儿童助听器选配

目前,新生儿听力筛查工作已经在我国部分地区得到很好的实施.但听力筛查只是早期听力筛查和干预的一部分,后期的干预工作,如助听器的选配同样应该得到重视.随着听力筛查工作的开展,儿童对助听器的需求也会越来越大.如果不能进行很好的早期干预,这些患儿的言语发育、认知能力和社会-情感的发育就有可能落后于同龄健听儿童.     

Hearing Aid Fitting by Prescription

A procedure for the specification of hearing aid response characteristics is described. Thresholds of discomfort and most comfortable levels for narrow bands of noise centered at 0.25, 0.5, 1, 2, 3 and 4 kHz are determined. The thresholds of discomfort relate to the maximum power output of the hearing aid and the most comfortable levels determine the gain and frequency response that will be required. The data derived from these measurements are given to the hearing aid dispenser who provides a hearing aid that matches the prescribed response characteristics

This technique requires less time than the conventional hearing aid evaluation procedure, and it provides the audiologist with measures of auditory function that can be directly related to hearing aid parameters     

婴幼儿助听器验配

新生儿听力筛查工作已在我国广泛开展,并取得了初步成效.众所周知,新生儿听力筛查工作包括听力筛查、早期诊断评估和干预、听觉言语和语言康复训练以及后期的追踪随访等诸多环节.目前,我国早期听力诊断评估及早期干预工作仍存在着严重的不足,尤其是早期干预质量堪忧.因此针对早期听力干预问题,应该制定相应的技术规范,以提高干预的力度和质量.     

儿童助听器验配应注意的风险

自20世纪以来,听力学在中国发展迅速,儿童听力障碍“早发现、早诊断、早干预”的三早观念已经深入人心,新生儿听力筛查在我国逐渐普及,后期的干预工作,如助听器选配同样应该得到重视[1]。儿童助听器验配是一个系统工程,由于儿童听觉系统发育程度、心理状态、视觉、智力、反应能力等与成人有较大差异,儿童助听器验配必须依靠听力学家、助听器验配师、语训教师和家长共同配合才能达到理想的效果。因此,为儿童选择、调试和评估助听器效果一直是个巨大的挑战,如不能进行科学的选配干预,这些患儿的听力康复、言语发育、认知能力和社会情感的发展就有可能落后于同龄健听儿童。然而,目前国内儿童助听器验配的现状令人担忧,特别是存在以下4方面的风险,如果不能正确认识和及时预防,有可能给家长和听障儿童造成不可挽回的损失。     

Electroacoustic Evaluation of Smartphone-Based Hearing Aid Applications

ObjectivesThis study evaluated the electroacoustic characteristics of smartphone-based hearing aid applications (apps).MethodsWe investigated hearing aid apps based on processing delay measurements, hearing instrument testing, simulated real ear measurements, and a head-and-torso simulator.ResultsMany apps exceeded the recommended level for processing delay. Hearing instrument testing showed the highest amplification characteristics and the best sound quality when a hearing aid was used, followed by the high-end apps and then the low-end apps. The simulated real ear measurements results showed that the high-end apps had a better ability to match the amplification targets than the low-end apps, but there was no consistent pattern among apps when controlling the output. Only a few apps could improve the signal-to-noise ratio in the head-and-torso simulator.ConclusionMost of the apps showed relatively poor electroacoustic performance in comparison with hearing aids. Generalizing access to hearing care through hearing aid apps induces a wide diversity of hearing performance with no fixed standard for reliability. However, we expect their overall quality to improve over the next few years.     

Effect of Hearing Rehabilitation Therapy Program in Hearing Aid Users: A Prospective Randomized Controlled Study

