Neurophysiologische Parameter zum Sprachverstehen von Patienten mit Cochlea-Implantaten

Robert Ernst; Maximilian Linxweiler; Katharina Anna Rink; Heike Rothe; Gregory Lecomte; Alessandro Bozzato; Dietmar Hecker

doi:10.1055/a-1399-9540

Laryngo-Rhino-Otologie, Inhaltsverzeichnis

Laryngorhinootologie 2022; 101(03): 216-227
DOI: 10.1055/a-1399-9540

Originalarbeit

Neurophysiologische Parameter zum Sprachverstehen von Patienten mit Cochlea-Implantaten

Neurophysiological parameters for speech recognition in patients with cochlear implants

Robert Ernst

¹Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany

,

Maximilian Linxweiler

¹Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany

,

Katharina Anna Rink

¹Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany

,

Heike Rothe

¹Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany

,

Gregory Lecomte

¹Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany

,

Alessandro Bozzato

¹Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany

,

Dietmar Hecker

²Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Germany

› Institutsangaben

Abstract

Zusammenfassung

Hintergrund Cochlea-Implantate (CI) stellen heutzutage die Behandlungsmethode der Wahl für schwerhörige bis vollständig ertaubte PatientInnen dar. Während für gehörlose PatientInnen bereits die Wiederherstellung eines basalen Höreindrucks einen enormen Erfolg darstellt, ist das Treffen von Vorhersagen für PatientInnen mit einem Restgehör oftmals komplexer. Im Rahmen dieser Studie soll anhand von erhobenen Daten der neurophysiologische Einfluss von objektiven Parametern beim klassifizierten Sprachverstehen (SPV) von CI-Trägern aufgezeigt werden.

Material und Methoden Insgesamt wurden 52 PatientInnen mit 65 Ohren im Alter von 18–80 Jahren eingeschlossen. Als objektive Parameter wurden ECAP-Schwellen und Impedanzwerte und als subjektive Parameter die T- und C/M-Werte genutzt. Klassifiziert wurden die Ergebnisse über die Performance des SPV.

Ergebnisse Die Unterschiede zwischen den Gruppen (Alter, Tragedauer) waren nicht signifikant, wobei das erreichte Hörvermögen bei 500 Hz signifikant mit dem Mehrsilbertest korrelierte. Die Elektrodenimpedanzen korrelierten im Mittel mit dem SPV bei gleichbleibender Variabilität. Die Verteilungen von objektiven und subjektiven Parametern zeigten zum Teil signifikante Unterschiede. Viele Verteilungen besaßen dabei signifikant auffällige Unterschiede zur Normalverteilung. Dementsprechend waren die Überlappungsbereiche der Signifikanzniveaus sehr eng begrenzt.

Schlussfolgerungen Höhere Impedanzen und nicht korrekt angepasste T-Werte ergaben ein schlechteres SPV. Die Verhältnisse von C/M-Werten zu den ECAP-Schwellen zeigten sich als wesentlich für ein gutes SPV.

Abstract

Objectives Cochlea Implants (CI) are the preferred treatment for deaf and highly hearing imparied people. While deaf people already profit enormously from any regained hearing perception, it is not as easy to predict a profitable outcome for people with a remaining sense of hearing. To provide patients the best possible outcome in speech understanding, a lot of parameters have to be identified and adjusted. The aim of this study is to show the influence of objective parameters on classified speech understanding using collected data.

Material and methods A total of 52 patients and 65 ears aged between 18 and 80 years were included in this study. ECAP-thresholds from intraoperative measurements and impedance were used as objective parameters. T- and C/M-levels were defined as subjective parameters. To classify the performance the value of speech understanding was used.

Results Differences between both groups (age, time after implantation) were not significant. The gained word scores at 500 Hz correlated significantly with the results of the speech perception threshold on two-digit numbers. The electrode impedances correlated on average with speech understanding with constant variability. The distributions of objective and subjective parameters showed partially significant differences. Many distributions showed significant differences to the normal distribution. Accordingly, the overlapping areas of the significance levels are very narrow.

Conclusion Higher impedances and incorrectly adjusted T-levels resulted in a worse speech understanding. Relation of C/M-levels to ECAP thresholds seem to be crucial for good speech understanding.

Schlüsselwörter

CI-Versorgung - Sprachverstehen - Impedanz - ECAP-Schwellen - Map-Einstellungen

Key words

CI-Implantation - speech understanding - impedance - ECAP threshold - map setting

Volltext

Referenzen

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