Supplementary Material for: Comparative Outcomes of Cochlear Implantation in Children with Auditory Neuropathy Spectrum Disorder and Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis

Background:
Cochlear implantation (CI) has emerged as a promising intervention for children
with auditory neuropathy spectrum disorder (ANSD). Several studies have investigated the
efficacy of cochlear implants in children with ANSD, demonstrating improvements in auditory
performance and language skills following implantation. Whether the benefits and outcomes of
CIs in children with ANSD are comparable to children with sensorineural hearing loss (SNHL) is
still debatable. The present updated systematic review and meta-analysis evaluated the outcomes
of CI for children with ANSD compared to children with SNHL.

Methods:
A meta-analysis was conducted on studies that included pediatric patients and the
outcomes of CI in patients with ANSD versus SNHL were compared. A comprehensive search
was performed using the following electronic databases: PubMed, Scopus, Web of Science,
EBSCOhost, and Cochrane Central Register of Controlled Trials (CENTRAL).

Results:.
Fourteen studies (no. of patients =722 patients) were included. The total number of patients in the
ANSD and SNHL groups in the present systematic review was 212 and 520, respectively. The
most utilized assessment tests were the Speech Intelligibility Rating (SIR) and Categories of
Auditory Performance (CAP) scores. The pooled estimate showed that patients with ANSD had
comparable CAP scores compared to patients with SNHL (MD -0.52, 95% CI [-1.34, 0.29], P
=0.21,). Likewise, three studies reported the SIR after CI and showed comparable findings between
ANSD and SNHL patients. The pooled estimate showed that patients with ANSD had comparable
SIR scores compared to patients with SNHL (MD -0.26, 95% CI [-0.65, 0.13], P =0.19).

Conclusion: While the results show mixed findings across various outcome measures, the overall
impact of CI on speech recognition and language development appears to be positive and
comparable between ANSD and SNHL.

背景：
人工耳蜗植入（CI）已成为儿童听神经病谱系障碍（ANSD）的一种极具前景的干预手段。多项研究探讨了人工耳蜗对ANSD儿童的疗效，结果显示植入后患儿的听觉表现和语言能力均有改善。然而，ANSD儿童接受CI的获益与预后是否与感音神经性听力损失（SNHL）儿童相当，目前仍存在争议。本项更新的系统综述与元分析旨在评估ANSD儿童与SNHL儿童接受CI后的预后差异。

方法：
本研究对纳入儿童患者的相关研究进行元分析，比较ANSD与SNHL患者接受CI后的预后。研究人员通过PubMed、Scopus、Web of Science、EBSCOhost及Cochrane对照试验中心注册库（CENTRAL）开展了全面检索。

结果：
共纳入14项研究，涉及722例患者，其中ANSD组212例，SNHL组520例。最常用的评估工具为言语清晰度评分（SIR）和听觉表现分类（CAP）评分。合并分析结果显示，ANSD患者与SNHL患者的CAP评分相当（MD=-0.52，95%CI [-1.34, 0.29]，P=0.21）。此外，3项研究报告了CI后的SIR评分，结果同样显示两组间无显著差异（MD=-0.26，95%CI [-0.65,0.13]，P=0.19）。

结论：尽管不同预后指标的结果存在差异，但总体而言，CI对ANSD与SNHL儿童的言语识别及语言发育均具有积极影响，且两组间的效果相当。