ObjectivesDespite sufficient hearing gains, many patients with hearing loss have difficulty using hearing aids due to poor word recognition ability. This study was performed to introduce our hearing rehabilitation therapy (HRT) program for hearing aid users and to evaluate its effect on hearing improvement.MethodsIn this prospective randomized case-control study, 37 participants with moderate or moderate-severe sensorineural hearing loss who had used bilateral hearing aids for more than 3 months with sufficient functional hearing gain were enrolled in this study. Nineteen participants were randomly assigned to the control group (CG) and 18 patients were assigned to participate in our HRT program once a week for 8 consecutive weeks (hearing rehabilitation therapy group [HRTG]). Their hearing results and questionnaire scores for hearing handicap and hearing aid outcomes were prospectively collected and compared between the two groups.ResultsAfter completing 8 weeks of the HRT program, the HRTG showed a significantly greater improvement in scores for consonant-only and consonant-vowel sound perception than the CG (P<0.05). In addition, the HRTG showed a significant improvement in hearing ability as measured by two questionnaires (P<0.05), while no differences were observed in the CG. However, word and sentence recognition test results did not show significant differences between the two groups.ConclusionEven after short-term HRT, patients had subjectively better hearing outcomes and improved phoneme perception ability; this provides scientific evidence regarding a possible positive role for HRT programs in hearing aid users. Further validation in a larger population through a long-term follow-up study is needed.     

Hearing Aid Technology to Improve Speech Intelligibility in Noise: Increasing the Effectiveness of Hearing Aid Directional Microphones

Directionality is the only hearing aid technology — in addition to amplification — proven to help hearing aid users hear better in noise. Hearing aid directionality has been documented to improve speech intelligibility in multiple laboratory studies. In contrast, real-world studies have shown a disconnect between the potential of the technology and what hearing aid users experience in their daily life. This article describes the real-world studies that inspired ReSound to take a different approach to applying directional microphone technology. This approach is based on the idea that hearing aid directionality can leverage natural binaural hearing and inherent listening strategies. The directional strategy includes three listening modes that will be explained. These are the Spatial Cue Preservation mode, the Binaural Listening mode, and the Speech Intelligibility mode. The strategy and the advantages it provides in terms of sound quality, spatial hearing, and improved signal-to-noise ratio with maintained awareness of surroundings are explained.     

Use of Hearing-Aid-Processed Stimuli in Hearing Aid Evaluation

In ‘hearing aid consultation’, recommendations for an aid are made without observing the patient's aided performance. This practice is undesirable since aided auditory discrimination ability is different to predict on the basis of unaided scores. On the other hand, maintenance in the clinic of a representative stock of hearing aids is costly and time- consuming. As a possible alternative, the intelligibility of ‘hearing-aid-processed’ PB lists (recorded through a hearing aid) was compared with aided discrimination under clinical conditions. Fifteen subjects with sensorineural loss were used. No differences resulted between the two test conditions, indicating that hearing-aid-processed stimuli can give useful information about aided discrimination ability     

老年人助听器配戴效果的问卷评估

目的评估老年人配戴助听器的效果。方法采用日常生活助听满意度问卷(the satisfaction with amplification in daily life,SADL)和患者导向的听觉改善分级(client oriented scale of improvement,COSI)问卷门诊或电话随访62例老年助听器配戴者(年龄62～87岁,平均73.45±5.54岁,配戴助听器时间为6周左右)的主观效果,包括配戴助听器后听力残疾的改善程度、最终能力和满意度等,并将SADL问卷结果与Cox等1999年建立的标准值作比较;比较耳背式与耳内式、双耳与单耳助听器配戴效果的差异。结果 62例受试者SADL问卷总平均分4.97±0.35,积极作用4.38±0.51,服务与花费4.55±0.39,负面作用5.82±0.68,个人形象5.88±0.60分;COSI问卷改善程度的得分为3.05±0.57,最终能力3.54±0.45分(分值越高代表效果越好)。SADL问卷在负面作用方面的得分高于Cox的标准,耳背式助听器在个人形象方面的得分低于耳内式助听器,在负面作用方面的得分高于耳内式,差异均有统计学意义(P<0.05)。单双耳配戴助听器后SADL和COSI问卷的得分差异均无统计学意义。结论 SADL和COSI问卷作为评估老年人助听器配戴效果的有效方法,简单易懂、耗时短;对于老年人,耳背式助听器在负面作用方面好于耳内式,个人形象方面差于耳内式助听器。     

