成人频率特异性chirp听性稳态反应与纯音听阈测试的相关性研究

目的采用chirp信号作为声刺激进行听性稳态反应(auditory steady-state response,ASSR)测试,观察chirp-ASSR反应阈值与纯音听阈的相关性,探讨chirp-ASSR客观听力检测在成人临床听力评估中的价值。方法研究对象包括正常成人组(年龄20～60岁,共计151耳)和感音神经性听力损失组(年龄22～82岁,共计83耳)。在500Hz、1000Hz、2000Hz和4000Hz处进行Chirp-ASSR和纯音听阈测试,并对结果进行统计学分析。结果 0.5～4kHz频率听力正常组Chirp-ASSR反应阈与纯音听阈的相关系数r分别为0.19、0.43、0.58、068;0.5-4.0kHz频率感音神经性听力障碍者的相关系数r分别为0.68、0.84、0.87、0.84;校正后0.5～4kHz各听力组预估听力阈值与纯音听阈的差值较校正前明显缩小。结论在0.5～4.0kHz频率,Chirp-ASSR反应阈与纯音听阈之间存在明显的相关性,在听力损失组中两者的相关性更加显著,而在500Hz处两者的相关性较其它频率低。Chirp-ASSR在客观听力评价中有较好的准确率。     

感音神经性听力损失患者舒适阈与不适阈研究

目的 探讨纯音测听上升法与下降法对感音神经性听力损失患者舒适阈、不适阈的影响.方法 对57名(111耳)感音神经性听力损失患者进行纯音测试测得听阈,然后随机将受试者分为两组,进行1 000 Hz纯音舒适阈测试.一组受试者先用上升法(ascending)测试其舒适阈,再进行下降法测试;另一组则相反,最后进行不适阈测试.分别比较两组以上升-下降法测得的MCL之差值(A-D差).结果 轻度听力损失患者平均MCL为64.83±7.82 dB HL,A-D差为5.67±5.94 dB,平均UCL为94.67±8.76 dB HL;中度听力损失患者平均MCL为66.56±8.80 dB HL,A-D差为5.75±4.32 dB,平均UCL为91.60±9.84 dB HL;中重度听力损失患者平均MCL为77.15±9.56 dB HL,A-D差为4.86±4.22 dB,平均UCL为98.89±9.11 dB HL;重度听力损失平均MCL为89.64±8.65 dB HL,A-D差为3.57±4.76 dB,平均UCL为106.43±9.00 dB HL.结论 听力损失程度越重,MCL、UCL越高.上升法较下降法测得的MCL低.     

感音神经性听力损失成年人短音诱发的听性脑干反应阈研究

目的 研究感音神经性听力损失成年人气导和骨导短音诱发的ABR反应阈与纯音听阈的关系,探讨短音ABR在估计纯音听阈方面的应用价值.方法 对24例(27耳)感音神经性听力损失成年人行耳鼻咽喉科常规体检、纯音测听、声导抗测试后,应用SmartEP听觉诱发电位仪记录受试者气导和骨导短音ABR.结果 感音神经性听力损失成年人短音ABR的反应阈与纯音听阈呈线性相关,气导的线性相关性好于骨导.500、1 000、2 000、4 000 Hz气导的线性相关系数分别为0.80、0.88、0.92、0.85,骨导的线性相关系数分别为0.58、0.49、0.54、0.84.500、1 000、2 000、4 000 Hz短音ABR气骨导反应阈差分别为2.1±10.2、-3.9±10.6、0.9±7.0、3.4±3.3 dB,除4 000 Hz外,各频率气导与骨导短音ABR反应阈差异无显著统计学意义.结论 短音ABR的反应阈可以用于估计纯音听阈.     

皮层听觉诱发电位在听力评估中的应用

目的 探讨短纯音刺激皮层听觉诱发电位(cortical auditory evoked potentials, CAEP)对听力评估的价值。方法 受试者为听力正常成人19例(36耳),感音神经性聋成人患者21例(21耳),以500、1 000、2 000和4 000 Hz短纯音作为刺激声，在醒觉状态下颅顶电极记录CAEP的N1-P2复合波，分析N1-P2阈值与纯音听阈的相关性，以及两者差值在不同人群中的差异。结果 所有受试者四个测试频率的N1-P2阈值与对应频率纯音听阈值的相关系数依次为0.971、0.967、0.958、0.955,呈显著的线性相关；听力正常组36耳500、1 000、2 000和4 000 Hz的N1-P2阈值上限(95%置信区间)依次为32、27、32、39 dB SPL,即正常人阈值上限为32.5 dB SPL;正常人N1-P2阈值与纯音听阈的差值依次为18.9±6.1、11.6±5.9、13.3±7.0、18.7±8.3 dB;感音神经性聋患者两者差值依次为10.3±6.0、6.8±8.9、6.5±9.5、12.9±11.4 dB,四个测试频率的差值在两组人群...     

