陡降型听力曲线者助听器选配效果观察

目的 为陡降型听力曲线的听障者选配助听器，使其能听清楚高频的声音。方法 听障者配戴助听器前和配戴普通线性放大助听器、多通道全数字电脑编程助听器后进行助听听阈、声源觉察率测试，并分别进行比较。结果 听障者配戴普通线性放大助听器与没有配戴助听器时助听效果没有明显差异；配戴多通道全数字电脑编程助听器和配戴普通线性放大助听器助听听阈在高频区有显著性差异，在对低频的正常耐受下大幅度补偿高频，从而助听听阈接近正常。结论 陡降型听力曲线听障者配戴多通道全数字电脑编程助听器，经过多次调整，对高频部分的听敏度有大幅度的提高。     

Advantages of Binaural Amplification to Acceptable Noise Level of Directional Hearing Aid Users

Objectives

The goal of the present study was to examine whether Acceptable Noise Levels (ANLs) would be lower (greater acceptance of noise) in binaural listening than in monaural listening condition and also whether meaningfulness of background speech noise would affect ANLs for directional microphone hearing aid users. In addition, any relationships between the individual binaural benefits on ANLs and the individuals'' demographic information were investigated.

Methods

Fourteen hearing aid users (mean age, 64 years) participated for experimental testing. For the ANL calculation, listeners'' most comfortable listening levels and background noise level were measured. Using Korean ANL material, ANLs of all participants were evaluated under monaural and binaural amplification with a counterbalanced order. The ANLs were also compared across five types of competing speech noises, consisting of 1- through 8-talker background speech maskers. Seven young normal-hearing listeners (mean age, 27 years) participated for the same measurements as a pilot testing.

Results

The results demonstrated that directional hearing aid users accepted more noise (lower ANLs) with binaural amplification than with monaural amplification, regardless of the type of competing speech. When the background speech noise became more meaningful, hearing-impaired listeners accepted less amount of noise (higher ANLs), revealing that ANL is dependent on the intelligibility of the competing speech. The individuals'' binaural advantages in ANLs were significantly greater for the listeners with longer experience of hearing aids, yet not related to their age or hearing thresholds.

Conclusion

Binaural directional microphone processing allowed hearing aid users to accept a greater amount of background noise, which may in turn improve listeners'' hearing aid success. Informational masking substantially influenced background noise acceptance. Given a significant association between ANLs and duration of hearing aid usage, ANL measurement can be useful for clinical counseling of binaural hearing aid candidates or unsuccessful users.     

双耳双模式助听儿童情感语调感知特征

目的探讨单侧人工耳蜗植入儿童对侧配戴助听器能否提升其情感语调识别能力,不同的情绪语调识别是否存在难度差异。方法选取35例(男15例,女20例)双耳双模式助听的重度、极重度感音神经性听力损失儿童,组内比较单侧人工耳蜗助听状态和双模式助听两种状态下儿童的情感语调识别特征。结果双耳双模式助听状态下听障儿童的语调得分极显著高于单侧人工耳蜗助听状态(P<0.01),识别率总体提升了16.65%。开心语调提升了20.59%,生气语调提升了19.21%,难过语调提升了13.23%。个体数据分析发现,有82.85%的儿童体现出双耳双模式优势。两种助听状态下,生气语调识别得分显著高于开心和难过(P<0.05),双耳双模式助听状态下,23.53%的儿童会将开心感知为难过语调,22.79%的儿童会将难过感知为开心语调。结论相比于单侧人工耳蜗植入,儿童通过双模式助听可以获得情感语调感知优势;两种助听模式下,生气语调的识别均比开心和难过容易,开心和难过语调容易混淆。频率变化可能是儿童感知情感语调的重要线索,提示在康复训练中应予以重视。     

A Contemporary Review of Hearing Aids

A contemporary review of hearing aids is provided with a focus on current styles of amplification devices, the goals of a hearing aid fitting and the signal processing schemes that allow the clinician to meet these goals, and the need to couple outside devices to hearing aids. A variety of new features available on hearing aids that improve the listener's experience with amplification are described. Some future challenges in hearing aid design and hearing evaluation are presented.     

