The efficacy of cochlear implantation in adult patients with profound hearing loss

Czech version

Authors: B. Gál ¹ ; J. Rottenberg ¹; T. Talach ¹; M. Veselý ¹; Z. Kadaňka Jr. ²; E. Kadaňková ²; I. Horová ³; M. Budíková ³ ; R. Kostřica ¹; J. Hložek ¹
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF MU a FN u sv. Anny v Brně ¹; Neurologická klinika LF MU a FN Brno ²; Ústav matematiky a fyziky, PřF MU Brno ³
Published in: Cesk Slov Neurol N 2018; 81(6): 664-668
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2018664

Overview

Aim:

The study objective was to evaluate the effect of unilateral cochlear implantation with direct stimulation of the VIII^th cranial nerve in adult patients, with profound perceptive hearing loss, with an emphasis on parameters of pure tone audiometry and speech intelligibility using speech audiometry.

Materials and methods:

A retrospective analysis of patients with unilateral cochlear implantation at the Department of Otorhinolaryngology and Head and Neck Surgery during the period 1/ 2012– 12/ 2017. The number of patients n = 68, men = 29 (43%), and mean age 44 (18– 87) years.

Results:

Pure tone audiometry – preoperative mean pure tone average (PTA) 101.1 ± 10.8 dB HL, postoperative mean PTA 40.1 ± 8.4 dB HL, mean PTA difference before and after surgery 60.9 ± 14.4 dB HL (p < 0.01). Speech audiometry (SA) – preoperative mean value of maximum speech intelligibility 8.4 ± 14.4%; postoperative mean SA 56.5 ± 19.4%, mean SA improvement before and after surgery 48.1 ± 22.1%; (p < 0.01). Postoperative Nottingham scale – 15 (22.1%) patients achieved grade 7, 25 (36.8%) patients achieved grade 6, 16 (23.5%) patients achieved grade 5, 9 (13.2%) patients achieved grade 4, 2 (2.9%) patients achieved grade 3, and 1 (1.5%) patient achieved grade 2. The age factor did not reveal any significant difference for functional outcome of surgery (the patient groups ≤ 50 years, 51– 65 years, > 65 years) – no significant differences in PTA and speech intelligibility for SA among all age groups (p > 0.05) was observed.

Conclusion:

In post-lingual deaf patients who no longer benefit from hearing aid fitting, the cochlear implantation with direct stimulation of the auditory nerve is a highly effective method of correcting hearing function. A significant improvement in speech discrimination and verbal communication without latency, representing a substantial benefit for the quality of life of implanted patients, is achieved by unilateral cochlear implantation. Concurrently, no evidence of dependence was found between age at the time of surgery and postoperative outcome.

Key words:

hearing loss – pure tone average – speech recognition threshold – unilateral cochlear implantation

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Chinese summary - 摘要

人工耳蜗植入治疗成人严重听力损失的疗效

目标：

该研究的目的是评估单侧人工耳蜗植入对成人患者第VIII颅神经的直接刺激的影响，具有深远的听觉损失，强调纯音测听参数和使用语音测听的语音清晰度。

材料和方法：

对2012年1月1日至12月期间耳鼻咽喉科和头颈外科单侧人工耳蜗植入患者的回顾性分析。患者人数n = 68，男性= 29（43％），平均年龄 44岁（18-87）。

结果：

纯音测听 - 术前平均纯音平均值（PTA）101.1±10.8 dB HL，术后平均PTA 40.1±8.4 dB HL，术前和术后平均PTA差异60.9±14.4 dB HL（p <0.01）。言语测听（SA） - 术前最大语音清晰度的平均值为8.4±14.4％; 术后平均SA为56.5±19.4％，术前和术后SA改善率为48.1±22.1％; （p <0.01）。术后诺丁汉量表 - 15名（22.1％）患者达到7级，25名（36.8％）患者达到6级，16名（23.5％）患者达到5级，9名（13.2％）患者达到4级，2名（2.9％）患者达到3级，1名（1.5％）患者达到2级。年龄因素未显示手术功能结果有任何显著差异（患者组≤50岁，51-65岁，> 65岁） - 观察到所有年龄组的PTA差异和SA的语音清晰度无显著差异（p> 0.05）。

结论：

在不再受益于助听器配合的舌下聋患者中，直接刺激听神经的人工耳蜗植入是一种非常有效的矫正听力功能的方法。通过单侧人工耳蜗植入实现了语音辨别和言语交流无延迟的显著改善，代表了植入患者生活质量的实质性益处。同时，在手术时的年龄与术后结果之间没有发现依赖的证据。

关键词：

听力损失 - 纯音平均 - 语音识别阈值 - 单侧人工耳蜗植入

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