感音神经性聋患者窄带CE-Chirp ASSR测试结果初步分析

目的探讨感音神经性听力损失患者CE-Chirp声诱发听性稳态反应(auditory steady state response,CE-Chirp ASSR)与纯音听阈各频率反应阈值的相关性。方法选取中、重度听力损失患者18例(30耳)为受试者,听性稳态反应调制频率为90 Hz,分别测试窄带CE-chirp ASSR和纯音听阈500、1000、2000和4000 Hz的反应阈值,并进行相关性分析。结果 0.5-4.0 kHz频率CE-Chirp ASSR反应阈与纯音听阈的的相关系数r分别为0.671、0.704、0.563、0.687(P<0.01)。结论 CE-Chirp ASSR反应阈与纯音听阈有显著相关性,在客观听力评估中有较好的准确性。     

极重度感音神经性聋佩戴助听器与人工耳蜗植入患儿残余听力的比较分析

目的:通过回顾性比较分析极重度感音神经性聋患儿接受佩戴助听器和人工耳蜗植入手术2种不同干预方式人群的听力学评估参数,探讨极重度感音神经性聋患儿有效残余听力的临床判断方法.方法:选取听力学评估和言语康复训练资料完整的22例双耳极重度感音神经性聋患儿,其中10例佩戴助听器并接受超过3个月的言语康复训练,另外12例接受人工耳蜗植入手术,其中有10例年龄区间与佩戴助听器组一致.佩戴助听器组患儿,根据言语康复训练效果分为良好(7例)和较差(3例),分别统计其佩戴助听器前ASSR和听力言语康复训练期间裸耳纯音测听在500、1000、2000、4000 Hz 4个频点的听阈阈值情况.年龄与佩戴助听器组一致的10例接受人工耳蜗植入术患儿,根据术前有否佩戴助听器情况,分为曾佩戴助听器但听力言语康复效果差者(5例)和未接受佩戴助听器者(5例),分别统计其佩戴助听器前和(或)手术前的ASSR在500、1000、2000、4000 Hz 4个频点的听阈阈值情况.结果:①ASSR的阈值情况.佩戴助听器且言语康复训练效果良好的7例(14耳)患儿,平均每耳有2.71个频点可引出ASSR反应,所引出的ASSR平均阈值为(110.92±7.43 )dB HL;佩戴助听器言语康复训练效果较差的3例患儿,再加上曾佩戴助听器但听力言语康复效果差而接受人工耳蜗植入术的5例,共8例(16耳),平均每耳只有1.06个频点可引出ASSR反应,所引出的ASSR平均阈值为(110.88±8.52 )dB HL.②裸耳纯音测听情况.佩戴助听器且言语康复训练效果良好的7例(14耳)患儿,所测频点的平均听阈为(96.11±7.81) dB HL;其中,每耳平均有3个频率点的裸耳纯音测听阈值≤100 dB HL.而在效果差的3例(6耳)患儿中,所测频点的平均听阈为(112.19±5.15) dB HL,裸耳纯音测听阈值≤100 dB HL耳的数量为0.结论:500、1000、2000、4000 Hz 各频率引出ASSR的频点数量和裸耳纯音测听阈值≤100 dB HL的数量,是临床上判断极重度感音神经性聋患儿有否存在可利用助听残余听力的有效指标.     

