双耳言语感知不对称对青少年人工耳蜗植入者定位、口语和读写能力的影响

文献信息

中文摘要

目的： 本研究旨在探讨双耳言语感知不对称对早期植入人工耳蜗（CI）青少年的定位、口语和阅读能力的影响。
方法： 80名长期双侧使用设备的青少年参与研究：10名使用双模式（BM）设备（CI加非植入耳助听器），70名使用双侧CI（BCI；14名同期，56名序贯）。参与者完成了定位、单侧言语感知、接受性语言和阅读测试。主成分分析创建了较好耳言语感知和双耳言语感知不对称的综合评分。分层回归分析了人口统计学、听力学因素和不对称对结果的影响。
结果： 两个BCI组的定位评分无显著差异。然而，两个BCI组的定位评分均显著优于BM组。三组的语言和阅读评分无显著差异。定位评分的回归分析显示，较早接受CI有积极影响，较长声学经验持续时间有负面影响，尽管这种影响受到残余听力程度的调节。较大的言语感知不对称对定位评分有负面影响，但对语言或阅读评分无影响。
结论： 言语感知不对称对青少年CI使用者的定位有负面影响，但对语言或阅读无影响。延长的声学经验（通过BM使用）增加了言语感知不对称并降低了定位技能。定位技能对青少年期的口语或阅读评分无显著影响。临床上，不对称指导设备推荐，但其影响（如果有）因结果而异。对于残余听力较好的儿童，早期声学听力（通过BM使用）有利于定位和语言。因此，建议仔细把握BCI的时机。
补充材料： https://doi.org/10.23641/asha.33490615。

英文摘要

PURPOSE: This study aimed to examine the effects of between-ear speech perception asymmetry on localization, spoken language, and reading in adolescents with early cochlear implants (CIs).
METHOD: Eighty adolescents, who have long-term bilateral device use, participated: 10 with bimodal (BM) devices (CI plus hearing aid at the nonimplanted ear) and 70 with bilateral CIs (BCIs; 14 simultaneous, 56 sequential). Participants completed localization, unilateral speech perception, receptive language, and reading tests. Principal component analysis created composite scores for better-ear speech perception and between-ear speech perception asymmetry. Hierarchical regression examined the effects of demographics, audiological factors, and asymmetry on outcomes.
RESULTS: Localization scores for the two BCI groups did not differ significantly. Both BCI groups' localization scores were, however, significantly better than those of the BM group. Language and reading scores were not significantly different for the three groups. Regression analyses of localization scores revealed positive effects for earlier receipt of CI/s and negative effects of longer duration of acoustic experience, although this effect was moderated by degree of residual hearing. Larger speech perception asymmetry negatively affected localization scores but had no effect on language or reading scores.
CONCLUSIONS: Speech perception asymmetry negatively affected localization but not language or reading in adolescent CI users. Prolonged acoustic experience (via BM use) increased speech perception asymmetry and reduced localization skills. Localization skills had no significant effects on spoken language or reading scores in adolescence. Clinically, asymmetry guides device recommendations, but asymmetry's impact, if any, differs by outcome. For children with better residual hearing, early acoustic hearing (via BM use) benefits both localization and language. Thus, careful timing of BCIs is advised.
SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.33490615.