整合式双模式与双侧人工耳蜗使用者：谁表现更好，以及他们在“真实生活”测试组合中与正常听力听者相比如何？

文献信息

中文摘要

目的：
成人通常仅接受单侧人工耳蜗植入（CI）。当对侧仍存在可助听听阈时，推荐采用双模式配置（即对侧佩戴助听器）。然而，标准助听器通常独立于CI工作，需要使用者整合不同的信号。整合式双模式技术正是为应对这一挑战而开发的。本研究旨在（1）使用更能代表真实生活聆听情境的空间听觉测试组合，比较整合式双模式与双侧CI的结局；（2）将这些结局与正常听力成人进行比较。
方法：
招募了26名佩戴整合式双模式技术的CI使用者、16名双侧CI使用者和45名正常听力成人。使用“真实生活”空间听觉测试组合（噪声下言语感知、定位测试和追踪测试）以及言语、空间和听觉质量量表（SSQ）评估表现和用户体验。
结果：
相对较小的样本量限制了统计效能。在噪声下言语表现方面，整合式双模式组与双侧CI组之间未观察到统计学显著差异；然而，这不应被解释为结局等效的证据。双侧CI使用者在定位（36%）和追踪（44%）表现上显著优于整合式双模式使用者。两个CI组的表现均显著差于正常听力组。第二侧植入物的感知获益显著大于整合式双模式配置的感知获益。
结论：
有限的样本量使得无法就整合式双模式与双侧CI使用者之间的噪声下言语差异得出确定性结论。双侧CI使用者的空间听觉表现显著优于整合式双模式使用者，尽管其结局仍显著差于正常听力成人。

英文摘要

OBJECTIVES: Adults typically receive only one cochlear implant (CI). Bimodal fitting (i.e. a contralateral hearing aid) is recommended when aidable hearing remains. However, standard hearing aids typically function independently from a CI, requiring the user to integrate disparate signals. Integrated bimodal technology has been developed to address this challenge. This study aimed to (1) to compare integrated bimodal and bilateral CI outcomes using a spatial hearing test battery that is more representative of real-life listening situations, and (2) to compare outcomes with those of adults with normal hearing.
METHOD: Twenty-six CI users fitted with the integrated bimodal technology, 16 bilateral CI users and 45 normal-hearing adults were recruited. Performance and user experience were assessed using a 'real-life' spatial hearing test battery (speech perception in noise, localisation test, and tracking) and the Speech, Spatial, and Qualities-of-Hearing Scale (SSQ).
RESULTS: The relatively small sample size limited statistical power. No statistically significant difference was observed between the integrated bimodal and bilateral CI groups in speech-in-noise performance; however, this should not be interpreted as evidence of equivalent outcomes. Bilateral CI users demonstrated significantly better localisation (36%) and tracking (44%) performance than integrated bimodal users. Both CI groups performed significantly more poorly than the normal-hearing group. Perceived benefit of a second implant was significantly greater than that from integrated bimodal fitting.
CONCLUSION: The limited sample size precluded definitive conclusions regarding speech-in-noise differences between integrated bimodal and bilateral CI users. Bilateral CI users demonstrated significantly better spatial listening perfromace than integrated bimodal users, although outcomes remained significantly poorer than those of normal hearing adults.