成人感音神经性聋的听觉稳态反应反应阈与纯音听阈

目的探讨成人感音神经性聋的听觉稳态反应（auditory steady-state responses,ASSR）反应阈与纯音听阈的关系。方法选择中国医科大学附属一院耳鼻咽喉科门诊感音神经性聋的成人患者,分别进行纯音听力测试、ASSR检查,比较ASSR在0.5、1、2、4 kHz频率处的反应阈与纯音听阈的相关性及按听力损失程度比较两者的差值。结果 ASSR反应阈与纯音听阈在各频率处的相关系数分别为0.840、0.905、0.886、0.924;随着感音神经性听力损失的加重二者的差值明显缩小。随着频率的增加,两者的差值明显缩小。结论成人感音神经性聋ASSR反应阈与纯音听阈有显著相关性,随着听力损失的加重,ASSR反应阈愈接近纯音听阈,ASSR作为成人感音神经性聋听力定量诊断的客观方法有很大的临床应用价值。     

感音神经性聋患儿的听功能综合评估

目的探讨听力测试组合（ABR＋ASSR＋声场环境中的行为测听）在感音神经性聋患儿残余听力评估中的应用价值。方法48名（96耳）感音神经性聋患儿中能配合纯音测听的患儿19人（38耳）设为PTA组,进行纯音测听及ASSR检测;不能配合纯音测听的患儿29人（58耳）设为BA组,进行声场环境中的行为测听（behavior audiometry,BA）、ABR及ASSR检测。结果①PTA组0．5、1、2、4kHz各频率ASSR反应阈与纯音听阈显著相关（P〈0．01）,各频率相关系数分别为0．75、0．76、0．76、0．83,建立本实验室的ASSR—PTA直线回归方程;②BA组23耳ABR无反应但仍可引出ASSR,而ASSR无反应耳ABR均未能引出;BA组29例患儿中ASSR检测反应较好耳（29耳）在0．5～4kHz四个频率上,ASSR可测得83个反应阈值,行为测听可测得89个反应阈值,综合ASSR和行为测听可以得到96个反应阈值。结论与单项听力测试方法相比,听力测试组合（行为测听＋ABR＋ASSR）能为更小年龄、听力损失更重的患儿进行残余听力的评估,同时能对双侧耳间听力差异、各频率的听力损失程度进行评估,为听力损失病变的定位判断提供参考。     

感音神经性听力损失患者助听后言语感知能力的评价

目的本研究对感音神经性听力损失患者助听器选配后的言语识别能力进行评价,并分析听力损失程度与年龄对助听后言语康复效果的影响。方法 30名感音神经性听力损失受试者,男13名,女17名,年龄26-86岁,双侧听力损失程度对称,双耳0.5-4 k Hz频率下纯音听力阈值(PTA0.5-4 k Hz)平均值40~75 d B HL。所有受试者均选配PhonakBolero Q50系列耳背式助听器。使用汉语普通话言语测试软件(Mandarin Speech Test Materials,MSTMs)进行裸耳和助听后安静与噪声环境下言语识别能力测试。结果(1)助听后,安静环境下的双音节识别率平均提高35.1±19.5%;噪声环境下语句识别率平均提高32.8±22.8%;(2)助听后言语识别能力与听力损失程度呈显著负相关关系;(3)助听优势高于平均水平的受试者纯音听阈均大于50 d B HL,但存在个体差异大的特点。结论助听器选配可以有效帮助感音神经性听力损失患者提高言语识别能力,但听力损失程度不是唯一影响助听效果的因素,助听后言语识别能力的改善存在较大个体差异。     

多频稳态诱发电位评估中度感音神经性聋儿童的应用

目的探讨多频稳态听觉诱发电位评估儿童中度感音神经性聋的可靠性。方法所有患者经纯音测听（PTA）检查筛选出中度感音神经性聋30例5～6岁儿童（共40耳），然后口服10％水合氯醛镇静睡眠后，行多频稳态听觉诱发电位（ASSR）检测，其阈值与纯音听阂阈值进行比较，分析不同频率处听力阈值分布情况及其相关性。结果分别比较语言频率ASSR阂值与纯音听闽阈值，结果显示，0．5kHz处相关性较差，其差值为2-18dB，而在4kHz处相关性最好。结论可以应用多频稳态听觉诱发电位评估中度感音神经性聋儿童的听力阈值，但需要注意0．5kHz处的相关性差异。     

Steady-state response audiometry in a group of patients with steeply sloping sensorineural hearing loss

