hearing

听证
  • 文章类型: Case Reports
    该案例研究探讨了COVID-19疫苗接种与耳鸣和高音的联系,考虑到疫苗接种后的发作和恶化。受试者是一名有双侧耳鸣病史的47岁女性,她的听力历史从2014年到2023年被追踪。2021年发生了强烈的耳鸣发作,与之前接种COVID-19疫苗后的经历不同,第二剂量。症状表现为突发性过度发作,发音为“咆哮”类型耳鸣,听力突然下降。听力测量结果表明,低频阈值降低,左耳语音得分降低。在群体条件和嘈杂环境中,这种升级会显著影响语音理解。耳鸣和高音严重程度逐渐改善,但是这个话题在言语理解方面有更大的问题。受试者的旅程包括拜访专家,包括神经成像在内的多种测试,自然疗法咨询,和焦虑药物。它强调医疗保健从业人员认识和记录这些问题的重要性,并需要及时的多学科干预和支持。需要进一步的研究来更好地了解COVID-19、疫苗接种、和听觉症状。
    The case study explores COVID-19 vaccination connection to tinnitus and hyperacusis, considering its onset and exacerbation post vaccination. The subject is a 47-year-old woman with a history of bilateral tinnitus, and her hearing history was tracked from 2014 to 2023. An intense episode of tinnitus occurred in 2021, distinct from previous experiences post COVID-19 vaccination, second dose. Symptoms manifested as sudden onset of hyperacusis, pronounced \"roar\" type tinnitus, and a sudden decline in hearing. Audiometric results showed reduce thresholds in low frequencies and lower speech scores in the left ear. This escalation significantly affects speech understanding in group conditions and noisy environments. There was a gradual improvement in tinnitus and hyperacusis severity, but the subject has a greater problem with speech understanding. The subject\'s journey involved visits to specialists, multiple testing including neuroimaging, naturopath consultations, and anxiety medication. It emphasizes the importance of healthcare practitioners recognizing and documenting these issues and need for timely multidisciplinary intervention and support. Further research is necessary to better understand the relationship between COVID-19, vaccination, and auditory symptoms.
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  • 文章类型: Journal Article
    随着两个趋势-残疾和残疾老龄化-继续出现,听力障碍在中国老年人中越来越普遍。这项研究旨在调查老年人听力残疾的发生率,并确定导致其发展的各种因素。
    在这项匹配的嵌套病例对照研究中,对2011年至2018年中国健康与退休纵向研究的数据进行了分析。从国家样本数据库中招募了4,523名老年人,其中1,094人符合纳入听力残疾队列的资格,而未被诊断为听力障碍的3,429名老年人被视为非听力障碍对照。听力障碍通过自我报告的问题进行评估。根据年龄和性别,这些对照以1:1的比例与听力残疾病例相匹配。采用logistic回归模型找出影响目标人群听力残疾的各种因素。
    在随访期间,共有1,094人(24.14%)出现听力障碍。1:1匹配后,2,182名受试者被纳入研究,病例组1091例。影响老年人听力残疾发生率的因素包括家庭年人均收入(OR=0.985,p=0.003)。认知功能(OR=0.982,p=0.015),抑郁水平(OR=1.027,p<0.001),躯体移动性(OR=0.946,p=0.007),肾病病史(OR=1.659,p<0.001),哮喘病史(OR=1.527,p=0.008),意外伤害史(OR=1.348,p=0.015),社区中是否有娱乐和健身活动的场所(OR=0.672,p<0.001),以及社区中是否有卫生服务中心/保健中心(OR=0.882,p=0.006)。
    中国老年人的听力障碍发生率很高。在老年人的护理中应充分考虑导致残疾发生率的保护和风险因素。
    As two line trends - aging disability and disability aging - continue to emerge, hearing disability is becoming increasingly prevalent among older adults in china. This study aimed to investigate the incidence of hearing disability among older adults and identify the various factors contributing to its development.
