聋儿配戴助听器后使用无线调频语训系统的效果评估

目的：研究和比较全数字助听器与无线调频语训（FM）系统不同结合方式对重度听力损失儿童的助听效果，方法：聋儿双耳分别配戴全数字助听器，双耳全数字助听器结合单耳FM系统，双耳全数字助听器结合双耳FM系统，在安静和噪声环境中，以不同强度的言语声测试言语可懂度，比较在安静环境和噪声环境中使用与不同使用FM系统及单耳使用与双耳同时使用的助听效果。结果：在安静和噪声环境下，使用FM系统的言语可懂度优于不使用该系统（P＜0．05），单耳使用该系统和双耳使用该系统无明显差异（P＞0．05）。结论：聋儿配戴助听器使用无线调频语训系统在安静和噪声环境下言语可懂度高于不使用该系统者。     

方向性麦克风技术在助听器中的应用

引言 目前，助听器的广泛使用已经使广大听力损失患者在很大程度上改善了他们的生活质量，但这些助听器用户在日常生活中还是会有一些聆听上的困难，尤其是在噪声环境下与人交谈。方向性麦克风系统（directional microphones system）也译为指向性麦克风，是用于提高助听器言语信噪比的一项重要技术，尤其能改善在噪声环境下的言语清晰度（可懂度）。本文通过介绍方向性麦克风的原理、作用以及实际应用方面等相关知识来帮助听力从业人员、技术人员和用户更好地了解和使用这项技术。     

重度聋者配戴移频与非移频助听器的对比研究

目的　比较移频助听器与非移频助听器在重度以上听力障碍患者听力康复中对声音的感知、辨别能力和语训效果。方法　以助听听阈、清晰度指数 (AI)、Ling′s 6音的感知率和听辨率测试以及听音辨图测试得分为指标比较移频和非移频助听器在声音的感知、辨别、识别方面的差异表现。结果　移频助听听阈较非移频助听听阈明显改善 ,在 2 0 0 0Hz以后的高频区改善尤为明显 (t =2 .45～ 47.46,P <0 .0 1)。移频助听器对清晰度指数较非移频助听器有非常显著的提高 (t=16.89,P <0 .0 1)。非移频助听状态下元音的感知率和听辨率较裸耳有显著提高 (χ2 =7.5～ 78.19,P <0 .0 1) ,但对辅音的感知率和辨别率无明显提高。但移频助听状态下的辅音、元音 i 的感知率和听辨正确率都明显高于非移频助听状态。移频助听的听音辨图测试得分较非移频助听时有明显的改善 (t =16.89,P <0 .0 1)。结论　移频助听器比非移频助听器在重度以上听力障碍患者的听力康复中 ,对声音感知、辨别、识别能力三个方面具有更好的助听效果     

≥80岁老人听,前庭及视动功能调查

目的：调查≥８０岁老人的听，前庭及视动功能变化，方法：用纯音测听及听性脑干反应测试听力功能；用眼震电图及姿态图测试半规管，视动及平衡功能；结果：（１）语频听力异常占８４．１％：（２）半规管功能和平衡功能异常者分别为３８．５％和７４．４％，与６０岁比较，重心晃动的轨迹长，速度大；（３）视动功能检查，≥８０岁老人扫视潜伏期延长，跟踪失真度加大。结论：随着年龄老化，≥８０岁老人半规管，视动，平衡功能，均     

助听器的基本知识及应用（下）

助听器的基本知识及应用（下）许时昂１３助听器的临床选配３．１病史的收集及听力检查首先要对患者听力下降情况有一个全面的了解，是渐进性的听力损失还是突发性聋，是波动性的听力损失还是持续性聋。患者是否作过手术，是否使用过助听器以及耳聋家族史。患者对听力的要...     

听力损失、言语和助听器（下）

听力损失、言语和助听器（下）ｖａｎＴａｓｅｌＤＪ３助听器的性能有些助听器的电声学性能可以用滤波器来进行一定程度的调控，其中包括频响、某些压缩的性能和饱和声压级。３．１在安静处３．１．１频响：多数的助听器增益处方是以调节频响至某一指标为目标的。通常以调...     

人工耳蜗植入术前助听器试戴的意义

对拟行人工耳蜗植入手术的双侧极重度耳聋患者进行助听器试戴和语言训练，并定期作言语识别记分（ＳＤＳ）。结果：３例患者戴助听器ＳＤＳ较未戴助听器时无明显提高，分值改变＜４０％，选择人工耳蜗植入且术后听觉效果好；另５例戴助听器后可进行一般交谈，以助听器为听力康复的最佳选择。对人工耳蜗植入术前助听器试戴的意义进行了讨论。     

硅胶发音管在全喉切除发音重建术中的应用及其声学和…

对３例喉鳞状上皮细胞癌患者全喉切除后发音建安放硅胶发音管，２例成功，随访２￣３年，利用电视纤维喉镜摄像系统观察新声门的运动特征，用喉声气流仪分析咽－气管发音的发学特点，从可懂度和流利度两方面对其语言进行评价。结果显示：新声源来自下咽粘膜振动，但基频、强度、气流量及最长发音时间比正常低，咽气管语言不如正常语言流利，其可懂度和正常喉语言一样，术后３周可发声进行语言交流，进食顺利，无误咽，显著改善了患者     