OBJECTIVES: The purpose of this study was to examine the predictive value of auditory steady-state response (ASSR) evoked potential thresholds and predicted behavioral thresholds in a group of children with steeply sloping sensorineural hearing loss (HL). STUDY DESIGN: Case series. METHODS: Twenty-nine children with sloping sensorineural HL underwent behavioral audiometric evaluation, impedance testing, distortion product otoacoustic emissions, and steady-state response testing. A t test was performed to compare the means of ASSR predicted behavioral thresholds and behavioral responses. Pearson correlation coefficients were calculated at each tested frequency, 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz, using the same data. RESULTS: Bracketed thresholds were obtained at 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz. Nineteen ears were used in this evaluation. A comparison of threshold difference as a function of bracketing revealed that the means were statistically different (P < .05). The mean threshold differences were calculated, and Pearson r values were determined between the behavioral thresholds and the predicted thresholds using the Rance 95 algorithm. The results revealed no difference of means at 500 Hz between predicted and measured behavioral thresholds. Linear regression analysis revealed strong correlation at 500 Hz, 1,000 Hz, and 2,000 Hz. CONCLUSIONS: The GSI Audera appears to predict the configuration of HL in children with steeply sloping sensorineural HLs and over-predicts the severity of the loss by 15 to 20 dB above 500 Hz at each test frequency (1,000, 2,000, and 4,000 Hz). Correlation coefficients display a strong correlation at 500 Hz, 1,000 Hz, and 2,000 Hz.     

REZ-Ⅰ型人工耳蜗植入对成人残余听力的影响

目的 评估REZ-Ⅰ型国产人工耳蜗植入对成人残余听力的影响,探讨该人工耳蜗植入的听力学安全性及其损伤的特点.方法 回顾性分析复旦大学附属眼耳鼻喉科医院2009年9月至2009年11月间16例单侧REZ-Ⅰ型(22通道)人工耳蜗植入者在手术前后的纯音测听、听觉稳态反应(auditory steady-state response,ASSR)、畸变产物耳声发射(DPOAE)及听觉脑干反应(ABR)的资料,比较手术前后残余听力的变化情况.结果 纯音测听植入侧术后残余听力保留率为41.67%;术后植人侧250、500、1000、2000及4000 Hz的残余听力较术前下降,差异具有统计学意义,其中500 Hz下降较明显,平均下降15.3 dB HL,P<0.01;通过与非植入侧对比发现500和1000 Hz的听力损失有统计学意义(P值均<0.05).植入侧术后ASSR阈值在250和500 Hz处较术前升高,差异具有统计学意义(P值均<0.05)),经与非植入侧对比发现500 Hz处ASSR阈值升高有统计学意义(P值<0.05).DPOAE及ABR植入前后差异均无统计学意义(P值均>0.05).结论 REZ-Ⅰ型人工耳蜗植入会对植入侧残余听力造成一定程度的损伤.     

Prevalence of cochlear implants in postlingually deafened adults in a Swedish region

Cochlear implantation (CI) rates vary between countries, depending on identification routines and economic restrictions. The present study aimed at determining the prevalence of CIs in postlingually deafened, aged 20-69 years old, in G?teborg, Sweden. Three patient databases with information on PTA, a questionnaire, medical records and consultations identified 88 subjects with sensorineural hearing loss >/=80 dB HL (PTA of 500, 1000, 3000 Hz), PB word score of 相似文献   

Assessment of basal sound identification skills and communication abilities in profoundly deaf children fitted with hearing aids or a cochlear implant

Basal auditory functions and early verbal communication skills were examined in young, profoundly deaf children with hearing aids or a cochlear implant. The hearing aid users (n = 23) were subdivided on the basis of their (unaided) hearing thresholds into: group A (pure tone average (PTA) at 0.5, 1 and 2 kHz: 90–100 dB HL); group B (PTA: 100–110 dB HL); and group C (PTA > 110 dB HL). All the children with a cochlear implant (n = 20) had a profound sensorineural hearing loss with a PTA that exceeded 120 dB HL. Functional hearing was evaluated by means of basal sound identification. The child’s communication abilities with hearing aids or a cochlear implant were assessed using structured observations on the Scales of Early Communication Skills for Hearing Impaired Children. The basal auditory functions on a sound identification level improved over time in the cochlear implant users and groups A and B. Hardly any improvement was seen in group C. The performance of all the groups (either hearing aid or cochlear implant) on the Scales of Early Communication Skills for Hearing Impaired Children at 6 months after fitting the device and at later evaluations, was close to the average level for their age.     