Effect of Hearing Aids on Psychosocial Dysfunctioning

The perception of communication abilities amongest adolescents with moderate and profound hearing loss was correlated with indices of psychosocial adjustment. This was done to determine whether the use of hearing aids could play a role in presence and improvement of psychosocial functioning among acquired hearing loss persons after the use of hearing aids. Amongest the deaf population, it was found that hearing loss did affect the social, the vocational, the personal and subjective well being, after intervention. The control group did not show any corresponding change except that the state anxiety among this group had increased.     

A Comparison of Hearing Aids with Amplitude Compression

Intelligibility scores with a modified rhyme test were obtained for normally hearing subjects and subjects with sensorineural hearing impairment using several commercial hearing aids. These hearing aids differed mainly in values of time constants of compression and of harmonic distortion during overshoots. In general, better performance was obtained for the shorter time constants of compression, but performance seemed also to be affected by the occurrence of higher levels of harmonic distortion and of peak-clipping during overshoots.     

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     

Verification of Improved Patient Outcomes With a Partially Implantable Hearing Aid,The SOUNDTEC Direct Hearing System

Introduction Partially implantable hearing devices have been developed to address some of the user‐perceived shortcomings of standard amplification systems. Partially implantable devices are purported to provide improved sound quality as a result of decreased occlusion, decreased feedback, and enhanced clarity resulting from increased high‐frequency gain. Such improvements may result in greater user satisfaction. To justify selection of a partially implantable device and undergoing a minor surgical procedure, verification techniques must be used to document user improvement or increased satisfaction over conventional amplification. Objective To evaluate patient satisfaction with the SOUNDTEC direct hearing system. Study Design Within‐subjects repeated measures design. Methods Objective and subjective evaluation pre‐ and post‐implantation with the SOUNDTEC device. Verification techniques included tonal functional gain measures with traditional amplification and the SOUNDTEC device, word recognition in quiet (NU‐6) and in noise (SPIN), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Hough Ear Institute Profile (HEIP). Results Although there was no significant difference between optimal traditional amplification and the SOUNDTEC device for speech perception measures, the SOUNDTEC device yielded statistically significant increased high‐frequency functional gain. Subjective reports indicated that the SOUNDTEC device provides a cleaner, more natural sound without feedback than traditional amplification. Conclusions Partially implantable hearing aids may address some of the limitations of traditional amplification systems.     

113例聋儿的助听及言语发育调查分析

目的了解0~6岁聋儿的助听、言语发育及交流情况。方法自制调查问卷表,随机对2005年2~5月在北京同仁医院耳科门诊就诊的113例双侧听力损失儿童的助听、语训、言语发育及交流能力等进行调查,并对相关数据作统计学分析。结果113例中助听器佩戴者85例(75.22%),其中,助听后语训者占51.76%(44/85),助听后无语训者占48.24%(41/85),无助听无语训者28例,占24.78%(28/113);无助听无语训者中重度聋以上23例,占82.14%(23/28)。70%的中度聋儿存在构音障碍和言语交流障碍;重度和极重度聋儿中,97.03%存在构音障碍,88.12%有不同程度的言语障碍和交流障碍。结论中-重度聋以上聋儿,无助听和无语训比例偏高,言语障碍和交流障碍较明显。加强聋儿家长对佩戴助听器和言语训练必要性的宣传和教育具有非常重要和深远的意义。     

助听器验配中非听力因素的研究

科技的进步仍然不能解决助听器验配的所有问题。很多耳聋患者主观拒绝配戴助听器,或者“配而不用”,主要是由于非听力学因素的影响,包括配戴者的精神心理、外界支持及社会状态等。本文从上述几个方面重点介绍非听力学因素的影响。     

