0.001), and SF-36 (+4.2; d = 0.27; p = 0.031). Speech perception improved markedly under CI-only conditions (monosyllabic d = 1.98; bisyllabic d = 2.92; sentence recognition d = 3.59). Longer duration of deafness was significantly associated with smaller THI improvement (β = 1.13 points/year, 95% CI 0.43-1.84; p = 0.002; adjusted β = 0.98, 95% CI 0.18-1.78; p = 0.017), whereas quality-of-life and sentence recognition outcomes were not associated with deafness duration.
CONCLUSION.: Unilateral CI produces clinically meaningful improvements in hearingrelated quality of life, tinnitus severity, hearing handicap, and speech perception in adults with SSD and AHL. Quality-of-life and speech outcomes were preserved regardless of deafness duration, whereas tinnitus suppression declined with increasing deaf duration. These findings support earlier CI for candidates with bothersome tinnitus.