非植入耳听力与年龄对成人不对称听力损失人工耳蜗使用者长期言语识别获益的影响
Influence of hearing in the non-implanted ear and age on long-term speech recognition benefit for adult cochlear implant users with asymmetric hearing loss.
文献信息
| PMID | 42745889 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sylvia Mihailescu |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. |
| 期刊 | Frontiers in neuroscience |
| SCI 分区 | Q2 |
| IF | 4.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
大多数非植入耳听力正常或为轻至中重度听力损失的人工耳蜗（CI）使用者，即不对称听力损失（AHL），与术前能力相比在空间听觉方面获得显著获益，但个体结局存在差异。本研究分析了非植入耳听力和年龄对35例成人AHL的CI使用者长期结局的影响。在开机后每年随访时通过行为学方法测量未助听听阈，并用于计算纯音平均听阈（PTA；0.5、1、2、4 kHz）。采用AzBio句子在10人说话者掩蔽声中评估噪声下言语识别，目标声来自前方扬声器，掩蔽声分别来自朝向植入耳90°、朝向非植入耳90°或与目标声同位置。空间掩蔽释放计算为掩蔽声朝向植入耳（SRMci）或朝向非植入耳（SRMcontra）时相对于同位置配置的言语识别获益。开机后1年之后，SRMci的空间掩蔽释放无显著变化，而SRMcontra继续显著改善。非植入耳听力显著影响SRMci。手术时年龄显著影响SRMcontra。6例（17%）参与者的非植入耳PTA下降≥15 dB HL，这对空间听觉产生负面影响。对于这些参与者，通过调整助听器验配或双侧人工耳蜗植入后，表现通常得到改善。成人AHL的CI使用者长期结局受非植入耳听力和年龄的显著影响——但在不同噪声下言语配置中影响存在差异。
英文摘要
Most cochlear implant (CI) users with normal hearing or mild to moderately-severe hearing loss in the non-implanted ear, known as asymmetric hearing loss (AHL), experience significant benefits in spatial hearing as compared to pre-operative abilities, though individual outcomes vary. This study analyzed the influence of the hearing in the non-implanted ear and age on long-term outcomes for 35 adult CI users with AHL. Unaided thresholds were measured behaviorally at annual post-activation visits and were used to calculate a pure-tone average (PTA; 0.5, 1, 2, 4 kHz). Sentence recognition in noise was assessed with the AzBio sentences in a 10-talker masker with the target presented from the front loudspeaker and the masker presented 90° toward the implanted ear, 90° towards the non-implanted ear, or co-located with the target. Spatial release from masking was calculated as the benefit in speech recognition when the masker was presented towards the implanted ear (SRMci) or the non-implanted ear (SRMcontra) as compared to the co-located configuration. Spatial release from masking did not change significantly after 1-year post-activation for SRMci and continued to significantly improve for SRMcontra. Hearing in the non-implanted ear significantly influenced SRMci. Age at surgery significantly influenced SRMcontra. Six (17%) participants experienced a PTA decline of ≥ 15 dB HL in the non-implanted ear, which negatively influenced spatial hearing. For those, performance generally improved with adjustments to the hearing aid fitting or after bilateral cochlear implantation. Long-term outcomes for adult CI users with AHL are significantly influenced by hearing in the non-implanted ear and age - though differentially across speech-in-noise configurations.