中老年听力障碍者助听器验配特点

目的通过123例50岁以上听力障碍患者的纯音听阈测试及助听器验配情况,了解其听力特点及助听器选配的特点。方法感音神经性聋患者123例,以每10岁为一年龄组,统计他们125～8000Hz的纯音听阈,根据听力情况验配西门子数字式助听器,记录最终验配情况并了解未验配的原因。结果各年龄段就诊的中老年聋者总体听力水平大致相仿,均为中重度感音神经性聋,纯音听阈测试表现为下降型听阈曲线。就诊者以70～岁年龄段者最多,最终接受助听器者以70岁以下年龄段者为多。70岁以上者多因戴上助听器后效果不理想或经济原因拒绝验配,70岁以下拒绝验配者则主要担心社会影响。结论中老年感音神经性聋患者的纯音听阈曲线主要为下降型,早诊查、早干预有助于提高生活质量。     

怎样为聋儿验配好助听器

前已述及．对于感音神经性耳聋．目前尚无有效的治疗方法，若要补偿和重建已损失的听力．学会用语言进行思维．用言语进行交流．唯一科学的手段是配戴助听器或植入人工耳蜗．然后进行系统的言语康复训练和康复教育。     

聋儿验配助听器程序

助听器几乎可使所有的聋人受益 ,尤其是处在听觉、语言、智能等诸方面发育阶段的聋儿 ,如果能尽早配戴合适的助听器、并进行听觉语言训练 ,就能尽最大可能地恢复听觉言语功能 ,回归主流社会。然而 ,无语言、不能合作是聋儿的共性 ,他们对助听效果不能作出主观评定。因此 ,聋儿助听器验配较之成年耳聋患者的难度大、周期长 ,需要耳科医生、听力学家、聋儿家长或教师通力合作 ,遵循验配助听器的程序 ,使聋儿获得最佳助听效果。1　听力资料准备选择助听器最首要的是掌握准确的听力资料。1 1　了解聋儿耳聋的病因、病程、发病情况及伴随症状 ,对…     

婴幼聋儿助听器的验配及随诊

成立助听观察室专为双耳感音神经性聋婴幼儿选配助听器,并进行定期调试及康复指导,用声场验配法评估助听效果。结果发现佩戴助听器1～3年后的助听效果较初戴时好,两者之间有显著性差异（P＜0．01）,高频差异更大。表明聋儿听敏度特别是高频部分的听敏度有提高。     

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。     

真耳介入增益法在聋儿助听器验配中的应用

真耳介入增益法是助听器常用的验配方法之一，本文应用ＮＡＬ－Ｒ、２／３增益公式，对感音神经经性聋听力损失程度为严重聋和极度聋的聋儿，进行了助听器验配、并对不同频率上的目标增益值、真耳介入增益值方面进行了比较，探索适合于这类患者的最佳预先公式，结果发现助听效果最好的２／３增益公式，助听效果最差的最ＮＡＬ－Ｒ公式，但在应用时要强调个体化。     

婴幼聋儿助听器的验配及随诊

成立的观察室专为双耳感音神经性聋婴幼儿和选配助听器,并进行定期调试及康复指导,用声场验配法评做助听效果。结果发同戴助听器１－３年后的助听效果较初戴时好,两者之间有显著性差异（Ｐ〈０．０１）,高频差异更大。表明聋儿听敏度特别是高频的听敏度有提高。     

小儿助听器验配

RECD测量的优点：整个RECD测量过程，包括系统设置的过程，不超过5分钟，而真正在儿童真耳上的给声过程只有几秒，大大缩短了要求儿童配合的时间。同时，由于是通过插入式耳机给声，即使儿童头和身体晃动也对测量不产生影响，克服了传统的探管麦克风在声场测量时儿童最易产生的偏差，对儿童的配合要求不高，90％的儿童在初次测试时就能测得RECD。而且RECD的重复性较好，在整个儿童助听器选配过程中，只需完成一次RECD的测量，就可将助听器选择及验证过程中的真耳电声学测量转化到无须儿童参与的、便于控制的2cc耦合腔中来完成。RECD的应用使得对6月龄以下聋儿的真耳选配也成为可能。     

周岁内聋儿的助听器验配

目的：探讨耳聋婴儿助听器验配的方法。方法：3个月以内的小儿，可通过观察在适宜声刺激下，听性反射动作的出现与否来判断助听器验配的效果；3个月以上的小儿，主要通过观察患儿的声定位反应来确定助听器验配的适合度。结果：凡在周岁以内验配了助听器的小儿，其言语康复的效果均优于同龄的周岁以后验配助听器的小儿，其中已进入正常幼儿园和小学的小儿，言语交流几乎没有障碍。结论：本文提出的助听器验配方法适合于周岁内听力障碍的聋儿。     

