Table 3:
Summary of Results of Systematic Reviews on Cochlear Implants vs. No Treatment for Single-Sided Deafness in Adults and Children
| Author, Year | No. of Studies | Results | Quality Assessment |
|---|---|---|---|
| Speech audiometrya | |||
| Kitterick et al, 201641 | 4 | Significant improvement in speech perception in noise when the implanted ear had a more favorable SNR (numeric data not shown) | Low–moderate quality |
| Peters et al, 201638 | 4 | Improvement in speech perception in noise in most patients (numeric data could not be summarized)b | Directness of evidence: low–moderate Risk of bias: moderate–high |
| van Zon et al, 201539 | 6 | Significant improvement in speech perception in noise when noise is from the better ear side and speech from the cochlear implant side (correctly repeated HSM 42.5% vs. 14.6%, P < .01) | Directness of evidence: moderate–high Risk of bias: moderate–high |
| Improvement or no change in other testing configurations | |||
| Vlastarakos et al, 201440 | 7 | Improvement in speech perception in noise when noise is from the front or the deafened eara (numeric data not shown) | Strength of recommendation: B (directly based on category II evidence or extrapolated recommendations from category I evidence) |
| Sound localizationa | |||
| Kitterick et al, 201641 | 3 | Improvement in sound localizationb (numeric data not shown) | Low–moderate quality |
| Peters et al, 201638 | 4 | Significant improvement in sound localization in most patients (RMS 14° vs. 41°, P < .05) | Directness of evidence: low– moderate Risk of bias: moderate–high |
| van Zon et al, 201539 | 2 | Significant improvement in sound localization (RMS 15° vs. 34°, P < .01) | Directness of evidence: moderate– high Risk of bias: moderate–high |
| Vlastarakos et al, 201440 | 6 | Improvement in sound localizationb (numeric data not shown) | Strength of recommendation: B (directly based on category II evidence or extrapolated recommendations from category I evidence) |
| Tinnitusa | |||
| van Zon et al, 201539 | 6 | Significant suppression of tinnitus loudness and distress (VAS loudness 3.5 vs. 8.5, P < .01) | Directness of evidence: moderate–high Risk of bias: moderate–high |
| Significant decrease in TRQ score (range 77%–100%) | |||
| Vlastarakos et al, 201440 | 8 | Tinnitus improved in 95% of patients | Strength of recommendation: B (directly based on category II evidence or extrapolated recommendations from category I evidence) |
| Hearing-specific quality of lifea | |||
| Kitterick et al, 201641 | 5 | Significant benefits on subjective benefits of hearing measured by SSQ (speech: 1.0 [range 0.6–1.5], spatial: 1.3 (0.7–1.9), qualities: 0.6 [0.1–1.0])c | Low–moderate quality |
| Peters et al, 201638 | 1 | Significant improvement in subjective benefits of hearing measured by child and parent version of SSQ (numeric data not shown) | Directness of evidence: high Risk of bias: moderate—high |
| van Zon et al, 201539 | 3 | Significant improvement in subjective benefits of hearing measured by SSQ (speech: 5.8 vs. 2.6; P = .01; spatial: 5.7 vs. 2.3; P < .01) | Directness of evidence: moderate–high Risk of bias: moderate–high |
| Vlastarakos et al, 201440 | 5 | Improvement in speech and spatial components of the SSQ (numeric data not shown)b | Strength of recommendation: B (directly based on category II evidence or extrapolated recommendations from category I evidence) |
| Speech and language developmenta | |||
| Peters et al, 201638 | 1 | Improvement in CAP-II scores and SIR scores in all childrenb | Directness of evidence: moderate Risk of bias: high |
Abbreviations: CAP-II, Categories of Auditory Performance II; HSM, Hochmair-Schulz-Moser sentence test; RMS, root mean square; SIR, Speech Intelligibility Rating; SNR, signal-to-noise ratio; SSQ, Speech, Spatial and Qualities of Hearing Scale; TRQ, Tinnitus Reaction Questionnaire; VAS, Visual Analog Scale.
Outcomes of speech audiometry, sound localization, and quality of life were for adults and children; outcome of tinnitus was for adults only; outcome of speech and language development was for children only.
Some results were statistically significant while others were not significant or not reported.
Effect sizes are reported as standardized mean differences (SMDs) that express pre–post differences as a multiple of their standard deviations. Positive SMDs indicate more favorable outcomes with the intervention.