Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial.

Q2 Medicine
BMC Ear, Nose and Throat Disorders Pub Date : 2014-08-11 eCollection Date: 2014-01-01 DOI:10.1186/1472-6815-14-7
Pádraig T Kitterick, Gerard M O'Donoghue, Mark Edmondson-Jones, Andrew Marshall, Ellen Jeffs, Louise Craddock, Alison Riley, Kevin Green, Martin O'Driscoll, Dan Jiang, Terry Nunn, Shakeel Saeed, Wanda Aleksy, Bernhard U Seeber
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引用次数: 26

Abstract

Background: Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds.

Methods/design: The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of the interventions on hearing- and health-related quality of life.

Discussion: This multi-centre trial was designed to provide evidence for the efficacy of cochlear implantation compared to the contra-lateral routing of signals. A purpose-built sound presentation system and established measurement techniques will provide reliable and precise measures of binaural hearing.

Trial registration: Current Controlled Trials http://www.controlled-trials.com/ISRCTN33301739 (05/JUL/2013).

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成人单侧耳聋患者人工耳蜗植入与信号助听器对侧路径的益处比较:一项前瞻性受试者纵向试验的研究方案。
背景:单侧重度至重度听力损失或单侧耳聋的个体,报告在许多日常情况下听力困难,尽管有一只耳朵的听觉保存完好。英国国家医疗服务体系提供的单侧耳聋护理标准是一种对侧信号助听器,它将声音从受损的耳朵传递到未受损的耳朵。这种助听器已被发现,当信号与噪声比在受损的耳朵比未受损的耳朵更有利时,可以提高在噪音中的语音理解。然而,当干扰声音位于受损耳朵的一侧时,不加选择地将信号路由到单耳可能会产生有害影响。最近发表的证据表明,在单侧耳聋患者中植入人工耳蜗可以恢复双耳线索,这是定位声音和将语音与其他干扰声音区分开来的能力的基础。方法/设计:目前的试验旨在评估人工耳蜗植入与对侧信号路径助听器在恢复成人获得性单侧耳聋双耳听力方面的疗效。患者在基线和接受信号助听器的对侧路由后进行评估。然后为那些没有从助听器中获得足够好处的患者提供人工耳蜗。受试者内纵向设计反映了在英国国家卫生服务中为单侧耳聋患者提供人工耳蜗植入的预期护理途径。主要终点是在基线、提供对侧信号助听器后和人工耳蜗植入后的双耳听力测量。双耳听力是根据声音定位的准确性和在背景噪音中感知语音的准确性来评估的。该试验还旨在衡量干预措施对听力和健康相关生活质量的影响。讨论:本多中心试验旨在为人工耳蜗植入与对侧信号传递的有效性提供证据。专门建造的声音呈现系统和既定的测量技术将提供可靠和精确的双耳听力测量。试验注册:Current Controlled Trials http://www.controlled-trials.com/ISRCTN33301739(2013年7月05日)。
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来源期刊
BMC Ear, Nose and Throat Disorders
BMC Ear, Nose and Throat Disorders Medicine-Otorhinolaryngology
CiteScore
3.30
自引率
0.00%
发文量
0
期刊介绍: BMC Ear, Nose and Throat Disorders is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of ear, nose and throat disorders, as well as related molecular genetics, pathophysiology, and epidemiology. BMC Ear, Nose and Throat Disorders (ISSN 1472-6815) is indexed/tracked/covered by PubMed, CAS, EMBASE, Scopus and Google Scholar.
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