应用于双麦克风耳背式助听器的自适应滤波技术的降噪效果

在物理和感知两个方面，评价噪声环境下使用耳背式助听器双麦克风的自适应波束形成器的言语理解效果．这是首次应用这种运算法则进行的大规模实时配戴的测试。主要的感知研究是针对：①干扰声的频谱-时间特性：②干扰声环境；③听力障碍；④助听器麦克风的基本构型这四个方面对降噪效果的影响。使用4种材料进行感知     

组合听力测试在聋儿早期验配助听器中的作用

目的：探讨短声听觉脑干反应（ABR）和行为测听2种测试组合在聋儿早期验配助听器中的作用。方法：对52例1～9岁聋儿进行行为测听或ABR测试,找到较准确的听阈值。采用理想感觉级配方法选配助听器,以真耳测试及声场测试判断助听效果,进行随访并定期调试助听器。结果：单纯ABR测试有反应耳与组合听力测试有反应耳比较,差异有统计学意义（P〈0．05）。助听效果明显改善41例,无效4例,失访7例。结论：聋儿听力评估应主、客观测听联合使用,助听器验配应遵循“三早”原则,即早期发现,早期诊断,早期进行听力康复。     

The intelligibility of deaf speech to experienced and inexperienced listeners

The study examines differences between experienced and inexperienced listeners in understanding the speech of the deaf. Listeners heard test words in three conditions: in sentences, as isolated words, and as segmented words (the later being words originally produced in sentences, excised, and then presented in isolation). Factors believed to account for listener differences were examined. These were relative word intelligibility, context, including the amount of linguistic information in a sentence, the overall length, and the position of the test word in the sentence. Scores for experienced listeners were consistently higher than those for inexperienced listeners across each factor considered. Differences between listeners were greatest for test words in sentences, followed by isolated and segmented test words. However, there was no statistically significant interaction between listener experience and any of the factors considered. Thus, the data do not support the hypotheses that have been proposed to account for listener differences. For both experienced and inexperienced listeners, scores varied systematically depending on the relative predicted intelligibility of the test words and the amount of context in the sentence.     

Evaluation of speech intelligibility for children with cleft lip and palate by means of automatic speech recognition

OBJECTIVE: Cleft lip and palate (CLP) may cause functional limitations even after adequate surgical and non-surgical treatment, speech disorders being one of them. Interindividually, they vary a lot, showing typical articulation specifics such as nasal emission and shift of articulation and therefore a diminished intelligibility. Until now, an objective means to determine and quantify the intelligibility does not exist. METHOD: An automatic speech recognition system, a new method, was applied on recordings of a standard test to evaluate articulation disorders (psycholinguistic analysis of speech disorders of children PLAKSS) of 31 children at the age of 10.1+/-3.8 years. Two had an isolated cleft lip, 20 a unilateral cleft lip and palate, 4 a bilateral cleft lip and palate, and 5 an isolated cleft palate. The speech recognition system was trained with adults and children without speech disorders and adapted to the speech of children with CLP. In this study, the automatic speech evaluation focussed on the word accuracy which represents the percentage of correctly recognized words. Results were confronted to a perceptive evaluation of intelligibility that was performed by a panel of three experts. RESULTS: The automatic speech recognition yielded word accuracies between 1.2 and 75.8% (mean 48.0+/-19.6%). The word accuracy was lowest for children with isolated cleft palate (36.9+/-23.3) and highest for children with isolated cleft lip (72.8+/-2.9). For children with unilateral cleft lip and palate it was 48.0+/-18.6 and for children with bilateral cleft lip and palate 49.3+/-9.4. The automatic evaluation complied with the experts' subjective evaluation of intelligibility (p<0.01). The multi-rater kappa of the experts alone differed only slightly from the multi-rater kappa of experts and recognizer. CONCLUSION: Automatic speech recognition may serve as a good means to objectify and quantify global speech outcome of children with cleft lip and palate.     

Tone production in Mandarin-speaking children with cochlear implants: a preliminary study

OBJECTIVE: More than a quarter of the world's population speak tone languages, such as Mandarin Chinese. In those languages, the pitch or tone pattern of a monosyllabic word conveys lexical meaning. The purpose of this study was to investigate tone production in Mandarin-speaking children with cochlear implants (CIs). MATERIAL AND METHODS: Speech samples were recorded from seven normal-hearing and four CI children aged 4-9 years. All subjects were native Mandarin speakers. The speech samples were used for acoustic analysis of the tone patterns, i.e. the fundamental frequency contours. In addition, a tone intelligibility test was carried out in which four normal-hearing native Mandarin-speaking adults listened to the speech materials and judged the intelligibility of the children's tone production. RESULTS: The tone production for the seven normal-hearing children was considered to be perfect in the intelligibility test. Acoustic analysis of the speech materials of the normal-hearing children produced the four typical tone patterns of Mandarin Chinese: (i) high and flat; (ii) rising; (iii) low and dipping; and (iv) falling. The tone patterns produced by the children with CIs tended to be flat, with some other patterns being irregular. The results of the tone intelligibility tests also showed degraded intelligibility of tone patterns. CONCLUSION: A potential speech development deficit was documented in prelingually deafened children with CIs whose native language is a tone language. The imperfect tone production of the implant children, which can be attributed to the paucity of pitch information delivered via the current CI stimulation, may have significant implications for communication using tone languages. Further research is warranted to determine factors that may affect tone development in children with CIs.     

