怎样理解和区分"验证"和"评估"在助听器验配中的使用

听力学是一门刚刚兴起的学科，在我国尚属起步阶段，许多专业词汇都是从英语翻译过来的。为了使广大读者对听力学基本概念有更清晰的认识和理解，本刊特别开辟专栏。约请加拿大达尔豪斯大学教授Dr．David Jiang撰写系列文章，对相关词汇及英语术语加以解释和界定。此间，Dr．David Jiang将选择一些容易混淆和误读的、有代表性的术语和词语，结合现实情况。给大家做更为详尽的介绍。以期我国听力语言康复科学学术界同仁对一些英文专业词汇有更为准确和精当的理解与应用。     

助听器验配工作指南(试行)

助听器是听力语言障碍者(以下简称听障者)专用的康复设备之一,须经过验配方能使用。如果验配条件或验配技术达不到要求,不但不能发挥其听力补偿的作用,甚至还会造成新的听力损伤。因此,为规范助听器验配的程序和方法,提高助听器配戴者的听觉康复质量,维护其合法权益,特制定本工     

Reorganization of the adult auditory system: perceptual and physiological evidence from monaural fitting of hearing AIDS

Changes in the sensory environment modify our sensory experience and may result in experience-related or learning-induced reorganization within the central nervous system. Hearing aids change the sensory environment by stimulating a deprived auditory system; therefore, they may be capable of inducing changes within the central auditory system. Examples of studies that have shown hearing aid induced perceptual and/or physiological changes in the adult human auditory system are discussed. Evidence in the perceptual domain is provided by studies that have investigated (a) speech perception, (b) intensity discrimination, and (c) loudness perception. Evidence in the physiological domain is provided by studies that have investigated acoustic reflex thresholds and event-related potentials. Despite the controversy in the literature concerning the rate, extent, and clinical significance of the acclimatization effect, there is irrefutable evidence that the deprived auditory system of some listeners can be modified with hearing aid experience.     

Improvement of hearing aid fitting with digital aids and new fitting strategies

Hearing aids with digital signal processing demonstrate a large dynamic range with negligible distortion and no significant inherent noise. Furthermore, many acoustic parameters allow the compensation of even severe hearing loss, and the adjustment is extremely accurate. However, the new hearing aid generation not only requires computerized fitting, but also an experienced examination with new integrated fitting procedures. In addition to in situ measurement, the hearing aid fitting should include not only the Freiburg speech test, but also the G?ttingen sentence test and the monosyllable rhyme test with different noises, for example the Fastl noise or the D?ring babble noise. Loudness scaling with different methods is particularly important.     

New aspects of hearing aid fitting in noise-induced hearing loss

In the past hearing aid fitting frequently turned out to be a problem in patients with noise-induced hearing loss. Selective amplification in the high frequency range and at the same time natural sound and appropriate wearing comfort (open fitting) could not be achieved in numerous cases. Today these problems can be tackled by modern hearing aid technology providing us with efficient feedback suppression algorithms making open fittings possible for many more patients. This development is particularly beneficial for patients with noise-induced hearing loss. Unfortunately, open fitting is in opposition to wearing hearing aids at noisy workplaces. Tight fittings, however, can be used at work if a special listening program for noisy conditions is available. This dilemma is discussed and possible solutions are pointed out.     

助听器的声场验配法

在声场测听条件下，对17名儿童（33耳）进行助听前和助听后的声场听阈测试。以助听后听阈值能否进入言语香蕉图范围来评价助听效果，为使助听效果满意，在测试时可调节助听器的各种调节使扭；测试结果显示，该法不失为助听器验配的有效方法之一。本文亦对影响本方法的一些因素做了讨论。     

双耳选配助听器的益处

人们生活中的绝大部分时间是处于多个声音和大量声反射面的复杂声学环境中，人的听觉系统需要不断地接受和处理声源与噪音或回声问的信息．目的是为了准确地定位．提高噪声环境下的言语清晰度以及抑制回声，双耳聆听系统在这些方面起到十分重要的作用。听力损失患者常常抱怨在复杂环境中无法听清语言从而导致交流困难．选配具有降噪技术的全数字助听器可以在一定程度上提高噪声环境下的言语清晰度，     

