目的:适应与耳蜗植入物(CI)交流的过程很复杂。人工耳蜗植入后使用听觉训练可能有助于改善新成年CI接受者的术后语音识别和生活质量。然而,听觉训练的有效性仍不确定,并且尚未在新的成年CI使用者的大样本中检查长期效果.因此,本研究的目的是研究常见形式的听觉训练对人工耳蜗植入后1年的语音识别和CI相关生活质量(CI相关QOL)结局的影响.我们假设,报告使用基于计算机的听觉训练(CBAT)的患者在植入物激活后1年表现出语音和CIQOL-35Profile评分的改善,与他们的同龄人相比。
方法:本研究设计为一项前瞻性研究,并在三级学术CI中心进行。参与者包括114名因双侧听力损失而接受人工耳蜗植入的成年人。患者在激活后的第一年中连续自我报告使用以下类型的CI后听觉训练:(1)面对面训练(例如,语言病理学家),(2)被动的家庭培训(例如,听有声读物),和(3)CBAT(例如,自主软件)。这项研究的结果指标包括辅音-核-辅音音素(CNCP)的变化,CNC字(CNCw),AzBio在安静的句子,和CIQOL-35从CI前到CI后12个月的全局和领域评分。
结果:在114名患者中,94(82.5%)使用了一种或多种听觉训练资源。其中,19.3%的人使用了面对面的训练,67.5%的被动家庭培训,和46.5%的CBAT。114名患者中,73有完整的CIQOL数据。12个月,只有CBAT的使用与全球和所有领域特定CIQOL评分的显着改善相关(d-range=0.72-0.87),与不使用CBAT的人相比。控制人口统计和多种培训资源的使用,CBAT仍然是CIQOL改善的最强正预测因子,与全球得分(β=12.019[4.127,19.9])和12个月CI后的所有领域得分显着相关:沟通(β=11.937[2.456,21.318),情绪(β=12.293[1.827,22.759),entertainment(β=17.014[5.434,28.774),环境(β=13.771[1.814,25.727]),倾听努力(β=12.523[2.798,22.248]),和社会(β=18.114[7.403,28.826])。在CI后12个月(d-range=-0.12-0.22),使用CBAT或任何其他形式的听觉训练和语音识别评分均未发现明显的益处。
结论:CBAT听觉训练与CI后12个月改善CI相关QOL结果相关。鉴于其可用性和低成本,这项研究提供了支持使用CBAT改善新成年CI接受者的真实世界功能能力的证据.
OBJECTIVE: The process of adapting to communicate with a cochlear implant (CI) is complex. The use of auditory training after cochlear implantation may help to facilitate improvements in postoperative speech recognition and quality-of-life outcomes in new adult CI recipients. However, the effectiveness of auditory training remains uncertain and long-term effects have not been examined in a large sample of new adult CI users. As such, the objective of this study was to examine the influence of common forms of auditory training on speech recognition and CI-related quality-of-life (CI-related QOL) outcomes at 1 year after cochlear implantation. We hypothesized that patients who reported use of computer-based auditory training (CBAT) would show improved speech and CIQOL-35 Profile scores at 1 year after activation of their implant, compared with their peers.
METHODS: This study was designed as a prospective study and was undertaken at a tertiary academic CI center. Participants included 114 adults undergoing cochlear implantation for bilateral hearing loss. Patients serially self-reported use of the following types of post-CI auditory training over their first-year postactivation: (1) face-to-face training (e.g., speech-language pathologist), (2) passive home-based training (e.g., listening to audiobooks), and (3) CBAT (e.g., self-directed software). Outcomes measures for this study included change in Consonant-Nucleus-Consonant phoneme (CNCp), CNC word (CNCw), AzBio sentences in quiet, and CIQOL-35 Profile global and domain scores from pre-CI to 12-mo post-CI.
RESULTS: Of 114 patients, 94 (82.5%) used one or more auditory training resources. Of these, 19.3% used face-to-face training, 67.5% passive home-based training, and 46.5% CBAT. Of 114 patients, 73 had complete CIQOL data. At 12 mo, only CBAT use was associated with significantly greater improvements in global and all domain-specific CIQOL scores ( d -range = 0.72-0.87), compared with those not using CBAT. Controlling for demographics and use of multiple training resources, CBAT remained the strongest positive predictor of CIQOL improvement, with significant associations with global score (ß = 12.019[4.127,19.9]) and all domain scores at 12-mo post-CI: communication (ß = 11.937[2.456,21.318), emotional (ß = 12.293[1.827,22.759), entertainment (ß = 17.014[5.434,28.774), environment (ß = 13.771[1.814,25.727]), listening effort (ß = 12.523[2.798,22.248]), and social (ß = 18.114[7.403,28.826]). No significant benefits were noted with use of CBAT or any other form of auditory training and speech recognition scores at 12-mo post-CI ( d -range = -0.12-0.22).
CONCLUSIONS: Auditory training with CBAT was associated with improved CI-related QOL outcomes at 12-mo post-CI. Given its availability and low cost, this study provides evidence to support using CBAT to improve real-world functional abilities in new adult CI recipients.