    In this matched nested case-control study, data from the China Health and Retirement Longitudinal Study from 2011 to 2018 were analyzed. A total of 4,523 older adults were recruited from a national sample database, of which 1,094 individuals were eligible for inclusion in the hearing disability cohort, while 3,429 older adults who had not been diagnosed with hearing disability were considered non-hearing disability controls. Hearing disability was assessed by a self-reported question. These controls were matched to hearing disability cases in a 1:1 ratio based on age and sex. The logistic regression models were used to find out various factors of hearing disability in the target population.
    Totally 1,094 individuals (24.14%) developed hearing disability during the follow-up period. After 1:1 matching, 2,182 subjects were included in the study, with 1,091 cases in the case group. Factors that influenced the incidence of hearing disability in older adults included annual per capita household income (OR = 0.985, p = 0.003), cognitive function (OR = 0.982, p = 0.015), depression level (OR = 1.027, p < 0.001), somatic mobility (OR = 0.946, p = 0.007), history of kidney disease (OR = 1.659, p < 0.001), history of asthma (OR = 1.527, p = 0.008), history of accidental injuries (OR = 1.348, p = 0.015), whether there is a place for recreational and fitness activities in the community (OR = 0.672, p < 0.001), and whether there is a health service center/health center in the community (OR = 0.882, p = 0.006).
    The incidence of hearing disabilities among older adults in China is high. The protective and risk factors that contribute to the incidence of disability should be fully considered in the care of older adults.
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  • 文章类型: Randomized Controlled Trial
    目的:研究人工耳蜗植入与同等生活质量相关的假设,听力益处和并发症发生率,与住院患者人工耳蜗植入相比。
    方法:单中心,非致盲,随机对照,三级转诊中心的等效试验。
    方法:30名符合单侧人工耳蜗植入手术条件的舌后双侧感音神经性耳聋成年患者被随机分配到日间或住院治疗组。对一般生活质量的影响,患者满意度,(主观)听力改善,术后并发症和交叉和/或再入院的原因使用问卷进行评估,1年随访期间的听觉评估和患者图表。
    结果:通过HUI3测量的总体生活质量在日间病例(n=14)和住院组(n=14)之间相等。患者的总体满意度显示出对住院方法的轻微支持。两个治疗组之间的主观和客观听力改善没有显着差异。在1年的随访期间,没有发生重大并发症。三天病例患者术中发生轻微并发症,导致九分之三的日间病例患者入院。日间患者入院的其他原因是恶心和呕吐(n=1),困倦(n=1),晚期计划手术(n=2),社会原因(n=1),或由于不清楚的原因(n=1)。没有患者需要再次入院。
    结论:我们发现QoL的结果相同,患者满意度,目标,白天和住院单侧人工耳蜗植入之间的主观听力结果。14天病例中有9人在术后至少一个晚上(交叉)入院。两组均无重大并发症发生。当使用特定的患者选择时,一种日常方法似乎是可行的,考虑手术计划和术前提供患者信息。除此之外,患者和手术团队对日间手术方法的熟悉可以提高日间手术的可行性.
    方法:
    OBJECTIVE: To investigate the hypothesis that day-case cochlear implantation is associated with equal quality of life, hearing benefits and complications rates, compared to inpatient cochlear implantation.
    METHODS: A single-center, non-blinded, randomized controlled, equivalence trial in a tertiary referral center.
    METHODS: Thirty adult patients with post-lingual bilateral sensorineural hearing loss eligible for unilateral cochlear implantation surgery were randomly assigned to either the day-case or inpatient treatment group. The effect on general quality of life, patient satisfaction, (subjective) hearing improvement, postoperative complications and causes of crossover and/or readmission were assessed using questionnaires, auditory evaluations and patients\' charts over a follow-up period of 1 year.
    RESULTS: Overall quality of life measured by the HUI3 was equal between the day-case (n = 14) and inpatient group (n = 14). The overall patients\' satisfaction showed a slight favor towards an inpatient approach. There was no significant difference in the subjective and objective hearing improvement between both treatment groups. During the 1-year follow-up period no major complications occurred. Minor complications occurred intraoperatively in three day-case patients resulting in three out of nine admissions of day-case patients. Other causes of admission of day-case patients were nausea and vomiting (n = 1), drowsiness (n = 1), late scheduled surgery (n = 2), social reasons (n = 1), or due to an unclear reason (n = 1). No patients required readmission.
