人工耳蜗使用者行为MAP与客观MAP听觉感知比较：一项系统综述

文献信息

中文摘要

目的： 本系统综述（PROSPERO ID：CRD42024573626）探讨在人工耳蜗（CI）使用者中，客观MAP是否比行为MAP带来更好的听觉感知。
设计： Medline、Embase、Web of Science、CENTRAL、CINAHL Plus with Full Text和Google Scholar的最后检索时间为2026年1月。纳入比较CI使用者行为MAP与客观MAP之间听觉感知的英文或法文同行评议全文发表文章。其质量和证据水平由两名评价者分别使用定量研究质量评估工具和2011年牛津循证医学中心证据水平独立评估。
研究样本： 纳入26项异质性低水平研究（495名CI使用者）。
结果： 大多数研究使用非验证工具，且非双盲、不精确和间接。使用四种客观测量来指导 fitting。两种主要客观测量是电诱发复合动作电位（eCAP）阈值和电诱发镫骨肌反射阈值（eSRT）。在儿童、语前听力损失个体和短期经验CI使用者中，eSRT指导的MAP往往比行为MAP产生显著更好的听觉感知。
结论： 需要进一步更大规模的双盲高水平研究来确认客观测量，特别是eSRT，指导 fitting 的明显疗效。

英文摘要

OBJECTIVE: This systematic review (PROSPERO ID: CRD42024573626) explores whether objective MAPs result in better auditory perception than behavioural MAPs in cochlear implant (CI) users.
DESIGN: Medline, Embase, Web of Science, CENTRAL, CINAHL Plus with Full Text, and Google Scholar were last searched in January 2026. English or French peer-reviewed full-length published articles comparing auditory perception between behavioural and objective MAPs in CI users were included. Their quality and level of evidence were independently assessed by two reviewers with the Quality Assessment Tool for Quantitative Studies and the 2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence.
STUDY SAMPLE: Twenty-six heterogeneous low-level studies were included (495 CI users).
RESULTS: Most studies used non-validated tools and were non-double-blinded, imprecise and indirect. Four objective measures were used to guide fitting. The two main objective measures were the electrically evoked compound action potential (eCAP) thresholds and the electrically evoked stapedial reflex thresholds (eSRTs). ESRT-guided MAPs tended to yield significantly better auditory perception than behavioural MAPs in children, individuals with prelingual hearing loss, and short-term experienced CI users.
CONCLUSIONS: Further larger double-blinded high-level studies are needed to confirm the apparent efficacy of objective measures, particularly eSRTs, to guide fitting.