Efficacy of Music Training in Hearing Aid and Cochlear Implant Users: A Systematic Review and Meta-Analysis

This study aimed to evaluate the efficacy of music training on the improvement of musical perception among hearing-impaired listeners using a systematic review and meta-analysis. Article search was conducted from five databases, Scopus, ScienceDirect, Web of Knowledge, CINAHL, and PubMed. A total of 186 participants from 10 studies investigating the music training effects on individuals fitted with hearing assistive devices and outcome measurements were included. The meta-analysis showed standardized mean difference as a measure of the effect size, in musical improvement between the preand post-training. Although the funnel plot yielded an asymmetrical graph, the Egger’s regression showed no significant publication bias. Interestingly, subgroup analysis showed that the training effect was greater in children than in adults. With a necessity of longer training period to significantly improve their musical perception, cochlear implant only users had better effect compared to bi-modal users with both cochlear implant and hearing aids. However, the difference in the training effect between the users with and without previous musical experience was nonsignificant. The present study concludes that auditory music training brings hearing-impaired listeners into better musical perception while informing that training effects differ depending on age, duration of the training, and the type of hearing device used.     

药物治疗突发性聋的前瞻性疗效观察

对64例突发性聋随机分四组，分别用脉络宁、复方丹参、腹蛇抗栓酶及泛影葡胺，联合多种药物治疗。结果显示各组治疗的有效率无明显差异P＞0．05，但显效率差异显著P＜0．05．使用脉络宁、复方丹参、腹蛇抗栓酶三组对听力改善的程度较泛影葡胺组好。     

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...     

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.     

Benefit From Directional Microphone Hearing Aids: Objective and Subjective Evaluations

Objectives

The aims of this study were to find and compare the effect of directional (DIR) processing of two different hearing aids via both subjective and objective methods, to determine the association between the results of the subjective and objective evaluations, and to find out individual predictive factors influencing the DIR benefit.

Methods

Twenty-six hearing aid users fitted unilaterally with each two different experimental hearing aid performed modified Korean Hearing in Noise Test (K-HINT) in three DIR conditions; omnidirectional (OMNI) mode, OMNI plus noise reduction feature, fixed DIR mode. In order to determine benefits from DIR benefit within a hearing aid and compare performance of the DIR processing between hearing aids, a subjective questionnaire was administrated on speech quality (SQ) and discomfort in noise (DN) domain. Correlation analysis of factors influencing DIR benefit was accomplished.

Results

Benefits from switching OMNI mode to DIR mode within both hearing aids in K-HINT were about 2.8 (standard deviation, 3.5) and 2.1 dB SNR (signal to ratio; SD, 2.5), but significant difference in K-HINT results between OMNI and OMNI plus noise reduction algorithm was not shown. The subjective evaluation resulted in the better SQ and DN scores in DIR mode than those in OMNI mode. However, the difference of scores on both SQ and DN between the two hearing aids with DIR mode was not statistically significant. Any individual factors did not significantly affect subjective and objective DIR benefits.

Conclusion

DIR benefit was found not only in the objective measurement performed in the laboratory but also in the subjective questionnaires, but the subjective results was failed to have significant correlation with the DIR benefit obtained in the K-HINT. Factors influencing individual variation in perceptual DIR benefit were still hard to explain.     

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。     

Vowel Perception in Listeners With Normal Hearing and in Listeners With Hearing Loss: A Preliminary Study

ObjectivesTo determine the influence of hearing loss on perception of vowel slices.MethodsFourteen listeners aged 20-27 participated; ten (6 males) had hearing within normal limits and four (3 males) had moderate-severe sensorineural hearing loss (SNHL). Stimuli were six naturally-produced words consisting of the vowels /i a u æ ɛ ʌ/ in a /b V b/ context. Each word was presented as a whole and in eight slices: the initial transition, one half and one fourth of initial transition, full central vowel, one-half central vowel, ending transition, one half and one fourth of ending transition. Each of the 54 stimuli was presented 10 times at 70 dB SPL (sound press level); listeners were asked to identify the word. Stimuli were shaped using signal processing software for the listeners with SNHL to mimic gain provided by an appropriately-fitting hearing aid.ResultsListeners with SNHL had a steeper rate of decreasing vowel identification with decreasing slice duration as compared to listeners with normal hearing, and the listeners with SNHL showed different patterns of vowel identification across vowels when compared to listeners with normal hearing.ConclusionAbnormal temporal integration is likely affecting vowel identification for listeners with SNHL, which in turn affects vowel internal representation at different levels of the auditory system.     