    CONCLUSIONS: We found equal outcomes of QoL, patient satisfaction, objective, and subjective hearing outcomes between day-case and inpatient unilateral cochlear implantation. Nine out of 14 day-case patients were admitted for at least one night postoperatively (crossover). No major complications occurred in both groups. A day-case approach seems feasible when using specific patient selection, surgical planning and the preoperative provision of patient information into account. Besides this, the familiarity with a day-case approach of both patient and the surgical team can increase the feasibility of day-case surgery.
    METHODS:
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  • 文章类型: Case Reports
    桥脑小脑角(CPA)脑膜瘤通常累及内耳道(IAC)。我们报告了一名68岁的特发性双侧深度耳聋并伴有脑膜瘤的病例,该病例是在人工耳蜗植入检查中发现的。我们同时切除了她的CPA和IAC脑膜瘤,并插入了耳蜗植入物(CI)。她恢复了功能性听力,生活质量得到了显着改善。术中电生理测试可用于确认耳蜗神经的保留,从而可以同时植入,出于临床和后勤原因,这是可取的。这为适当患者进行IAC/CPA肿瘤手术时的听力康复提供了选择。
    Cerebellopontine angle (CPA) meningiomas commonly involve the internal auditory canal (IAC). We report a case of a 68-year-old lady with idiopathic profound bilateral deafness with a meningioma which was discovered on workup for cochlear implantation. We performed simultaneous excision of her CPA and IAC meningioma with insertion of a cochlear implant (CI). She regained functional hearing with marked improvement in quality of life. Intraoperative electrophysiological testing can be used to confirm preservation of the cochlear nerve enabling simultaneous implantation which is preferable for clinical and logistical reasons. This creates an option for hearing rehabilitation at the time of IAC/CPA tumour surgery in appropriate patients.
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  • 文章类型: Journal Article
    目的:描述特征,管理,以及散发性前庭神经鞘瘤(sVS)儿科患者的预后。
    方法:这是一个三级护理中心的系列病例。通过研究库和图表审查确定患者。干预是显微外科手术,立体定向放射外科(SRS),和观察。结果措施是肿瘤控制,面神经功能,和听力。
    结果:2006-2022年有8例患者符合纳入标准(单侧VS无2型神经纤维瘤病(NF2)的遗传或临床证据;年龄≤21岁),平均年龄17岁(14-20岁)。内听道的平均最大肿瘤长度为9.7mm(4.0-16.1)。桥小脑角中的平均最大肿瘤尺寸(4/8肿瘤)为19.1mm(11.3-26.8)。5例(62.5%)患者的主要治疗是显微外科手术,观察到两个(25%),和SRS合二为一(12.5%)。四名(80%)手术患者进行了总切除,其中1人(20%)在接近全切除后再生,并接受了SRS.一名被观察的患者和主要的SRS患者在3.5年和7年的影像学上保持稳定。分别。另一位观察患者在观察12个月后需要手术治疗肿瘤生长。两名手术患者的面神经预后较差。所有术后患者均出现耳聋。平均随访时间为3年(0.5-7)。
    结论:我们描述了美国报道的最大的儿童sVS队列之一。勤奋地排除NF2是至关重要的。鉴于最终需要干预的可能性很高,并且已知SRS的不利影响,显微外科仍是首选治疗方法。然而,可以在选择的情况下考虑观察。
    OBJECTIVE: To describe the characteristics, management, and outcomes of pediatric patients with sporadic vestibular schwannoma (sVS).
    METHODS: This was a case series at a tertiary care center. Patients were identified through a research repository and chart review. Interventions were microsurgery, stereotactic radiosurgery (SRS), and observation. Outcome measures were tumor control, facial nerve function, and hearing.