2635例助听器验配情况分析

目的:调查具备助听器适应证的患者未成功验配助听器的原因。方法:回顾性分析2005-2010年2 635例患者验配助听器的资料,对其中助听器验配未验成功者的数据进行分析。结果:2 635例患者中,1 700例成功验配了助听器,验配总成功率为64.52%,验配成功率总体变化趋势为逐年上升。对935例助听器验配失败患者的数据分析结果表明,在影响助听器成功验配的众多因素中,经济因素所占比例最大(23.64%),其次是患者不接受助听器(18.61%),对专业机构的认可度及满意度(10.27%),此外患者对助听器效果不满意占8.13%。听力专科门诊的验配成功率要高于普通耳鼻咽喉科门诊(P<0.05)。935例助听器验配失败的患者中年龄≥50岁者有568例;<50岁者助听器验配成功率(61.29%)低于≥50岁者(66.33%),差异有统计学意义(P<0.05)。结论:针对经济因素、患者对助听器的接受程度、验配机构专业性等诸多影响助听器成功验配的重要因素,在日常工作中,助听器验配人员需要针对性地开展工作,包括加大听力康复知识的宣传力度和提高自身的专业素质和水平。只有这样,才能有效增进患者对助听器验配人员和助听器本身的信任,有效提高助听器验配成功率。     

真耳介入增益法在聋儿助听器验配中的应用

真耳介入增益法是助听器常用的验配方法之一。本文应用 NAL -R、2 / 3增益公式 ,对感音神经性耳聋听力损失程度为严重聋和极度聋的聋儿 ( 1 5人 3 0只耳 ) ,进行了助听器验配 ,并对不同频率上的目标增益值、真耳介入增益值方面进行了比较 ,探索适合于这类患者的最佳预选公式。结果发现助听效果最好的是 2 / 3增益公式 ,助听效果最差的是 NAL-R公式 ,但在应用时要强调个体化。     

改良Contour试验测试正常听力与感音神经性听力损失儿童响度增长

目的 应用改良Contour试验测试听力正常与感音神经性听力损失儿童的响度增长,探讨改良Contour试验的临床应用价值.方法 对26例(26耳)听力正常儿童、25例(25耳)感音神经性听力损失儿童采用临床对照试验用改良Contour试验进行响度测试.在初测2～3周后进行复测.采用多因素方差分析进行统计学分析.结果 在听力正常组、不同程度听力损失组间(F=1386.32,P值＜0.001)及不同响度分级间(F=682.21,P＜0.001)响度的差异均有统计学意义.听力正常组与听力损失组动态范围间差异有统计学意义(F=214.26,P＜0.001).感音神经性听力损失儿童响度增长特征:听力损失越重,响度增长越快,动态范围越小.听力正常组与听力损失组初复测结果高度相关(r值分别为0.97和0.91),可信度较高.结论 儿童助听器验配应尽可能获取个体的响度测试结果以帮助助听器调试到最适合该患儿使用.改良Contour试验易为儿童接受、可靠性好,值得进一步研究用于临床,以帮助提高助听器验配质量.     

Prediction of the use of conventional hearing aids in Korean adults with unilateral hearing impairment

Objective: To determine the use of a hearing aid at six months post-fitting and to evaluate the predictors of its ongoing use in Korean adults with unilateral hearing impairment (HI). Design: Retrospective study at a secondary referral hospital over a 15-year period. Study sample: This study analysed 119 adults with unilateral HI who had been recommended for hearing amplification (55 men and 64 women, mean age, 58.0 ± 11.7 years). Six months after the fitting, all of the participants were surveyed regarding subsequent decisions and actions about obtaining hearing aids. Results: General uptake rate for a hearing aid was 68.1% (58.0% of participants surveyed were successful users, and 10.1% were intermittent users). The most significant parameter associated with hearing-aid use was social and/or work activities (R² = 0.457), and the significant predictors for successful hearing-aid use were social and/or work activities and method of signal processing (discriminatory power = 56.3%). Conclusions: Six months post-fitting, 68.1% of Korean adults with unilateral HI who had agreed to try a hearing aid continued to use it regularly. The predictors for hearing-aid use six months post-fitting included social and/or work activities and digital signal processing.     