对侧助听器对人工耳蜗使用者言语感知贡献研究

目的探讨讲汉语普通话的人工耳蜗(Cochlear Implantation,以下简称CI)使用者对侧佩戴助听器(Hearing Aid,以下简称HA)的获益。方法:选取对侧使用HA的14名母语为汉语普通话的CI使用者,分别测试其在使用CI和CI+HA(即双模式)两种助听模式下的声调、双音节词、及句子的识别表现,并分析助听器耳残余听力对双模式言语表现的影响。结果:安静环境下使用CI和CI+HA模式下的声调识别率分别为67.6%±10.5%、71.6%±12.5%,双音节词识别率分别为72.3%±21.8%、74.2%±23.3%,句子识别率分别为62.3%±28.3%、61.8%±31.3%,噪声环境句子识别率分别为37.6%±36.5%、42.4%±35.9%。统计分析发现声调识别表现在CI+HA模式下显著优于CI模式(t=-2.285,P=0.04),其余言语识别表现在两种聆听模式下均无显著差异;且1000Hz及以下频率的助听器耳残余听力与CI+HA模式下言语识别表现显著相关。结论::对于"大龄"语前聋患者,一侧人工耳蜗植入联合对侧助听器的双模式应用,需考虑助听器耳的残余听力情况,极重度感音神经性聋助听器辅助效果有限,必要时需考虑双侧人工耳蜗植入。     

儿童听力言语康复分类训练及评估的汉语视听系统素材编制

目的 根据儿童听力损失程度和听力言语发育水平为其提供循序渐进的听力言语康复训练.方法训练素材由易到难进行设计,按照汉语语音学规律分为字词长短、声调辨别、元音辨别和辅音辨别四个难度不同的部分.结果系统词表包括练习、筛选测试及训练三部分,共21张,其中练习词表1张,筛选测试词表4张,训练词表16张.结论系统素材编制遵从汉语语音学规律,同时依据儿童听力言语发育水平及听力损失水平进行,从而能够适用于不同听力损失程度及训练水平的患儿.     

助听器对耳鸣的治疗作用

目的探讨助听器对耳鸣的治疗作用。方法对20例伴有听力下降、病程在1年以上的耳鸣患者,观察配戴助听器至少6个月后耳鸣的变化情况。结果20例耳鸣患者中痊愈3例(15%),显效5例(25%),有效7例(35%),无效5例(25%),总的有效率为75%(15/20)。每天使用助听器超过4个小时的患者有效率为90.9%,而每天使用时间少于4个小时的患者有效率为55.6%,二者差异有统计学意义(P<0.05)。结论对于伴有听力下降的耳鸣患者,配戴助听器不仅能够补偿听力,而且对耳鸣也有治疗作用,每天较长时间配戴助听器的患者疗效更明显。     

Results of Active Middle Ear Implantation in Patients With Mixed Hearing Loss After Middle Ear Surgery: A Prospective Multicenter Study (the ROMEO Study)

ObjectivesThis study was conducted to evaluate the user satisfaction, efficacy, and safety of round window (RW) vibroplasty using the Vibrant Soundbridge (VSB) in patients with persistent mixed hearing loss after mastoidectomy.Methods The study included 27 patients (mean age, 58.7 years; age range, 28–76 years; 11 men and 16 women) with mixed hearing loss after mastoidectomy from 15 tertiary referral centers in Korea. The VSB was implanted at the RW. The Korean translation of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire and the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire were used to evaluate user satisfaction as the primary outcome. The secondary outcome measures were audiological test results and complication rates.ResultsThe mean scores for ease of communication (61.3% to 29.7% to 30.2%), reverberation (62.1% to 43.1% to 37.4%), and background noise (63.3% to 37.7% to 34.3%) subscales of the APHAB questionnaire significantly decreased after VSB surgery. The mean K-IOI-HA scores at 3 and 6 months after surgery were significantly higher than the mean preoperative score (18.6 to 27.2 to 28.1). The postoperative VSB-aided thresholds were significantly lower than the preoperative unaided and hearing aid (HA)-aided thresholds. There was no significant difference between preoperative unaided, preoperative HA-aided, and postoperative VSB-aided maximum phonetically balanced word-recognition scores. None of the 27 patients experienced a change in postoperative bone conduction pure tone average. One patient developed temporary facial palsy and two developed surgical wound infections.ConclusionRW vibroplasty resulted in improved satisfaction and audiological test results in patients with mixed hearing loss after mastoidectomy, and the complication rate was tolerable.     

