Reliability and intersubject variability of the real ear unaided response

Intratester test-retest reliability of the real ear unaided response (REUR) was determined on 49 ears using the Frye 6500 real ear analyzer. Results revealed mean differences of less than 1 dB for repeat measurements at seven test frequencies between 250 and 4000 Hz. The average peak resonant frequency of the repeated measure was within 16 Hz of the initial measure. In addition, the intersubject variability of the amplitude of REUR was quite large. A range of 7 dB was found at 250 to 500 Hz with the range expanding to 15 to 20 dB at 2000 to 4000 Hz. Also, the peak resonant frequency varied between 2100-4800 Hz. These results are discussed in terms of those dispensers who use the REUR to "custom" order hearing aids.     

Measuring the real-ear to coupler difference transfer function with an insert earphone and a hearing instrument: are they the same?

OBJECTIVE: The purpose of the study was to compare the real-ear to coupler difference (RECD) measured with an insert earphone and two models of hearing instrument. DESIGN: The RECD was obtained from one ear of 18 normal-hearing subjects by subtracting the 2-cc coupler (HA1 and HA2) response from a real-ear aided response, using a conventional probe-tube microphone system. The measurements were made with a conventional ER-3A earphone and two models of behind-the-ear hearing instrument (Unitron US80, Unitron, Kitchener, Canada; and Widex Diva, Widex, Vaerloese, Denmark). RESULTS: The procedures were very reliable, with mean differences on retest of less than 1 dB. There were statistically significant differences between the mean RECDs obtained using an insert earphone compared with those obtained with each hearing instrument (p < 0.05). The differences were greatest when using the HA2 2-cc coupler. For example, the maximum difference in mean RECD between the insert earphone and the Widex Diva was 6 dB and 11 dB when using the HA1 and the HA2 2-cc coupler, respectively. CONCLUSIONS: The RECD is dependent on the acoustic impedance of the sound source, the coupling system, and the coupler and ear. The acoustic impedance may be different for an insert earphone and a given hearing instrument. Therefore, the RECD measured with an insert earphone may not always accurately represent the difference in performance of a hearing instrument measured in the real ear and the 2-cc coupler.     

Treatment of mixed hearing losses via implantation of a vibratory transducer on the round window

Early clinical findings are reported for subjects implanted with the Vibrant Med-El Soundbridge (VSB) device. The present criteria for the VSB, limiting its application to patients with normal middle ear function, have been extended to include patients with ossicular chain defects. Seven patients with severe mixed hearing loss were implanted with the transducer placed onto the round window. All had undergone previous surgery: six had multiple ossiculoplasties, and one had the VSB crimped on the incus with unsuccessful results. Round window implantation bypasses the normal conductive path and provides amplified input to the cochlea. Post-operative aided thresholds of 30 dB HL were achieved for most subjects, as compared with unaided thresholds ranging from 60-80 dB HL. Aided speech reception thresholds at 50% intelligibility were 50 dB HL, with most subjects reaching 100% intelligibility at conversational levels, while unaided thresholds averaged 80 dB HL, with only one subject reaching 100% intelligibility. These results suggest that round window implantation may offer a viable treatment option for individuals with severe mixed hearing losses who have undergone unsuccessful ossiculoplasties.     

Treatment of mixed hearing losses via implantation of a vibratory transducer on the round window

Early clinical findings are reported for subjects implanted with the Vibrant Med-El Soundbridge® (VSB) device. The present criteria for the VSB, limiting its application to patients with normal middle ear function, have been extended to include patients with ossicular chain defects. Seven patients with severe mixed hearing loss were implanted with the transducer placed onto the round window. All had undergone previous surgery: six had multiple ossiculoplasties, and one had the VSB crimped on the incus with unsuccessful results. Round window implantation bypasses the normal conductive path and provides amplified input to the cochlea. Post-operative aided thresholds of 30 dB HL were achieved for most subjects, as compared with unaided thresholds ranging from 60–80 dB HL. Aided speech reception thresholds at 50% intelligibility were 50 dB HL, with most subjects reaching 100% intelligibility at conversational levels, while unaided thresholds averaged 80 dB HL, with only one subject reaching 100% intelligibility. These results suggest that round window implantation may offer a viable treatment option for individuals with severe mixed hearing losses who have undergone unsuccessful ossiculoplasties.     

