成人长期单侧耳聋患者人工耳蜗植入的多中心研究
A Multicenter Study of Cochlear Implantation in Adults With Prolonged Unilateral Deafness.
文献信息
| PMID | 42717814 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Evan J Patel |
| 作者单位 | Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, San Francisco, California, USA. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 评估长期单侧耳聋患者植入人工耳蜗（CI）后的言语感知和使用结果。
方法： 在五个三级学术中心进行的回顾性队列研究，纳入接受人工耳蜗植入的长期（>10年）单侧重度至极重度听力损失的成年患者。主要结局指标包括术后单词识别评分（WRS）和CI的平均每日使用时间。
结果： 共分析68例患者，单侧耳聋的中位持续时间为17年（IQR，12-35年）。植入后≤1年时，个体平均每日CI使用时间为8.4小时（SD，4.5小时），>1年时为7.1小时（SD，5.0小时）。大多数患者（54.5%，30例）植入后WRS绝对增加≥20%，32.7%（18例）绝对增加≥50%。对完成相同测试的患者进行术前和术后言语识别的单变量分析显示，临床和统计学上均有显著改善，最新听力图上的平均变化为28.4%（SD 31.6%；p<0.001）。在排除无术后数据的患者的分析中，多变量分析显示耳聋持续时间不能预测CI术后WRS。
结论： 在我们的研究中，大多数长期单侧听觉剥夺患者从CI中获益。尽管发现听觉剥夺持续时间与较差的CI言语感知表现之间的关联不一致，但我们的发现支持个体化的CI候选评估，并表明仅凭长期耳聋不应作为人工耳蜗植入的绝对排除标准。
英文摘要
OBJECTIVE: To evaluate cochlear implant (CI) speech perception and usage outcomes in patients after prolonged unilateral deafness.
METHODS: Retrospective cohort study at five tertiary academic centers of adult patients with prolonged (> 10 years) unilateral severe to profound hearing loss who underwent cochlear implantation. Main outcome measures included post-operative word recognition scores (WRSs) and average daily usage of CI.
RESULTS: A total of 68 patients were analyzed with a median duration of unilateral deafness of 17 years (IQR, 12-35 years). The mean individual average daily CI usage was 8.4 h (SD, 4.5 h) at ≤ 1 year after implantation and 7.1 h (SD, 5.0 h) at > 1 year. The majority of patients (54.5%, 30 patients) had an absolute increase in WRS of ≥ 20% after implantation and 32.7% (18 patients) had an absolute increase of ≥ 50%. Univariate analysis comparing pre- and post-operative speech recognition in patients who completed the same test revealed a clinically and statistically significant improvement, with a mean change of 28.4% (SD 31.6%; p < 0.001) at their latest audiogram. In the analysis excluding those without post-operative data, duration of deafness was not predictive of post-CI WRS on multivariable analysis.
CONCLUSIONS: Most patients with prolonged unilateral auditory deprivation in our study benefited from a CI. Although the duration of auditory deprivation was found to be inconsistently associated with poorer CI speech perception performance, our findings support individualized CI candidacy assessment and suggest that prolonged deafness alone should not be used as an absolute exclusion criterion for cochlear implantation.