A Follow-up Study of Patients Suffering from Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss (S-SNHL) is a common problem with a high recovery rate. However, little is known of the long-term prognosis of affected patients. The purpose of this follow-up study was to evaluate the long-term hearing results of S-SNHL patients. The sample consisted of 168 patients with S-SNHL treated with carbogen inhalation and or anticoagulant therapy during the period 1982-89. A questionnaire was sent to these patients, and audiological investigations were carried out in a selection of these patients in 1997. Comparison of the different treatment methods showed that the difference observed in improvement of hearing was statistically significant between the carbogen inhalation and anticoagulant treatment groups. The hearing improvement achieved was stable for, on average, 8 years of follow-up. During the follow-up period, Ménière's disease was diagnosed in only 1 of the 116 patients who answered the questionnaire and no cases of acoustic neurinoma were diagnosed, indicating that establishment of a careful patient history and clinical and audiological investigations are sufficient for the diagnosis of S-SNHL. In general, the hearing improvement achieved in S-SNHL patients is stable during long-term follow-up.     

Defibrinogenation Therapy for Idiopathic Sudden Sensorineural Hearing Loss in Comparison with High-dose Steroid Therapy

Objective--The efficacy of defibrinogenation therapy for idiopathic sudden sensorineural hearing loss was studied in comparison with high-dose steroid therapy.

Material and methods--Eighty-eight consecutive patients with hearing levels &gt;40 dB and who had suffered hearing loss for ≤30 days were enrolled: 40 patients for high-dose steroid therapy (PSL group) and 48 for defibrinogenation therapy (BX group). Hearing recovery was evaluated by grade assessment and by the improvement in hearing compared to the unaffected contralateral ear.

Results--The overall hearing outcomes of the two groups were roughly equivalent. However, with regard to patients with initial hearing levels &lt;80 dB, the hearing improvement rate of the BX group was significantly worse than that of the PSL group (61.2%±7.3% vs 88.7%±8.9%; p&lt;0.05), whereas in patients with initial hearing levels ≥80 dB, the hearing outcomes did not differ between the 2 groups. Three patients in the PSL group manifested hyperglycemia while no serious side-effects were observed in the BX group.

Conclusion--These results indicate that high-dose steroid therapy should be employed in preference to defibrinogenation therapy for patients with moderate hearing loss, whereas defibrinogenation therapy has an advantage for those with severe hearing loss, in view of its lower frequency of side-effects.     

Evaluation of Speech-Perception Training for Hearing Aid Users: A Multisite Study in Progress

Following an overview of theoretical issues in speech-perception training and of previous efforts to enhance hearing aid use through training, a multisite study, designed to evaluate the efficacy of two types of computerized speech-perception training for adults who use hearing aids, is described. One training method focuses on the identification of 109 syllable constituents (45 onsets, 28 nuclei, and 36 codas) in quiet and in noise, and on the perception of words in sentences presented in various levels of noise. In a second type of training, participants listen to 6- to 7-minute narratives in noise and are asked several questions about each narrative. Two groups of listeners are trained, each using one of these types of training, performed in a laboratory setting. The training for both groups is preceded and followed by a series of speech-perception tests. Subjects listen in a sound field while wearing their hearing aids at their usual settings. The training continues over 15 to 20 visits, with subjects completing at least 30 hours of focused training with one of the two methods. The two types of training are described in detail, together with a summary of other perceptual and cognitive measures obtained from all participants.     