    RESULTS: Eight patients over 2006-2022 fulfilled inclusion criteria (unilateral VS without genetic or clinical evidence of neurofibromatosis type 2 (NF2); age ≤ 21) with a mean age of 17 years (14-20). Average greatest tumor length in the internal auditory canal was 9.7 mm (4.0-16.1). Average greatest tumor dimension (4/8 tumors) in the cerebellopontine angle was 19.1 mm (11.3-26.8). Primary treatment was microsurgery in five (62.5%) patients, observation in two (25%), and SRS in one (12.5%). Four (80%) surgical patients had gross total resections, and one (20%) had regrowth post-near total resection and underwent SRS. One observed patient and the primary SRS patient have remained radiographically stable for 3.5 and 7 years, respectively. The other observed patient required surgery for tumor growth after 12 months of observation. Two surgical patients had poor facial nerve outcomes. All post-procedural patients developed anacusis. Mean follow-up was 3 years (0.5-7).
    CONCLUSIONS: We describe one of the largest reported cohorts of pediatric sVS in the USA. Diligent exclusion of NF2 is critical. Given the high likelihood of eventually requiring intervention and known adverse effects of SRS, microsurgery remains the preferred treatment. However, observation can be considered in select situations.
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  • 文章类型: Case Reports
    前庭神经鞘瘤的手术可分为保留听力手术和非保留听力手术。由于前庭神经鞘瘤引起的耳聋患者通常不考虑保留听力手术,因为听力不太可能改善,手术旨在以牺牲听力为代价最大限度地切除肿瘤。我们报告了一例极为罕见的病例,一例46岁的男性,由于前庭神经鞘瘤伴左池明显的囊性变性,导致单侧严重听力损失。在保留听力手术后,听力水平显着恢复到接近正常的水平。听力损失逐渐恶化,术前纯音评估显示左耳完全听力丧失。然而,保留了对畸变产物耳声发射的响应,听力损失被认为是耳蜗后。肿瘤切除采用后迷路入路,并使用背侧耳蜗核动作电位进行连续监测,听觉脑干反应,和面神经肌肉动作电位功能。肿瘤的水箱部分与壁几乎完全切除。术后,左侧的纯音阈值明显改善。本案清楚地证明了耳蜗后听力损失患者听力恢复的可能性。我们应该考虑扩大保留听力手术的适应症。
    Surgery for vestibular schwannoma can be divided into hearing-preserving and nonhearing-preserving surgeries. Hearing-preserving surgery is usually not considered in patients with deafness due to vestibular schwannoma, because hearing is unlikely to improve, and surgery aims to maximize the tumor resection at the expense of hearing. We report an extremely rare case of a 46-year-old man with unilateral profound hearing loss due to a vestibular schwannoma with marked cystic degeneration in the left cistern, which significantly recovered to near-normal hearing levels after hearing-preserving surgery. Hearing loss gradually worsened, and preoperative pure-tone evaluation showed complete hearing loss in the left ear. However, the response to the distortion product otoacoustic emission was preserved, and hearing loss was considered to be retrocochlear. Tumor resection was performed using the retrolabyrinthine approach with continuous monitoring using dorsal cochlear nucleus action potential, auditory brainstem response, and facial nerve function muscle action potential. The cistern portion of the tumor was almost completely resected along with the wall. Postoperatively, the pure-tone threshold on the left side markedly improved. The present case clearly demonstrates the possibility of hearing recovery in patients with retrocochlear hearing loss. We should consider expanding the indications for hearing-preserving surgery.
