从配对刺激转换为顺序刺激对人工耳蜗使用者言语识别的影响。

文献信息

中文摘要

目的： 多年来，配对刺激策略（P）是Advanced Bionics推荐用于人工耳蜗使用者的标准配置。然而，近期证据已证明顺序策略（S）的优势，促使该公司将其采纳为新的标准。尽管有此变化，许多使用者仍继续依赖P策略。在此背景下，本研究旨在确定对于已使用P策略至少三个月的使用者，S策略是否确实提供优势。值得注意的是，尚无关于该主题的研究以葡萄牙语或其他拉丁语系语言进行。
方法： 九名人工耳蜗使用者参与了研究，共分析十一只耳。所有参与者最初使用以P策略编程的映射图，并进行常规临床随访。这些映射图根据每位使用者测得的舒适水平（M）进行配置。在重新编程为S策略后，最大刺激水平（M）根据个体舒适报告重新调整。检测阈值（T）在原始和更新映射图中均设定为M值的10%。每只耳均接受使用P策略的句子识别测试，随后接受使用S策略的测试，从而可直接比较表现。对于此比较，使用配对Student t检验，采用的显著性水平为5%（p < 0.05）。
结果： 所有参与者均表现出使用S策略时性能改善。两种策略之间的差异具有统计学显著性，转换为顺序刺激后句子识别平均提高23%。
结论： 结果表明，顺序策略提供的性能显著优于配对策略。

英文摘要

OBJECTIVE: For many years, the paired stimulation strategy (P) was the standard configuration recommended by Advanced Bionics for cochlear implant users. However, recent evidence has demonstrated advantages of the sequential strategy (S), leading the company to adopt it as the new standard. Despite this change, many users continue to rely on the P strategy. In this context, the present study aimed to determine whether the S strategy truly provides advantages for users who have been using the P strategy for at least three months. Notably, no studies on this topic have been conducted in Portuguese or other Latin-based languages.
METHODS: Nine cochlear implant users participated in the study, totalling eleven ears analyzed. All participants initially used maps programmed with the P strategy, with routine clinical follow-up. These maps were configured based on each user's measured comfort level (M). After reprogramming to the S strategy, the maximum stimulation levels (M) were readjusted according to individual comfort reports. Detection thresholds (T) were set at 10% of the M value for both the original and the updated maps. Each ear underwent a sentence recognition test using the P strategy and, subsequently, the S strategy, allowing for direct comparison of performance. For this comparison, the paired Student's t-test was used, the level of significance adopted was 5% (p < 0.05).
RESULTS: All participants demonstrated improved performance with the S strategy. The difference between strategies was statistically significant, with an average increase of 23% in sentence recognition following the transition to sequential stimulation.
CONCLUSION: The results indicate that the sequential strategy provides significantly better performance than the paired strategy.