正常听力受试者佩戴不同组合全向性与方向性麦克风的效果比较

目的 比较噪声环境下全向性麦克风与自适应方向性麦克风的不同组合佩戴方式对听力正常成年人言语识别率的影响,从而选择最佳的组合佩戴方式.方法 选择20例(40耳)听力正常青年人(男、女各10例)分别按照双耳全向性麦克风模式(组合1),双耳自适应方向性麦克风模式(组合2),一耳全向性麦克风、一耳自适应麦克风模式(组合3)3种方式,在信噪比变化的漫射声场中进行言语识别率测试,从而进行助听效果的评估.结果 组合1、2、3三种方式测出的L50值(50%言语识别率的信噪比)分别为-3.55±2.37 dB,-7.15±2.18 dB,-5.40±2.35 dB,三者之间两两比较差异均有显著统计学意义(P<0.05).结论 噪声环境下无论双耳佩戴自适应方向性麦克风模式还是一耳佩戴自适应方向性麦克风、另一耳佩戴全向性麦克风,其言语识别能力均高于双耳佩戴全向性麦克风模式,且双耳佩戴自适应方向性麦克风模式的言语识别率高于一耳自适应麦克风、一耳全向性麦克风模式.     

儿童突发性感音神经性听力损失的诊治体会

对18例20耳8～14岁突发性感音神经性听力损失患儿的临床资料进行了总结和分析,结果表明儿童突发性感音神经性听力损失发病与首诊之间病程较长,部分患儿有上感、流行性腮腺炎病史,可能和听力损失发生有关.儿童突发性感音神经性听力损失治疗效果类似于成人患者,而全聋者疗效差.东菱克栓酶同样适于治疗儿童突发性感音神经性听力损失且疗效和安全性较好,无明显的出血倾向和其它并发症.     

听力相关疾病成人患者的年龄因素分析

目的对因听力相关疾病就诊的成人患者年龄因素进行分析,了解听力损失年龄分布特征,为听力损失的预防及干预策略的制定提供依据。方法对首都医科大学附属北京同仁医院临床听力学中心2009年6月1日至2009年8月31日因听力相关疾病就诊的3 018例成人患者的年龄分布进行分析,并比较不同听力损失程度、听力损失类型、听力曲线类型的年龄分布特征。结果①患者年龄分布集中于41~60岁,占全体就诊患者的44.70%;②除正常听力外,轻度、中度、重度和极重度听力损失分布比例最高的年龄范围均为51~60岁;③传导性听力损失主要分布在低年龄范围,感音神经性和混合性听力损失分布比例最高的年龄范围均为51~60岁;④陡降型听力损失分布比例最高的年龄范围为51~60岁,平坦型和"U"型听力损失在60岁以下呈均衡分布。结论成人听力损失在程度、类型及听力曲线类型上均呈现出明显的年龄分布特征,感音神经性及混合性听力损失及听阈曲线为陡降型者以51~60岁年龄段为多见。     

宁夏地区助听器康复救助项目受助者适配效果分析

目的调查分析宁夏地区136例听障患者发放助听器后的配戴效果,了解使用助听器情况及影响因素,为听障患者助听器验配及项目执行提供参考依据。方法通过询问病史,进行耳内镜检查、纯音听力测试,了解患者听力损失程度及听阈曲线类型,为患者进行助听器验配,采用助听器效果国际性调查问卷(the international outcome inwentory for hearing aids,IOI-HA)通过面对面问答或电话随访的方式进行助听器效果评价,比较不同配戴时间、听力损失程度、听阈曲线类型助听器IOI-HA的得分。结果118例(86.76%)助听器使用者认为配戴助听器后对生活有中等程度以上的帮助;130例(95.6%)助听器使用者认为使用助听器后生活满意度有中等及以上提高;每天使用时间及参与社会活动时仍存在的困难不同年龄段之间的平均得分不同,且差异具有统计学意义(P<0.05),随着年龄的增加,以上两个项目的平均得分逐渐减少;不同文化程度、听力损失程度、听阈曲线图类型的听力障碍患者配戴助听器使用效果组间差异无统计学意义。结论助听器使用者对配发的助听器总体较为满意,使用情况良好;助听器使用时,还要大力提倡坚持配戴、及早干预;加强对助听器配戴者回访的管理,对于助听器使用中的不足与问题应及时调试。