不同程度感音神经性听力损失儿童ASSR、click-ABR反应阈与行为听阈的相关性

目的 探讨不同程度感音神经性听力损失儿童听性稳态反应(ASSR)、短声听性脑干反应(click-ABR)与行为阈值的相关性及在听障儿童听力评估中的价值.方法 回顾性分析2019年1月至2019年12月确诊的46例(92耳)感音神经性听力损失儿童的ASSR、click-ABR及行为听阈结果,其中,轻度听力损失4耳,中度听...     

鼓室内注射地塞米松治疗突聋的临床研究

目的:观察鼓室内注射地塞米松治疗突聋的临床效果。方法:对21例突聋患者采用鼓膜穿刺注入5 g/L地塞米松1 ml治疗,每日1次,7 d为1个疗程。比较地塞米松鼓室内注射前后4个频率(500、1 000、2 000、4 000 Hz)气导纯音听阈均值(PTA),下降10 dB以上为有效。结果:21例患者鼓室内注射地塞米松前后PTA分别为(65.65±24.73)dB HL和(50.25±25.59)dB HL,有明显下降,P<0.01。10例有效,11例无效,总有效率为47.6%。对发病至治疗的时间短、不伴眩晕的突聋患者应用鼓室内注射地塞米松治疗效果好。本组病例未出现鼓室内感染、鼓膜穿孔和听力下降。结论:鼓室内注射地塞米松治疗突聋安全、有效,发病至治疗的时间以及是否伴有眩晕是影响预后的因素。     

A comparison of 40 Hz auditory steady-state response (ASSR) and cortical auditory evoked potential (CAEP) thresholds in awake adult subjects

Evoked potential thresholds using the 40 Hz auditory steady-state response (ASSR) and cortical auditory evoked potential (CAEP) were recorded at 500 Hz and 4000 Hz test frequencies in 36 subjects with normal acuity, and 30 subjects with sensorineural hearing loss. ASSR threshold sensation levels (SLs) were lower in ears with greater degrees of hearing loss, and for the 500 Hz stimulus. Mean SLs (maximum duration of a single recording: 89 seconds) were as follows at 500 Hz and 4000 Hz respectively: normal hearing group, 16.9+/-10.3 dB and 42.4+/-14.4 dB; mild-moderate group, 10.6+/-8.8 dB and 23.8+/-8.1 dB; severe-profound group, 10.0+/-13.2 dB and 21.5+/-18.9 dB. CAEP SLs showed no change with hearing level and CAEP/behavioural differences were similar at each test frequency. Mean SLs for CAEP threshold (single recording duration: 84 seconds) at 500 Hz and 4000 Hz respectively were: normal hearing group, 10.3+/-6.4 dB and 11.5+/-3.8 dB; mild-moderate group, 8.4+/-7.4 dB and 13.2+/-12.4 dB; severe-profound group, 11.0+/-6.6 dB and 15.9+/-16.4 dB. The results of this study suggest that while both 40 Hz ASSR and CAEP can reflect the behavioural audiogram, CAEPs may provide a more reliable estimate of hearing in awake adults.     

Characteristics of transient evoked otoacoustic emissions in normal-hearing and hearing-impaired children

OBJECTIVE: Transient evoked otoacoustic emissions (TEOAEs) were measured in children with normal hearing and in children with hearing loss to investigate the characteristics of TEOAEs as they relate to overall amplitude and amplitude spectra of evoking stimuli, and to audiometric status. DESIGN: Three parameters of response measure (signal to noise ratio, amplitude and reproducibility) were assessed to determine accuracy of identification of varying degrees of hearing loss for broadband clicks, frequency-specific click bands and tone bursts. Forty-four children (66 ears) between 4 and 13 yr of age were evaluated for participation in the study. Fifty-nine ears with intact tympanic membranes were included in the final analyses: 14 ears with normal hearing and 45 ears with hearing loss. RESULTS: Children with normal hearing had robust responses that displayed nonlinear growth functions for broadband clicks and for tone bursts. Children with hearing loss had responses that decreased rapidly with decreasing stimulus level, if emissions were present at all. Data were analyzed using clinical decision analysis and receiver operator characteristic curves. Broadband clicks presented at 80 and 86 dB peSPL identified a hearing loss > or = 30 dB HL with a high degree of accuracy. Click responses filtered into octave bands centered at 500 and 1000 Hz did not improve classification of hearing loss, in fact, the 500 Hz band was particularly inaccurate. Results for click responses filtered into half-octave bands centered at 2000 and 4000 Hz were comparable with those for the broadband click, although the 2000 Hz band was superior for identification of hearing loss > or = 20 dB HL for an 80 dB peSPL click, and > or = 30 dB HL for an 86 dB peSPL click. Results for tone bursts centered at 500, 1000, 2000 and 4000 Hz, presented at 80 dB peSPL, were similar to results of the filtered click bands. Accuracy for identifying hearing loss increased with increasing center frequency. The 2000 and 4000 Hz tone bursts provided the best separation between normal-hearing and hearing-impaired ears, with 4000 Hz being slightly better. CONCLUSIONS: Data from this study suggest that TEOAEs in children can separate ears with normal hearing from those with hearing loss using a variety of stimulus and response conditions. Moreover, by using multiple stimulus levels it may be possible to distinguish between mild and moderate hearing losses.     