Auditory brainstem response results as predictors of behavioral auditory thresholds in severe and profound hearing impairment

Pediatric cochlear implantation is restricted to patients with stable, bilateral profound sensorineural hearing losses who derive no benefit from conventional amplification. Obtaining reliable audiologic thresholds in a young child with sudden or early-onset hearing loss can be challenging. This study examines the accuracy with which auditory brainstem response evaluation can predict unaided and aided behavioral thresholds in a child with severe-to-profound hearing loss. Reliable behavioral thresholds were obtained on 119 children who had no measurable click-evoked auditory brainstem responses at instrumentation limits of 100 dB HLn. These data show that an absent auditory brainstem response at 100 dB HLn does not necessarily indicate the absence of measurable unaided hearing for test frequencies ranging from 250 Hz to 4000 Hz. Average aided thresholds of better than 60 dB were present in 43% of the children for 500, 1000, and 2000 Hz and in 53% for 500 and 1000 Hz. Therefore, the absence of a click-evoked auditory brainstem response at 100 dB HLn in a young child is not prima facie evidence of the child's cochlear implant candidacy.     

Hearing aid use in Finnish children--impact of hearing loss variables and detection delay

OBJECTIVE: The aim was to study the factors contributing to the mode of hearing aid use in children, with special emphasis on hearing loss variables and detection delay. METHODS: The subjects were 328 children and adolescents (58.5% boys, 41.5% girls) aged 1-18 years with hearing loss of > or =30 dB HL in the better ear fitted with hearing aid(s). The study was cross-sectional analysing the mode of using the aid binaurally/unilaterally or not at all. RESULTS: The children with hearing-impairment ranging from 50 to 90 dB HL used more regularly their hearing aids. In the subjects with hearing loss > or =80 dB HL the presence of measurable hearing threshold at 4 kHz related significantly to the acceptance of amplification (p=0.027). In 19% of the subjects hearing aid was discarded. Bilateral amplification was used in 38%. Unilateral use was the prevailing mode (44%). The younger the children (p=0.000) and the worse their hearing loss (p=0.008), the more regular their bilateral use was. Early detection of hearing loss and early hearing aid fitting promoted binaural hearing aid use (p=0.004). A marked asymmetry in pure tone thresholds was a significant audiological reason for fixed unilateral hearing device use (38%, p=0.001). CONCLUSIONS: The study shows that early detection of hearing loss and early habilitation of hearing increase bilateral use of hearing device and decrease the number of nonusers. Furthermore, residual unaided hearing at 4 kHz significantly improves the use of device.     

Preservation of residual hearing with cochlear implantation: how and why

CONCLUSIONS: Hearing may be conserved in adults after implantation with the Nucleus Contour Advance perimodiolar electrode array. The degree of hearing preservation and the maximum insertion depth of the electrode array can vary considerably despite a defined surgical protocol. Residual hearing combined with electrical stimulation in the same ear can provide additional benefits even for conventional candidates for cochlear implantation. OBJECTIVES: We present preliminary results from a prospective multicentre study investigating the conservation of residual hearing after implantation with a standard-length Nucleus Contour Advance perimodiolar electrode array and the benefits of combined electrical and acoustic stimulation. MATERIAL AND METHODS: The subjects were 12 adult candidates for cochlear implantation recruited according to national selection criteria. A "soft" surgery protocol was defined, as follows: 1-1.2-mm cochleostomy hole anterior and inferior to the round window; Nucleus Contour Advance electrode array inserted using the "Advance-off-stylet" technique; and insertion depth controlled by means of three square marker ribs left outside the cochleostomy hole. These procedures had been shown to reduce insertion forces in temporal bone preparations. Variations in surgical techniques were monitored using a questionnaire. Pure-tone thresholds were measured pre- and postoperatively. Patients who still retained thresholds <90 dB HL for frequencies up to 500 Hz were re-fitted with an in-the-ear (ITE) hearing aid. Word recognition was tested in quiet and sentence perception in noise for the cochlear implant alone and in combination with an ipsilateral hearing aid. RESULTS: Hearing threshold level data were available for 12 patients recruited from 6 of the centres. Median increases in hearing threshold levels were 23, 27 and 33 dB for the frequencies 125, 250 and 500 Hz, respectively. These median increases include the data for two patients who had total loss of residual hearing due to difficulties encountered during surgery. "Cochlear view" X-ray images indicated that the depth of insertion varied between 300 and 430 degrees, despite modest variations in the length of the electrode inserted (17-19 mm). The insertion angle had some influence on the preservation of residual hearing at frequencies of 250-500 Hz. Six of the 12 patients retained sufficient hearing for effective use of an ipsilateral ITE hearing aid (< or = 80 dB HL at 125 and 250 Hz; < or = 90 dB HL at 500 Hz). Word recognition scores in quiet were improved from 10% to 30% with the cochlear implant plus ipsilateral hearing aid in 3 patients who had at least 3 months postoperative experience. Signal:noise ratio thresholds for sentence recognition were improved by up to 3 dB. Patients reported that they experienced greatly improved sound quality and preferred to use the two devices together.     