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  • 文章类型: Journal Article
    双侧前庭病(BV)是一种慢性前庭疾病,以双侧前庭功能缺失或显著受损为特征。症状通常包括,但不限于,不稳定和运动引起的视力模糊(示波)。这项前瞻性病例对照研究旨在阐明BV对认知和运动表现以及认知运动干扰的影响。认知和运动表现,以及使用2BALANCE双任务方案在BV和听力正常的人中测量认知运动干扰.实验组按年龄与健康对照组相匹配,性别,和教育水平。2BALANCE协议包括评估视觉空间记忆的认知测试,心理旋转,视觉和听觉反应抑制,视觉和听觉工作记忆,和处理速度。认知测试是在单任务条件下(就座时)进行的,并且在双重任务条件下(在静态和动态运动任务期间)。静态电机任务包括在带有泡沫垫的力平台上进行平衡。动态运动任务包括以自己选择的速度行走。这些运动任务也在单任务条件下执行。使用广义估计方程模型来研究所有认知和运动结果指标的群体差异。估计的边际手段,以及赔率比(OR),并计算其95%置信区间(CI)。对于后向数字召回测试,使用Student-t检验进行基线测量和分析.总共对22例BV和听力正常的患者和22例健康对照受试者进行了评估[平均年龄(SD),BV=53.66(13.35)和HC=53.21(13.35),68%男性]。BV组在单一任务条件下的心理旋转技能较差,与对照组相比[比值比(OR)=2.30,置信区间(CI)=1.12-4.73,P=0.024]。同样,在单任务条件下,BV组的听觉和视觉工作记忆也较差(分别为P=0.028和P=0.003)。BV组在双重任务条件下的心理旋转任务和视觉反应抑制任务的表现也较差(分别为OR=2.96,CI=1.57-5.59,P<0.001和OR=1.08,CI=1.01-1.16,P=0.032)。此外,相互作用效应,表明BV组的认知运动干扰增加,被观察到心理旋转,反应抑制,听觉工作记忆(P=0.003~0.028)。在所有测试条件下,与对照组相比,BV组的所有静态运动结果参数均显示出更多的姿势摇摆(P<0.001至0.026)。动态运动任务没有发现组差异。这些发现表明前庭功能和认知表现之间存在联系,以及BV中认知和运动表现之间的更大干扰,与健康对照相比。
    Bilateral vestibulopathy (BV) is a chronic vestibular disorder, characterized by bilaterally absent or significantly impaired vestibular function. Symptoms typically include, but are not limited to, unsteadiness and movement-induced blurred vision (oscillopsia). This prospective case-control study aimed to elucidate the impact of BV on cognitive and motor performance and on cognitive-motor interference. Cognitive and motor performance, as well as cognitive-motor interference were measured in persons with BV and normal hearing using the 2BALANCE dual-task protocol. The experimental group was matched to a healthy control group based on age, sex, and educational level. The 2BALANCE protocol comprises cognitive tests assessing visuospatial memory, mental rotation, visual and auditory response inhibition, visual and auditory working memory, and processing speed. The cognitive tests were performed in single-task condition (while seated), and in dual-task condition (during a static and a dynamic motor task). The static motor task consisted of balancing on a force platform with foam pad. The dynamic motor task consisted of walking at a self-selected speed. These motor tasks were also performed in single-task condition. A generalized estimating equations model was used to investigate group differences for all cognitive and motor outcome measures. The estimated marginal means, as well as the odds ratios (OR), and their 95% confidence intervals (CI) were calculated. For the backward digit recall test, a baseline measurement was performed and analyzed using a student-t test. A total of 22 patients with BV and normal hearing and 22 healthy control subjects were assessed [mean age (SD), BV = 53.66 (13.35) and HC = 53.21 (13.35), 68% male]. The BV group had poorer mental rotation skills in single-task condition, compared to the control group [odds ratio (OR) = 2.30, confidence interval (CI) = 1.12-4.73, P  =  0.024]. Similarly, auditory and visual working memory were also poorer in the BV group in single-task condition (P = 0.028 and P = 0.003, respectively). The BV group also performed poorer on the mental rotation task and the visual response inhibition task in dual-task condition (OR = 2.96, CI = 1.57-5.59, P  <  0.001 and OR = 1.08, CI = 1.01-1.16, P  =  0.032, respectively). Additionally, an interaction effect, indicating increased cognitive-motor interference in the BV group, was observed for mental rotation, response inhibition, and auditory working memory (P  =  0.003 to 0.028). All static motor outcome parameters indicated more postural sway in the BV group compared to the control group for all test conditions (P  <  0.001 to 0.026). No group differences were noted for the dynamic motor task. These findings suggest a link between vestibular function and cognitive performance, as well as a greater interference between cognitive and motor performance in BV, compared to healthy controls.