The 500 Hz masking-level difference and word recognition in multitalker babble for 40- to 89-year-old listeners with symmetrical sensorineural hearing loss

The purpose of this study was to determine if performances on a 500 Hz MLD task and a word-recognition task in multitalker babble covaried or varied independently for listeners with normal hearing and for listeners with hearing loss. Young listeners with normal hearing (n = 25) and older listeners (25 per decade from 40-80 years, n = 125) with sensorineural hearing loss were studied. Thresholds at 500 and 1000 Hz were < or = 30 dB HL and < or = 40 dB HL, respectively, with thresholds above 1000 Hz < 100 dB HL. There was no systematic relationship between the 500 Hz MLD and word-recognition performance in multitalker babble. Higher SoNo and SpiNo thresholds were observed for the older listeners, but the MLDs were the same for all groups. Word recognition in babble in terms of signal-to-babble ratio was on average 6.5 (40- to 49-year-old group) to 10.8 dB (80- to 89-year-old group) poorer for the older listeners with hearing loss. Neither pure-tone thresholds nor word-recognition abilities in quiet accurately predicted word-recognition performance in multitalker babble.     

Effects of stimulus level on the speech perception abilities of children using cochlear implants or digital hearing aids

OBJECTIVE: The present investigation was designed to provide information to facilitate the decision of whether a child should continue using digital signal processing (DSP) hearing aids with wide dynamic range compression (WDRC) or be recommended for a cochlear implant, based on the unaided pure-tone average (PTA at 500, 1000, and 2000 Hz). DESIGN: Fifty-two children (ages 5 to 15 yr) with unaided PTAs in the moderately severe to profound range, wearing (DSP) hearing aids with (WDRC) or a Nucleus 24, Clarion 1.2, or CII cochlear implant system, participated: 26 with unaided PTAs from 60 to 98 dB HL using DSP hearing aids and 26 with pre-implant unaided PTAs from 93 to 120 dB HL, using cochlear implants. An open-set speech perception test, the Lexical Neighborhood Test (LNT; ), was administered at intensity levels representative of raised (70 dB SPL) and soft (50 dB SPL) speech at two different times approximately 1 mo apart. Minimum audibility of soft sounds was determined for the children with implants and with DSP hearing aids using warble-tone thresholds at octave intervals between 250 and 4000 Hz. RESULT: Regression analyses and significance testing were used to determine the unaided PTA values at which the performance of the DSP Hearing Aid group (DSP HA group) and Cochlear Implant group on the LNT test were statistically different at the 0.05 significance level. For the 70 dB SPL presentation level, the statistically different PTAs were 113 and 97 dB HL at Time 1 and Time 2, respectively, and 96 and 88 dB HL at 50 dB SPL for Time 1 and Time 2, respectively. CONCLUSIONS: The Unaided PTA at which children in the cochlear implant group would be expected to score significantly better than the children in the DSP HA group was lowest (96 and 88 dB HL) for the lower signal level (50 dB SPL). Assuming that LNT scores at 50 dB SPL are representative of long-term hearing of soft incidental speech that is essential for language learning and fluent communication, the children with PTA values greater than the range from 88 to 96 dB HL would be expected to have significantly better LNT scores with a cochlear implant. These results should be further examined with research efforts focusing on early intervention with optimally fitted DSP hearing aids and cochlear implants.