Bone-anchored hearing aid system application for unilateral congenital conductive hearing impairment: audiometric results.

OBJECTIVE: To study the audiologic outcome of bone-anchored hearing aid (BAHA) application in patients with congenital unilateral conductive hearing impairment. STUDY DESIGN: Prospective audiometric evaluation on 20 patients. SETTING: Tertiary referral center. PATIENTS: The experimental group comprised 20 consecutive patients with congenital unilateral conductive hearing impairment, with a mean air-bone gap of 50 dB. METHODS: Aided and unaided hearing was assessed using sound localization and speech recognition-in-noise tests. RESULTS: Aided hearing thresholds and aided speech perception thresholds were measured to verify the effect of the BAHA system on the hearing acuity. All patients fulfilled the criteria that the aided speech reception thresholds or the mean aided sound field thresholds were 25 dB or better in the aided situation. Most patients were still using the BAHA almost every day. Sound localization scores varied widely in the unaided and aided situations. Many patients showed unexpectedly good unaided performance. However, nonsignificant improvements of 3.0 (500 Hz) and 6.9 degrees (3,000 Hz) were observed in favor of the BAHA. Speech recognition in noise with spatially separated speech and noise sources also improved after BAHA implantation, but not significantly. CONCLUSION: Some patients with congenital unilateral conductive hearing impairment had such good directional hearing and speech-in-noise scores in the unaided situation that no overall significant improvement occurred after BAHA fitting in our setup. Of the 18 patients with a complete data set, 6 did not show any significant improvement at all. However, compliance with BAHA use in this patient group was remarkably high. Observations of consistent use of the device are highly suggestive of patient benefit. Further research is recommended to get more insight into these findings.     

Benefits of amplification for unaided speech discrimination in age-related hearing loss with flat type audiogram

ObjectiveThe present study aimed to investigate whether hearing aid use can induce improvement as acclimatization effect in unaided speech perception in patients with age-related hearing loss.MethodsFifty ears in 41 patients (age range: 65-91 years) diagnosed as age-related hearing loss were enrolled in this study. They used hearing aids for more than 8 hours per day. Unaided speech audiometry using 67-S Japanese monosyllabic word list was performed one or two years after the commencement of hearing aid use. The changes in the unaided speech discrimination score before and after the commencement of hearing aid use were analyzed. To investigate factors for improvement, the patients’ backgrounds in terms of age, sex, pure tone average, unaided maximum speech discrimination score, fitting period (one year/two years), fitting ear (bilateral/unilateral), audiogram type (flat-type/other-type), and the level of amplification were also analyzed.ResultsSignificant improvement in the unaided speech discrimination score after hearing aid use was seen only in the flat-type audiogram group. More than half of older patients in the flat-type audiogram group improved their unaided maximum speech discrimination score 10 % or more. The analysis of aided hearing thresholds revealed that the flat-type audiogram group had significantly lower thresholds of 3kHz and 4kHz than the other-type audiogram group. The age, sex, pure tone average, fitting period, fitting ear, functional gain were not influential factors for improvement. On the other hand, unaided maximum speech discrimination score before using hearing aid and aided hearing threshold at 4kHz had a negative correlation with improvement.ConclusionThe findings suggested that older patients with age-related hearing loss whose audiogram is a flat type can benefit from amplification as means of improving their unaided speech perception since flat-type audiogram can be more easily adjusted to sufficiently amplify speech sound at high frequencies. It should be considered that the potential for experience-dependent plasticity is retained even in older adults.     