Saudi Arabic Speech Audiometry

Phonetically balanced monosyllabic classical Arabic word lists were chosen to construct a Saudi Arabic speech test. These words were taken from primary school books, daily newspapers and children's stories. They were first evaluated by our students for their familiarity and homogeneity and then divided into six sub-groups of 20 words each. The normal speech-audiometric curves obtained from our students (normally hearing subjects) with this material are similar to normal curves obtained with most European and American monosyllabic word lists. The threshold of intelligibility for our test material was also found to be similar to that of most foreign languages using monosyllabic word lists under the same conditions.     

Development of a script of phonemically balanced monosyllable lists of Mandarin-Chinese

Objectives To develop a set of monosyllable audiometry test material that can be used in speech recognition testing in Mandarin Chinese. Materials and Methods In an effort to improve reliability and efficiency in clinical practice, a set of 30 test lists of 25 monosyllable test items each was designed with consideration of the following: length of the list, phonemical balance (PB), word utility frequency, coverage of common words, and equivalency among lists. The 30 lists contained 750 monosyllabic words and were constructed on the basis of Chinese phoneme distribution probability summarized in the Manual of Acoustic. The occurrence incidence of the 22 consonants, 36 vowels, and 4 tones of the Chinese Mandarin characters in the 30 test lists were calculated. To achieve PB, 489 monosyllables were selected from the 2500 most commonly used Chinese characters and the 4000 most commonly used Chinese phrases to compile the 30 monosyllable test lists using a computer algorithm with manual adjustment. Results Thirty phonemical balanced word lists of common Mandarin Chinese monosyllabic words were compiled. Each list consisted of 25 monosyllables. A total of 489 phonemes (consonants, vowels and tones) were included in the set. Conclusions This set of lists can potentially be used as the basic lists for future development of Mandarin PB monosyllable speech test materials.     

普通话言语测听材料的数字化录制与等价性分析

目的：对已经编制并通过初步等价性测试的普通话言语测听材料（MSTM）进行数字化录制，并进行第2次等价性测试和分析，为全面推广和进一步的多中心试验做准备。方法：根据第1次等价性测试的结果调整词表内容，增加练习用表。按照国际标准数字化录制所有材料，最后形成3张CD。每张CD均含有校准纯音、练习表、测试表。测试了60名青年正常听力受试者，单音节词、双音节词和句表的给声强度不尽相同。结果：统计分析后得到了具有等价性的两套单音节词表（每套9表）、9张双音节词表和27张句表。临床应用中如果不需要如此多的词表，可以选用最具有等价性的词表、句表用于同一（组）受试者。结论：具有等价性的普通话言语测听词表已经制备成CD，可以直接提供临床应用。     

Predicted and measured speech recognition performance in noise with linear amplification

OBJECTIVE: The purpose of this study was to investigate the applicability of the Speech Intelligibility Index (SII) in hearing aid fitting. It was hypothesized that estimated speech intelligibility, based on the SII, could be a more reliable measure than real speech recognition results for comparing hearing aid characteristics. DESIGN: The test subjects were 29 elderly persons (66 to 80 yr) with mild-to-moderate hearing loss, who were using monaurally fitted linear hearing aids. They were selected from the files at Sahlgrenska hearing clinic. Speech recognition scores were obtained at fixed speech-to-noise ratios with Phonemically Balanced (PB) words in speech-weighted noise and in low-frequency noise. A Just-Follow-Conversation (JFC) test was performed with connected speech presented in the same background noises. The subjects were tested without hearing aid and with their hearing aids set at three different frequency responses. Predicted speech recognition scores were calculated for each condition based on the SII, complemented with a correction for sensorineural hearing impairment. The calculations involved speech and noise spectra, pure tone thresholds and insertion gain responses. RESULTS: For each condition, the measured speech recognition scores were, on average, well predicted by the calculated scores. The intra-individual standard deviation of the predicted scores was estimated to be about one percent unit. The group results of the JFC test were in agreement with the word recognition results for the aided conditions, but a floor effect was observed for the unaided conditions. CONCLUSIONS: Speech intelligibility prediction based on the modified SII is a valid estimate of speech recognition performance of hearing-impaired persons with mild-to-moderate hearing loss. Estimated intelligibility based on the SII is more reliable than actually measured speech recognition performance, for comparing amplification conditions within subjects.