Manohar Bance, Maria Costales Marcos, Jérémie Guignard, Wendy Huinck, Matthijs Killian, Vikte Lionikaite, Hafsa Quadri, Kim Rand, Ville Sivonen
{"title":"双侧人工耳蜗植入对双侧感音神经性听力损失的益处：一项系统回顾和荟萃分析。","authors":"Manohar Bance, Maria Costales Marcos, Jérémie Guignard, Wendy Huinck, Matthijs Killian, Vikte Lionikaite, Hafsa Quadri, Kim Rand, Ville Sivonen","doi":"10.1080/14670100.2025.2516932","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To perform a systematic literature review (SLR) on hearing and quality-of-life (QoL) benefits of bilateral versus unilateral cochlear implants (CIs) in adults with sensorineural hearing loss (SNHL), and to quantify benefits through a meta-analysis when feasible.</p><p><strong>Methods: </strong>Embase, MEDLINE, and Cochrane were searched from January 2005-June 2022. Eligible studies presented effectiveness of CIs and/or QoL of adult CI users. Articles that presented numerical point estimates for, or numerical difference between, bilateral and unilateral CI, and measures of uncertainty were considered for meta-analysis, with data analyzed using fixed- and random-effects models.</p><p><strong>Results: </strong>Thirty-five articles were included. There was a trend of significant improvement with bilateral CIs in sound localization and binaural redundancy. A meta-analysis confirmed statistically significant benefits in speech perception (in quiet, 12.6 percentage point [95% confidence interval: 7.1, 18.1] improvement; in noise, improvement in speech reception threshold of 1.5 dB signal-to-noise ratio [-1.5 dB; 95% confidence interval: -2.5, -0.4]). There were beneficial trends of bilateral CIs regarding head-shadow effect and binaural release from masking. Significant improvements in hearing-specific QoL were observed; generic QoL was mostly unchanged.</p><p><strong>Discussion: </strong>Bilateral CIs provide audiological benefit over unilateral CI, resulting in hearing-specific QoL improvements. Lack of changes in generic QoL may reflect that instrument domains are insensitive to hearing-related changes when going from unilateral to bilateral CIs. Meta-analyses could not be performed for all hearing and QoL outcomes owing to variability in methodologies across studies.</p><p><strong>Conclusions: </strong>These findings should be used to inform clinical decision-making to ensure the best outcomes for adults with bilateral SNHL.</p>","PeriodicalId":53553,"journal":{"name":"COCHLEAR IMPLANTS INTERNATIONAL","volume":" ","pages":"1-16"},"PeriodicalIF":1.4000,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The benefit of bilateral cochlear implants in adults with bilateral sensorineural hearing loss: a systematic review and meta-analysis.\",\"authors\":\"Manohar Bance, Maria Costales Marcos, Jérémie Guignard, Wendy Huinck, Matthijs Killian, Vikte Lionikaite, Hafsa Quadri, Kim Rand, Ville Sivonen\",\"doi\":\"10.1080/14670100.2025.2516932\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To perform a systematic literature review (SLR) on hearing and quality-of-life (QoL) benefits of bilateral versus unilateral cochlear implants (CIs) in adults with sensorineural hearing loss (SNHL), and to quantify benefits through a meta-analysis when feasible.</p><p><strong>Methods: </strong>Embase, MEDLINE, and Cochrane were searched from January 2005-June 2022. Eligible studies presented effectiveness of CIs and/or QoL of adult CI users. Articles that presented numerical point estimates for, or numerical difference between, bilateral and unilateral CI, and measures of uncertainty were considered for meta-analysis, with data analyzed using fixed- and random-effects models.</p><p><strong>Results: </strong>Thirty-five articles were included. There was a trend of significant improvement with bilateral CIs in sound localization and binaural redundancy. A meta-analysis confirmed statistically significant benefits in speech perception (in quiet, 12.6 percentage point [95% confidence interval: 7.1, 18.1] improvement; in noise, improvement in speech reception threshold of 1.5 dB signal-to-noise ratio [-1.5 dB; 95% confidence interval: -2.5, -0.4]). There were beneficial trends of bilateral CIs regarding head-shadow effect and binaural release from masking. Significant improvements in hearing-specific QoL were observed; generic QoL was mostly unchanged.</p><p><strong>Discussion: </strong>Bilateral CIs provide audiological benefit over unilateral CI, resulting in hearing-specific QoL improvements. Lack of changes in generic QoL may reflect that instrument domains are insensitive to hearing-related changes when going from unilateral to bilateral CIs. Meta-analyses could not be performed for all hearing and QoL outcomes owing to variability in methodologies across studies.</p><p><strong>Conclusions: </strong>These findings should be used to inform clinical decision-making to ensure the best outcomes for adults with bilateral SNHL.</p>\",\"PeriodicalId\":53553,\"journal\":{\"name\":\"COCHLEAR IMPLANTS INTERNATIONAL\",\"volume\":\" \",\"pages\":\"1-16\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-06-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"COCHLEAR IMPLANTS INTERNATIONAL\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/14670100.2025.2516932\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"COCHLEAR IMPLANTS INTERNATIONAL","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/14670100.2025.2516932","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
The benefit of bilateral cochlear implants in adults with bilateral sensorineural hearing loss: a systematic review and meta-analysis.
Objectives: To perform a systematic literature review (SLR) on hearing and quality-of-life (QoL) benefits of bilateral versus unilateral cochlear implants (CIs) in adults with sensorineural hearing loss (SNHL), and to quantify benefits through a meta-analysis when feasible.
Methods: Embase, MEDLINE, and Cochrane were searched from January 2005-June 2022. Eligible studies presented effectiveness of CIs and/or QoL of adult CI users. Articles that presented numerical point estimates for, or numerical difference between, bilateral and unilateral CI, and measures of uncertainty were considered for meta-analysis, with data analyzed using fixed- and random-effects models.
Results: Thirty-five articles were included. There was a trend of significant improvement with bilateral CIs in sound localization and binaural redundancy. A meta-analysis confirmed statistically significant benefits in speech perception (in quiet, 12.6 percentage point [95% confidence interval: 7.1, 18.1] improvement; in noise, improvement in speech reception threshold of 1.5 dB signal-to-noise ratio [-1.5 dB; 95% confidence interval: -2.5, -0.4]). There were beneficial trends of bilateral CIs regarding head-shadow effect and binaural release from masking. Significant improvements in hearing-specific QoL were observed; generic QoL was mostly unchanged.
Discussion: Bilateral CIs provide audiological benefit over unilateral CI, resulting in hearing-specific QoL improvements. Lack of changes in generic QoL may reflect that instrument domains are insensitive to hearing-related changes when going from unilateral to bilateral CIs. Meta-analyses could not be performed for all hearing and QoL outcomes owing to variability in methodologies across studies.
Conclusions: These findings should be used to inform clinical decision-making to ensure the best outcomes for adults with bilateral SNHL.
期刊介绍：
Cochlear Implants International was founded as an interdisciplinary, peer-reviewed journal in response to the growing number of publications in the field of cochlear implants. It was designed to meet a need to include scientific contributions from all the disciplines that are represented in cochlear implant teams: audiology, medicine and surgery, speech therapy and speech pathology, psychology, hearing therapy, radiology, pathology, engineering and acoustics, teaching, and communication. The aim was to found a truly interdisciplinary journal, representing the full breadth of the field of cochlear implantation.
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