Short-term hearing fluctuation in Meniere's disease

This study aimed to assess the extent and implications of short-term hearing fluctuation in Meniere's disease. Thirty-six subjects diagnosed with Meniere's were recruited to measure their own hearing using in-situ audiometry via a hearing aid (Widex Diva) and a portable programmer (SP3). Self-hearing tests measuring up to 14 frequency bands were conducted three times a day over eight weeks using the expanded Sensogram^TM. Twenty-three ears showed low frequency fluctuation while ten fluctuated in mid frequencies with some ‘double peak’ audiogram configurations. Eight ears in the later stages of Meniere's, contrary to expected, also recorded fluctuation across all frequencies. Self-hearing testing Meniere's ears over eight weeks revealed great hearing fluctuation with significant changes in audiogram configuration. It suggests that as endolymphatic hydrops progresses through the cochlea, low frequency fluctuation is followed by fluctuation in the mid frequencies, leading to fluctuation across all frequencies. Use of a self-hearing test may facilitate diagnosis and hearing aid fitting for this population, as clinical audiograms may not provide accurate information of hearing fluctuation.     

Natural history of contralateral residual hearing in unilateral cochlear implant users - long-term findings

Abstract Conclusion: The long-term stability of low-frequency residual hearing found in a significant number of bilateral-bimodal users (cochlear implant (CI) in one ear and a hearing aid (HA) on the other ear; CI/HA) with severe-to-profound or profound hearing loss in the non-implanted ear justifies bilateral-bimodal fitting efforts in this group. Since low-frequency residual hearing tends to deteriorate in some of these CI/HA users, periodic evaluation, which includes pure-tone thresholds and speech perception tests, is mandatory for determining the point in time at which CI/HA hearing is no longer effective, and the patient should accordingly be considered as a candidate for contralateral cochlear implantation. Objective: To determine, in bilateral-bimodal (CI/HA) users with severe-to-profound or profound hearing loss in the non-implanted ear, the rate of residual hearing deterioration in the non-implanted ear after cochlear implantation. Methods: Pure-tone aided and unaided thresholds in the non-implanted ears of 39 CI/HA users at 0.25-4.0 kHz were recorded prospectively up to 6 years after implantation. Results: Group mean threshold values in the non-implanted ears remained stable over 3, 4, 5 and 6 years post-implantation, except for significant deterioration at 4.0 kHz of both unaided (4.2, 5.2, 9.0 and 8.2 dB, respectively) and aided thresholds (8.1, 4.6, 6.1 and 8.3 dB, respectively).     

Reliability and validity of judgments of sound quality in elderly hearing aid wearers

OBJECTIVE: The aim of the present study was to evaluate a particular sound-quality rating procedure, referred to here as the Judgments of Sound Quality (JSQ) test, for potential use as an outcome measure with elderly hearing aid wearers. The validity and reliability of the JSQ as an outcome measure were determined for unaided and aided listening conditions. DESIGN: A repeated-measures design was employed with two primary independent variables, each with two values: 1) aided condition (aided versus unaided listening); and 2) trial (test versus retest). Sixteen elderly, hearing-impaired hearing aid users participated in the study. The participants provided ratings on eight dimensions of sound quality (softness, brightness, clarity, fullness, nearness, loudness, spaciousness, and total impression) under four stimulus conditions (speech at 65 dB SPL with a +8 dB signal-to-noise ratio, speech at 65 dB SPL in quiet, music at 90 dB SPL, and music at 75 dB SPL). Test and retest ratings were obtained in both unaided and aided conditions. RESULTS: No significant differences were found between median test and retest scores on the JSQ. The median ratings for each sound-quality dimension were found to have moderate test-retest reliability, with test-retest correlations (r) ranging from 0.20 to 0.73 (median r value = 0.58) for the unaided listening condition, and from 0.23 to 0.85 (median r value = 0.51) for the aided listening condition. Test validity was established through significant differences in JSQ ratings for various stimulus pairs (e.g., speech in quiet versus speech in noise). In addition, significant differences were observed between unaided and aided ratings for the dimensions of clarity, nearness, loudness, and total impression with aided JSQ ratings approaching normative "ideal" values established previously. CONCLUSIONS: The JSQ appears to be a potentially useful measure of hearing aid outcome, especially when using group data to document the benefits of amplification. Additional efforts should be directed at improving the reliability of the JSQ, however, before application to hearing aid wearers on an individual basis.     

