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DOI: 10.1055/s-0042-109615
20 Jahre bilaterale Cochleaimplantation – eine Analyse seither implantierter erwachsener Patienten
20 Years of Bilateral Cochlear Implantation – an Analysis of the Implanted PatientsPublication History
eingereicht 08 February 2016
akzeptiert 17 May 2016
Publication Date:
15 December 2016 (online)
Zusammenfassung
Binaurales Hören ist Voraussetzung für die Lokalisationsfähigkeit und verbessert das Hören im Störgeräusch. Die bilaterale Cochleaimplantation wird seit 20 Jahren zur Wiederherstellung des binauralen Hörens eingesetzt. In einer Querschnittsstudie wurden 103 der 165 in Würzburg zwischen 1995 und Juni 2014 bilateral implantierten erwachsenen Patienten bezüglich ihres Sprachverständnisses in Ruhe (Freiburger Einsilber, Hochmair-Schulz-Moser (HSM)-Satztest, jeweils bei 70 dB) und im Störgeräusch (HSM Test, Signal/Rausch-Abstand 10 dB) untersucht. Es zeigte sich, dass bei fast der Hälfte der Patienten die zweite implantierte Seite das bessere Sprachverständnis aufwies. Im Vergleich zur ersten Seite stieg das Einsilberverständnis bilateral im Mittel von 54 auf 63% und das Satzverständnis von 86 auf 96% in Ruhe. Im Störgeräusch stieg das Satzverständnis von 47 auf 65%. Das Sprachverständnis der zweiten Seite war vom Zeitintervall zwischen der Implantation beider Seiten in dem hier untersuchten postlingual ertaubten Kollektiv unabhängig. Die Querschnittsdaten unterstreichen die Bedeutung der bilateralen Cochleaimplantation für die Verbesserung des Sprachverstehens in Ruhe und mehr noch im Störschall und damit für die Verbesserung in alltäglichen Situationen. Die bilaterale Implantation sollte daher zum anerkannten Standard der Patienten-versorgung werden.
Abstract
Binaural hearing is essential for localization abilities and improves the speech perception in noise. Since 20 years, bilateral cochlear implantation is routinely performed to restore binaural hearing. In this cross-sectional study, we evaluated speech perception in quiet (Freiburger monosyllables, Hochmair-Schulz-Moser (HSM) sentence test, each at 70 dB) and in noise (HSM test, signal-to-noise ratio 10 dB) in 103 out of 165 adult patients who were bilaterally implanted in Würzburg between 1995 and June 2014. In almost half the patients, the second implanted side showed the better speech perception. Compared to the first implanted side, the average monosyllable scores with bilateral implants were improved from 54 to 63% and the HSM scores from 86 to 96%. In noise the speech perception improved from 47 to 65%. The speech perception of the second implanted side was independent of the time interval between the implantation of both sides in this cohort of postlingually deafened patients. This cross-sectional data underline the importance of bilateral cochlear implantation for speech understanding in quiet and even more in noise and thus, for the everyday life. For this, bilateral cochlear implantation should be the generally accepted standard in the treatment of deaf patients.
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