助听器验配的新进展--开放耳选配技术

本文描述了助听器验配的新进展之一——开放耳选配技术,该技术主要解决助听器患者的堵耳效应问题。传统的做法是使用通气孔及开放的耳模,但不能做到真正的开放。开放耳选配技术的挑战在于如何提供合适的增益并控制反馈。近几年一种全新的数字信号处理技术(digitalsignalprocessing,DSP)即舒适技术(ComforTec)能够达到这一目的,提供清晰、自然的音质,还可以消除反馈和堵耳效应,确保聆听舒适。舒适技术包括复合宽动态范围和数字反馈抑制稳定器技术。此美观且配戴舒适的开放式助听器,必将给越来越多的听力障碍病人带来帮助。     

Societal effects of hearing aid fitting among the moderately hearing impaired

The objective of this study was to evaluate hearing aid fitting from a societal viewpoint, rather than the more traditional patient perspective. The effects of hearing aid fitting on generic quality of life (EuroQol), social functioning (SF36), auditory disability, productivity at paid and unpaid labour, and medical consumption, were assessed in a prospective study among 80 moderately hearing-impaired first-time hearing aid applicants. The study showed that hearing aid fitting solved problems with paid employment, but did not seem to affect unpaid work. Use of medical services remained relatively stable after first-time hearing aid fitting. The Amsterdam Inventory proved to be a useful questionnaire to assess the effects on hearing disability. No effects of hearing aid fitting on generic quality of life could be determined with the EuroQol, while hearing aid fitting did lead to an improvement in one aspect of generic quality of life; namely social functioning.     

Age at fitting of hearing aids and speech intelligibility

This paper reports on the effect of age at fitting of hearing aids on subsequent achievements in speech intelligibility among hearing-impaired children. Four groups of hearing-impaired children were included in this investigation. Group A (n = 32) started using hearing aids in their first 6 months of life; Group B (n = 32) in their second 6 months of life; Group C (n = 38) in their second year of life and Group D (n = 51) in their third year of life. The children in each group were matched with regard to age, sex, age at onset of deafness, degree of hearing loss and educational establishment attended. The speech intelligibility of each child was rated by his/her class teacher on a 7-point scale. It was found that the speech intelligibility of the children in Group A was significantly superior to the speech intelligibility of the children in the other three groups. All other differences in speech intelligibility obtained between groups (Group B v. Group C v. Group D) were small and none proved to be statistically significant.     

Surgical management of complications after hearing aid fitting

OBJECTIVES: Standard procedures for hearing aid fitting performed in accordance with established guidelines are well tolerated, safe, and effective. In this article, we present unusual complications after hearing aid fitting that required surgical management. METHODS: Four otologists at a major university center with a combined 65 years of experience performed a retrospective analysis of their surgical practice. Six patients were identified that had encountered severe complications from improper earmold fitting that required surgical intervention. RESULTS: One patient had a perforation of the tympanic membrane with earmold material found to have migrated into the middle ear cleft. The tympanic membrane healed spontaneously, resulting in persistent otalgia and a maximum air-bone gap. The earmold cast was successfully removed by means of a tympanomastoidectomy. Two patients with presbycusis and normal ear canals developed eardrum perforations and conductive hearing deficits. In both patients, earmold material was found partially occupying the middle ear cleft and removed by way of a transcanal approach. Three patients with prior canal wall down mastoidectomy defects and narrow external ear canals required microtoscopy under general anesthesia or canaloplasty for removal of impacted material. CONCLUSION: Proper fitting of hearing aids performed by well-trained medical professionals results in a very low incidence of significant complications. Perforation of the tympanic membrane with impaction of earmold material in the middle ear or mastoid bowl may occur and can be successfully managed by standard otologic surgical techniques.