移频助听器在极重度听力损失耳中的应用

目的本研究通过为极重度听力损失的儿童验配移频助听器并跟踪其语言训练结果,分析配戴移频助听器后的听力语言康复效果。方法为20位(3～16岁)儿童验配移频助听器,经过18个月跟踪随访观察,评价其配戴移频助听器前后的声母听辨能力、发音能力、口语清晰度和对话难易程度。结果通过强化听辨训练,这20位听障儿童在听辨能力及语言清晰度上得到了明显提高。结论移频助听器可明显提高极重度听力损失耳的听辨能力和语训效果。     

Children with hearing impairment--living with cochlear implants or hearing aids

Objective

The aim of this study was to enhance knowledge about the life circumstances of children with cochlear implants or hearing aids, regarding daily functioning and attitude to the impairment.

Methods

Data were obtained from 36 children with cochlear implants and 38 children with hearing aids via study-specific questionnaires with fixed answer alternatives. The questions covered (1) usage of aids and related factors, (2) hearing in different everyday situations, (3) thoughts about the children's own hearing and others’ attitudes to it, and (4) choice of language. The data were analyzed using SPSS, and presented via the theoretical frame of the International Classification of Functioning, Disability and Health, Child and Youth version (ICF-CY).

Results

Children with CI and HA functioned equally well in daily life, but there were also certain differences. Symptoms from neck and shoulders were more common among children with hearing aids than among children with cochlear implants (p < .001). Children with hearing aids used their aids significantly less often than those with cochlear implants (p < .001). The participation variables showed that children with hearing aids had significantly more hearing problems in team sports (p = .033) and outdoor activities (p = .019), in comparison to children with cochlear implants. The two groups had similar thoughts regarding their own hearing, mostly considering it not to be a problem. They also did not generally think that other people found their hearing to be a problem.

Conclusions

Children with cochlear implants and children with hearing aids have, in some aspects, equally good functioning in everyday life situations. However, certain differences were found in dimensions of functioning, regarding neck and shoulder pain, usage of aids and sign language, and hearing problems in some activities.     

A comparison of the consonant production between Dutch children using cochlear implants and children using hearing aids

Objectives

The main purpose of the present study was to compare the consonant error patterns of Dutch prelingually deaf CI children with prelingually hearing-impaired hearing aid (HA) children. The authors hypothesized that subjects using conventional hearing aids would have poorer consonant production skills. Additionally, the impact of the age at implantation (CI) and the degree of hearing loss (HA) was determined.

Methodology

This is a comparative study of 29 prelingually deaf CI children (m.a. 9;0 y) and 32 prelingually hearing-impaired HA children (m.a. 9;11 y) who received their first hearing aid before the age of 2 years. Nineteen CI children were implanted before the age of 5 years. Nine HA children had thresholds above 90 dB (range: 91-105 dB), 15 between 70 and 90 dB (range: 72-90 dB) and 8 below 70 dB (range: 58-68 dB). Speech samples of all the children were elicited by means of a picture naming test and were video-recorded for further phonetic and phonological analysis.

Results

Considerably more phonetic and phonologic errors were observed in the HA children with thresholds above 70 dB (range: 72-105 dB). No notable differences could be found between deaf CI children and HA children with thresholds below 70 dB. Even children implanted after the age of 5 years showed significantly fewer phonetic and phonological errors than HA children.

Conclusion

The consonant production of implanted children is more adequate than the consonant production of HA children with a hearing loss of 70 dB or more. In addition, the results also indicate that even after the age of 5 years, implantation can still have an advantageous effect on a child's consonant production.     

老年人重度和极重度聋双耳助听效果评价

目的评价老年人重度和极重度聋双耳助听效果。方法比较单耳和双耳助听后的言语识别率。结果　单耳助听后的言语识别率,单音节词为７７．５３±２．０７％,双音节词为８６．８２±４．３６％。双耳助听后的言语识别率,单音节词为８６．４７±１．８７％,双音节词为９１．６５±２．１８％。双耳助听效果显著优于单耳。结论双耳助听不仅可显著改善言语分辨能力,而且可使声源定向能力亦获显著改善。非常适合双耳重度和极重度聋的老年人。     

听障儿童助听器效果评估方法的一致性分析

目的对听障儿童的助听器效果评估方法进行一致性分析。方法为北京及广西400名听障儿童验配助听器,在验配后（初期）、助听器配戴1个月（中期）、助听器配戴3个月（末期）分3次进行多项助听器效果评估,分析各项评估方法之间的相互关系。结果各种评估方法随着助听器配戴的时段变化呈现出逐步增长的一致性趋势,各时段之间均有显著性差异。末期的各项测试结果两两之间存在正相关性,初期助听昕阈和Ling’s六音测试结果与末期家长、教师助听器问卷结果之间也相互呈正相关性,相关系数都处在低至中相关性之间。结论各项评估方法在助听器效果评价上是一致的,通过初期验配时的满意度可以预测将来实际应用的满意度,但各种评估方法之间存在差异,无法相互替代。