The reliability of functional gain

This study examined the test-retest reliability of unaided and aided sound-field thresholds and the functional gain values derived from these measurements. Sound-field warble-tone thresholds were obtained at 250, 1000, and 4000 Hz from 24 hearing-impaired listeners with and without their hearing aids. Test-retest standard deviations were significantly larger for functional gain than for unaided thresholds, but only slightly and nonsignificantly larger than for aided thresholds. The variability of functional-gain measures is discussed in relation to measures of insertion gain obtained with probe-tube microphones.     

Indications and outcome of subtotal petrosectomy for active middle ear implants

The aim of this study was to describe the outcome and possible complications of subtotal petrosectomy (SP) for Vibrant Soundbridge (VSB) device surgery in a tertiary referral center. A secondary objective was the evaluation of hearing results in a subgroup of subjects who received the VSB device. Between 2009 and early 2011, 22 adult subjects with chronic otitis media (COM) underwent a SP, blind sac closure of the external auditory canal and abdominal fat obliteration to facilitate the application of an active middle ear implant (AMEI) in a staged procedure. Indications consisted of mixed hearing loss after previous tympanomastoplasty and failure of hearing rehabilitation with a hearing aid or bone conduction device in COM. Pre- and postoperative pure-tone audiograms were analyzed in respect to deterioration of inner ear function, unaided and aided (hearing aid, bone-anchored hearing aid and VSB) speech audiograms were compared to verify improvements in communications skills and functional gains. Incidence and type of complications were reviewed. No significant change was observed regarding mean bone conduction thresholds after the first stage procedure. Some minor wound healing problems were noted. Speech perception using the VSB (n = 16) showed a mean aided speech discrimination at 65-dB SPL of 75 % [standard deviation (SD) 28.7], at 80-dB SPL of 90 % (SD 25.1). Our results suggest that for selected patients with open mastoid cavities and chronic middle ear disease, SP with abdominal fat obliteration is an effective and safe technique to facilitate safe AMEI placement.     

Aided auditory steady-state responses in infants

Infants with hearing loss routinely receive hearing aids several months before reliable behavioral responses to amplified sound can be observed. This necessitates objective measures to validate hearing-aid fittings. A single report has demonstrated the use of ASSRs to determine aided thresholds in children but data in young infants is still lacking. The current study explored aided ASSR compared to unaided ASSR thresholds and subsequent behavioral thresholds in a group of six young infants with hearing loss who received hearing aids between three and six months of age. Aided ASSR thresholds were obtained in 83% of frequencies where aided behavioral thresholds were obtained, with a mean threshold difference of 13+/-13 dB. The aided ASSR-based threshold estimates were within 15 dB of behavioral thresholds in 63% of cases, indicating a moderate correlation (r = 0.55). Comparing aided and unaided ASSR measurements revealed an average functional gain of 36+/-15 dB. These results indicate that ASSRs can provide the first evidence of robust hearing aid benefit in young infants several months before behavioral responses are observed.     

Aided auditory steady-state responses in infants

Infants with hearing loss routinely receive hearing aids several months before reliable behavioral responses to amplified sound can be observed. This necessitates objective measures to validate hearing-aid fittings. A single report has demonstrated the use of ASSRs to determine aided thresholds in children but data in young infants is still lacking. The current study explored aided ASSR compared to unaided ASSR thresholds and subsequent behavioral thresholds in a group of six young infants with hearing loss who received hearing aids between three and six months of age. Aided ASSR thresholds were obtained in 83% of frequencies where aided behavioral thresholds were obtained, with a mean threshold difference of 13±13 dB. The aided ASSR-based threshold estimates were within 15 dB of behavioral thresholds in 63% of cases, indicating a moderate correlation (r = 0.55). Comparing aided and unaided ASSR measurements revealed an average functional gain of 36±15 dB. These results indicate that ASSRs can provide the first evidence of robust hearing aid benefit in young infants several months before behavioral responses are observed.     

Gain and maximum output of two electromagnetic middle ear implants: are real ear measurements helpful?

We compared the output of two electronic middle ear implants: the Otologics MET device and the Vibrant Soundbridge device. Both devices were programmed in the linear amplification mode. Aided minus unaided sound pressure levels recorded in the ear canal (objective gain) were compared to unaided minus aided soundfield thresholds (functional gain) in 13 patients with severe sensorineural hearing loss. In addition, input/output characteristics were studied with the help of ear canal measurements. Objective gain was consistently lower than functional gain, with wide variation between patients and frequencies. Using input/output data measured in the ear canal in combination with functional gain data, the mean maximum output of the two devices was estimated, expressed in dB SPL. In comparison to NAL-R target values, (functional) gain was adequate; however, the maximum output was low, especially for the Vibrant Soundbridge device.     