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  • 文章类型: Journal Article
    背景:Cogan综合征是一种罕见的血管炎,主要影响年轻受试者的性别,将耳蜗前庭和眼科损伤相关联。尽管接受了治疗,听觉预后不确定,50-60%的患者表现出不可逆的严重至严重的听力损失,因此是人工耳蜗植入的候选人。遵循CARE指南,我们报告了10例Cogan综合征的人工耳蜗植入,在使用植入物至少1年的经验后,评估语音接收阈值和最大清晰度。
    方法:在2005年至2020年期间,来自4个中心的10名患者接受了Cogan综合征的人工耳蜗植入物(14个植入物)。经过1年的经验,语音接收阈值(P=0.0002)和最大清晰度(P=0.0002)均有显著改善.
    结论:与眼科表现相关的听觉前庭征象应提示Cogan综合征。听力损害通常是不可逆转的。人工耳蜗植入可能是必要的,可以改善听力。
    BACKGROUND: Cogan\'s syndrome is a rare form of vasculitis mainly affecting young subjects of whatever gender, associating cochleovestibular and ophthalmological damage. Despite medical treatment, auditory prognosis is uncertain, with 50-60% of patients showing irreversible severe to profound hearing loss, thus being candidates for cochlear implantation. Following CARE guidelines, we report 10 cases of cochlear implantation in Cogan\'s syndrome, with assessment of speech reception threshold and maximum intelligibility after a minimum 1 year\'s experience with the implant.
    METHODS: Ten patients from 4 centers received cochlear implants (14 implants) for Cogan\'s syndrome between 2005 and 2020. After 1 year\'s experience, there was significant improvement in speech reception threshold (P=0.0002) and maximum intelligibility (P=0.0002).
    CONCLUSIONS: Audiovestibular signs associated with ophthalmological manifestations should suggest Cogan\'s syndrome. Hearing impairment is usually irreversible. Cochlear implantation may be necessary and improves hearing performance.
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  • 文章类型: Case Reports
    背景:目前还没有文献报道重复使用重复经颅磁刺激联合强化言语-语言-听力治疗后语言功能的改善和脑血流量的变化。该病例报告涉及对中风后失语症的某些患者重复使用重复经颅磁刺激和强化言语-语言-听力疗法的疗效。加上脑血流测量的结果。
    方法:患者是一名71岁的日本男性,他在左大脑中动脉中风后出现流利的失语症。他总共接受了五次重复的经颅磁刺激和强化的言语-语言-听力治疗。重复经颅磁刺激以1Hz的频率加每天2小时的密集言语-语言-听力治疗应用于右额下回。对患者的语言功能进行短期和长期评估。使用单光子发射计算机断层扫描扫描测量脑血流量。因此,在短期内,患者的语言功能得到改善,尤其是在初次住院期间。从长远来看,逐渐好转,趋于稳定。右半球的脑血流量增加。
    结论:研究结果表明,反复使用重复经颅磁刺激和强化言语-语言-听力疗法可能有效改善和保持语言功能,增加中风后失语症的脑血流量。
    BACKGROUND: There have been no papers reporting improvement in language function and changes in cerebral blood flow following repeated use of repetitive transcranial magnetic stimulation in combination with intensive speech-language-hearing therapy. This case report concerns the efficacy of repeated use of repetitive transcranial magnetic stimulation and intensive speech-language-hearing therapy for a certain patient suffering from aphasia following stroke, plus the findings of the cerebral blood flow measurements.
    METHODS: The patient was a 71-year-old right-handed Japanese male who developed fluent aphasia following a left middle cerebral artery stroke. He underwent repetitive transcranial magnetic stimulation and intensive speech-language-hearing therapy five times in total. The repetitive transcranial magnetic stimulation was applied to right inferior frontal gyrus at the frequency of 1 Hz plus 2 hours per day of intensive speech-language-hearing therapy. The patient\'s language function was evaluated in the short term and long term. Cerebral blood flow was measured with single photon emission computed tomography scan. As a result, in the short term, the patient\'s language function improved especially during the initial hospitalization. In the long term, it improved gradually and stabilized.Cerebral blood flow was increased in the right hemisphere.
