背景:许多研究表明,单侧听力损失(UHL)儿童的学业问题增加。然而,听力设备是否可以改善与UHL相关的教育困难还没有得到很好的研究。因此,当前系统评价的目的是回答以下问题:做非手术扩增装置,骨锚式助听器,和/或人工耳蜗植入物改善UHL学龄儿童和青少年的学业成绩?
方法:Embase,MEDLINE,Scopus,CINAHL,APAPsycInfo,ClinicalTrials.gov,和Cochrane数据库从开始到12/21/22检索。已发布,同行评审的研究比较了有和没有听力设备的年龄≥5岁和≤19岁的UHL患者的学术结果(非手术放大设备,骨锚式助听器,或耳蜗植入物)包括在内。研究结果是定性合成的,使用有效公共卫生实践项目(EPHPP)质量评估工具评估偏倚风险。
结果:通过搜索确定了总共5,644篇非重复出版物,包括四项研究进行合成,其中每一个都在调查非手术扩增。一个小的,单臂研究显示,在使用BTE助听器进行3~4个月试验后,主观课堂听力困难显著改善.其他三项非手术放大设备的研究表明,FM系统以及常规和CROS式助听器在多个学术成果中没有任何益处。
结论:样本量小,异质和/或不明确的研究样本,现有文献的总体质量较低,最终很难得出关于非手术扩增装置在改善UHL儿童学业成绩方面的有效性的明确结论。没有发现研究耳蜗植入物或骨锚式助听器的文章。进一步的研究与高质量的研究设计,大样本量,需要长期随访来回答这个临床上重要的问题.
BACKGROUND: Many studies have shown increased academic problems in children with unilateral hearing loss (UHL). However, whether hearing devices can ameliorate the educational difficulties associated with UHL is not well studied. Therefore, the objective of the current systematic review was to answer the question: do nonsurgical amplification devices, bone-anchored hearing aids, and/or cochlear implants improve academic outcomes in school-aged children and adolescents with UHL?
METHODS: Embase, MEDLINE, Scopus, CINAHL, APA PsycInfo,
ClinicalTrials.gov, and Cochrane databases were searched from inception to December 21, 2022. Published, peer-reviewed studies comparing academic outcomes in patients with UHL aged ≥5 and ≤19 years with and without hearing devices (nonsurgical amplification devices, bone-anchored hearing aids, or cochlear implants) were included. Results of studies were qualitatively synthesized, and the risk of bias was evaluated with the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool.
RESULTS: A total of 5,644 non-duplicate publications were identified by the search, and four studies were included for synthesis, every one of which was investigating nonsurgical amplification. One small, single-arm study demonstrated significant improvement in subjective classroom listening difficulties after a 3- to 4-month trial with a behind-the-ear hearing aid. The other three studies of nonsurgical amplification devices showed no benefit across multiple academic outcomes with FM systems and conventional and CROS-style hearing aids.
CONCLUSIONS: The small sample sizes, heterogeneous and/or ill-defined study samples, and overall low quality of the available literature ultimately make it hard to draw definitive conclusions regarding nonsurgical amplification devices\' effectiveness in improving academic outcomes in children with UHL. No articles were identified that studied cochlear implants or bone-anchored hearing aids. Further studies with high-quality study design, large sample sizes, and long-term follow-up are needed to answer this clinically important question.