Delayed feedback audiometry: reliability of repeated measures

The test-retest reliability of hearing thresholds at 1000 Hz measured by a delayed auditory feedback procedure was compared with the reliability of thresholds obtained with voluntary responses to the same signal in 10 adults with normal hearing sensitivity. Thresholds for each procedure were obtained three times on each of 5 different days. Although the delayed feedback procedure yielded estimates of threshold which averaged 4.6 dB greater than those estimated by voluntary responses (p less than 0.05), there was no evidence that experience over time resulted in a change for the poorer in the precision of the test.     

Preservation of residual hearing with cochlear implantation: How and why

Conclusions Hearing may be conserved in adults after implantation with the Nucleus Contour Advance perimodiolar electrode array. The degree of hearing preservation and the maximum insertion depth of the electrode array can vary considerably despite a defined surgical protocol. Residual hearing combined with electrical stimulation in the same ear can provide additional benefits even for conventional candidates for cochlear implantation.

Objectives We present preliminary results from a prospective multicentre study investigating the conservation of residual hearing after implantation with a standard-length Nucleus Contour Advance perimodiolar electrode array and the benefits of combined electrical and acoustic stimulation.

Material and methods The subjects were 12 adult candidates for cochlear implantation recruited according to national selection criteria. A “soft” surgery protocol was defined, as follows: 1–1.2-mm cochleostomy hole anterior and inferior to the round window; Nucleus Contour Advance electrode array inserted using the “Advance-off-stylet” technique; and insertion depth controlled by means of three square marker ribs left outside the cochleostomy hole. These procedures had been shown to reduce insertion forces in temporal bone preparations. Variations in surgical techniques were monitored using a questionnaire. Pure-tone thresholds were measured pre- and postoperatively. Patients who still retained thresholds <90 dB HL for frequencies up to 500 Hz were re-fitted with an in-the-ear (ITE) hearing aid. Word recognition was tested in quiet and sentence perception in noise for the cochlear implant alone and in combination with an ipsilateral hearing aid.

Results Hearing threshold level data were available for 12 patients recruited from 6 of the centres. Median increases in hearing threshold levels were 23, 27 and 33 dB for the frequencies 125, 250 and 500 Hz, respectively. These median increases include the data for two patients who had total loss of residual hearing due to difficulties encountered during surgery. “Cochlear view” X-ray images indicated that the depth of insertion varied between 300 and 430°, despite modest variations in the length of the electrode inserted (17–19 mm). The insertion angle had some influence on the preservation of residual hearing at frequencies of 250–500 Hz. Six of the 12 patients retained sufficient hearing for effective use of an ipsilateral ITE hearing aid (≤80 dB HL at 125 and 250 Hz; ≤90 dB HL at 500 Hz). Word recognition scores in quiet were improved from 10% to 30% with the cochlear implant plus ipsilateral hearing aid in 3 patients who had at least 3 months postoperative experience. Signal:noise ratio thresholds for sentence recognition were improved by up to 3 dB. Patients reported that they experienced greatly improved sound quality and preferred to use the two devices together.     

对称性聋患者单耳助听后双耳言语识别率差别探讨

目的通过检测对称性聋患者单耳助听后双耳言语识别率的差别来进一步研究听觉剥夺效应。方法选取右耳助听4～5年的双耳对称性感音神经性聋患者15名,在标准隔声室中,测试其双耳的纯音气导和骨导听闻,然后再采用汉语普通话单音节词表分别进行左右裸耳言语识别率测试,并将所得数据进行对比研究。结果15名受试者右耳配戴助听器前及配戴4～5年后两耳间平均听阈无显著性差异（P〉0．05）;受试者右耳助听前及助听4～5年后左、右耳平均听阀前后无显著性差异（P〉0．05）;右耳助听4～5年后,受试者左、右耳裸耳言语识别率存在显著性差异（t=2．76,P=0．02〈0．05）。结论对称性感音神经性聋患者单耳助听后裸耳平均听阈无显著改变,但非助听耳言语识别能力显著下降。