    CONCLUSIONS: The findings of the study indicate that the repeated use of repetitive transcranial magnetic stimulation and intensive speech-language-hearing therapy may be effective in improving and preserving language function and increasing cerebral blood flow for aphasia following stroke.
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  • 文章类型: Journal Article
    背景:在新修订的国家健康与护理卓越研究所(NICE,TA566,2019)人工耳蜗植入(CI)指南明确规定,听力损失必须是双侧的。在此修订之前,当一只耳朵符合听力学标准时,阈值不对称的儿童和年轻人(CYP)被认为是单耳CI.不对称听力损失的儿童代表了潜在CI候选的重要队列,除非有证据支持植入和最大化后续获益,否则将继续阻止患者从CI获益.这项研究的目的是评估一组儿童的“现实生活”听力表现,这些儿童接受了单方面的CI,并且对侧耳的听力阈值超出了当前的UKNICE2019听力标准。使用常规助听器(HA)辅助对侧耳。这个“双峰”组的结果将与一组接受双侧CI的儿童和一组使用双侧HA的儿童进行比较,以扩展有关CYP中双边CI,双边HA和双峰听力之间不同表现水平的当前知识。
    方法:30岁6-17岁,10个双峰用户,10个双侧HA使用者和10个双侧人工耳蜗使用者将接受测试,包括:(1)掩蔽空间释放,(2)复杂的俯仰方向判别,(3)旋律识别,(4)语音中韵律特征的感知和(5)TEN测试。受试者将以其最佳设备模态进行测试。将收集标准的人口统计学和听力健康信息。在缺乏可比的已发表数据来支持这项研究的情况下,样本量是根据实用理由确定的。测试是探索性的,用于产生假设的目的。因此,将使用p<0.05的标准标准。
    背景:这已得到英国卫生研究管理局和NHSREC的批准(22/EM/0104)。行业资金是通过竞争性研究人员主导的赠款申请流程获得的。试验结果将根据本方案中给出的结果的定义进行公布。
    In the new revised National Institute for Health & Care Excellence (NICE, TA566, 2019) guidelines for cochlear implantation (CI) have clearly stipulated that the hearing loss must be bilateral. Prior to this revision, children and young people (CYP) with asymmetrical thresholds have been considered for unilateral CI when one ear was in audiological criteria. Children with asymmetrical hearing loss represent an important cohort of potential CI candidates, who will continue to be prevented from benefiting from CI unless evidence is produced to support implantation and maximise subsequent benefit.The aim of this study is to evaluate the \'real-life\' hearing performance in a group of children who have received a unilateral CI and who have hearing thresholds in the contralateral ear that are outside the current UK NICE 2019 audiological criteria for CI. The contralateral ear will be aided using a conventional hearing aid (HA). The outcomes from this \'bimodal\' group will be compared with a group of children who have received bilateral CI, and a group of children using bilateral HA, to extend the current knowledge about the different performance levels between bilateral CI, bilateral HA and bimodal hearing in CYP.
    Thirty CYP aged 6-17 years old, 10 bimodal users, 10 bilateral HA users and 10 bilateral cochlear implant users will be subjected to a test battery consisting of: (1) spatial release from masking, (2) complex pitch direction discrimination, (3) melodic identification, (4) perception of prosodic features in speech and (5) TEN test. Subjects will be tested in their optimal device modality. Standard demographic and hearing health information will be collected. In the absence of comparable published data to power the study, sample size was determined on pragmatic grounds. Tests are exploratory and for hypothesis generating purposes. Therefore, the standard criterion of p<0.05 will be used.
    This has been approved by the Health Research Authority and NHS REC within the UK (22/EM/0104). Industry funding was secured via a competitive researcher-led grant application process. Trial results will be subject to publication according to the definition of the outcome presented in this protocol.
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