热爱是基石，敬业是根本--如何做好一名助听器验配师

助听器是帮助听障者康复的主要工具。让患者配戴助听器后听得见并听得清，是助听器验配师的主要职责。助听器验配师是我国人力资源和社会保障部于2007年设立的卫生行业特有的国家职业，其主要工作是最大限度地开发利用听障者的残余听力，为其提供最佳声音响度和清晰度，使其尽早感知声音、听懂言语并与人交流，回归主流社会。     

助听器操作难易度评估

目的 掌握助听器使用的情况,分析操作难易度对助听器整体效果的影响,从而为临床科学选配助听器及开展针对性的选配辅导工作提供借鉴.方法 本研究采用中文版助听器效果国际性调查问卷（International Outcome Inventory for Hearing Aids,IOI-HA）和自行设计的助听器操作难易度问卷作为评估素材,通过多中心回顾性研究,得到助听器使用难易度的基础数据.结果 ①IOI-HA总分呈偏态分布,主要分布在25～30范围内,助听器整体满意度较高;②分析表明,助听器摘戴、程序调整、音量调节、耵聍挡板/耵聍罩更换及助听器清洁操作的难易程度对IOI-HA总分有显著影响,具体表现为随着操作难度的增加,IOI-HA总分呈下降趋势.结论 ①助听器基本操作直接影响助听器的综合使用效果;②受试者较好地掌握了助听器摘戴、电池更换、程序调整、音量调节和助听器清洁的操作;③耵聍挡板/耵聍罩的更换操作尚未被受试者熟练掌握,临床助听器选配工作中对该项操作的辅导有待进一步加强.     

Hearing Aid–Related Standards and Test Systems

Many documents describe standardized methods and standard equipment requirements in the field of audiology and hearing aids. These standards will ensure a uniform level and a high quality of both the methods and equipment used in audiological work. The standards create the basis for measuring performance in a reproducible manner and independent from how and when and by whom parameters have been measured. This article explains, and focuses on, relevant acoustic and electromagnetic compatibility parameters and describes several test systems available.     

单侧聋使用信号对传式助听器干预效果研究

目的 进行言语识别率测试和助听效果评估调查问卷(COSI问卷)初步评价信号对传式(contralateral routing of sound,CROS)助听器应用于单侧聋患者的助听效果.方法 20例单侧聋患者进行助听后效果评估,分别进行CROS助听器干预前后安静环境下和噪声环境下言语测试、噪声下言语识别速测表(Qui...     

Effects of Room Reverberation upon Hearing Aid Quality Judgments

Hearing-aid-processed speech recorded in reverberant and nonreverberant environments was ranked utilizing quality judgment and speech discrimination tasks. 21 normally hearing and 20 hearing-impaired listeners ranked the hearing-aid-processed speech. Quality judgments in reverberant environments may yield important information with respect to hearing aid selection. In contrast, speech discrimination rankings in a non-reverberant environment appeared to be similar to the speech discrimination rankings obtained in the reverberant condition.

21 sujets à audition normale et 20 sujets souffrant d'une atteinte de l'audition participèrent à cette étude qui avait pour but de classer un certain nombre d'appareils de correction auditive, compte tenu des résultats d'un test de qualité et d'un test de discrimination de la parole en milieu réverbérant et en milieu non réverbérant. En milieu réverbérant, les jugements subjectifs de qualité sont susceptibles de fournir des renseignements importants pour le choix de l'appareil de correction auditive. Par contre, le classement de ces appareils par l'étude de la discrimination de la parole en milieu réverbérant est semblable à celui effectué en milieu non réverbérant.     

Evaluation of Fitting Rules with a Programmable Hearing Aid

A study was performed with the 3M 8200 multi-programmable hearing aid in order to try to identify an optimal frequency-gain response, based on the standard calculation rules: NAL, POGO, Berger and Half gain. Furthermore, we examined to what extent multiple programs are used and appreciated. The 3M hearing aid was presented to 126 hearing-impaired patients for a trial period. The participants undertook several tests of speech intelligibility and sound quality. In comparison to the final settings after the trial period, it transpired that the NAL rule came closest to the most used program and gave the best prediction of the gain at 1000 Hz. The attempt to optimize standard calculation rules according to indications made by the patients failed. The SRT-in-noise test showed improvements of the S/N ratio of 2.5 dB. The results of this study point towards separate processing of low-and high-frequency sounds as a useful concept.