Presbyacusis,Hearing Aids and Aging

This paper considers the factors of presbyacusis and age-related psychological changes in older adults in terms of their effects on the use or potential use of hearing aids as a means of improving aural communication. Data are presented on the prevalence of hearing impairment and the extent of hearing aid use in aging listeners. Four major classes of presbyacusis are described (sensory, neural, metabolic, and cochlear conductive) and a hearing aid prognosis is made for each type of disorder. It is shown that aging produces deficits in pure-tone thresholds, the speech reception threshold, and speech discrimination, but not all losses can be 'corrected' with a hearing aid. Binaural (stereophonic) devices are psychoacoustically superior to monaural devices; however, behavioral and personality changes in older patients often create problems of adaptation to the binaural aid. These changes may also affect the fitting of an aid and the patient's ability to learn to use it. Some practical suggestions are offered on the evaluation of hearing aids and it is emphasized that adequate orientation and counseling are typically required if hearing aid treatment is to be successful in presbyacusis.     

语前聋儿童佩戴助听器后塞音发音特点

目的分析听力障碍患儿佩戴助听器后塞音的发音特点。方法以佩戴助听器的语前聋患儿30例(助听器组)和健听儿童30例(健听组)为研究对象,年龄3~6岁(分为3~、4~、5~6岁组,每组2类儿童各10例),日常均使用汉语普通话交流,具备一定的发音能力。以塞音词表进行测试,分析两组儿童塞音(/b/、/d/、/g/、/p/、/t/、/k/)的发音正确率和错误类型,分析不同生理年龄、助听时间与发音正确率的关系。结果助听器组儿童塞音发音的正确率从高到低为/b/>/d/>/g/>/k/>/t/>/p/,健听组儿童塞音发音的正确率从高到低依次为/b/>/g/>/k/>/p/>/d/>/t/;健听组儿童塞音/b/、/g/、/k/、/t/、/p/的正确率显著高于助听器组儿童(P<0.05)。助听组儿童发音错误规律包括:①发音方法相同的音互相替代,如不送气塞音的互相替代和送气塞音的互相替代;②发音部位相同的音互相替代;③发音方法和发音部位不同的替代,如:塞音擦音化,塞音塞擦音化,不送气化。4~、5~6岁组听障儿童塞音/g/、/p/、/k/发音的正确率明显高于3~岁组(P<0.05),助听器佩戴时间大于2年的听障儿童塞音/p/、/t/发音的正确率明显高于小于2年的儿童(P<0.05)。结论听障儿童塞音发音清晰度落后于健听组儿童,生理年龄、听觉干预的时间对听障儿童部分塞音发音的正确率有影响,需进行积极的干预和有针对性的康复训练。     

Binaural masking level difference for pure tone signals

The binaural masking level difference (BMLD) is a psychoacoustic method to determine binaural interaction and central auditory processes. The BMLD is the difference in hearing thresholds in homophasic and antiphasic conditions. The duration, phase and frequency of the stimuli can affect the BMLD. The main aim of the study is to evaluate the BMLD for stimuli of different durations and frequencies which could also be used in future electrophysiological studies. To this end we developed a GUI to present different frequency signals of variable duration and determine the BMLD. Three different durations and five different frequencies are explored. The results of the study confirm that the hearing threshold for the antiphasic condition is lower than the hearing threshold for the homophasic condition and that differences are significant for signals of 18ms and 48ms duration. Future objective binaural processing studies will be based on 18ms and 48ms stimuli with the same frequencies as used in the current study.     

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。     

Head Diffraction Effects on Ear-Level Hearing Aids

In this paper, head baffle and head shadow effects were measured at a front-oriented and at a back-oriented micro-phone in a hearing aid casing when worn by human subjects and when placed on a dummy head. Some differences in head baffle and head shadow effects were observed for the front- and back-oriented microphones in that greater head baffle effects were observed at the front microphone than at the back microphone while the reverse was true in terms of head shadow effects. Results obtained with the hearing aid mounted on a dummy head were similar in some respects and in other respects they differed from those observed when the hearing aid was worn by six subjects. Comparison of the results obtained in this study with the data of Wiener measured at the entrance to the ear canal indicated smaller head baffle effects but larger head shadow effects at the hearing aid microphone than at the canal entrance. Finally, it is suggested that reproduction of frequencies above 2000 Hz and that a resonance peak at about 3000 Hz in the frequency response curve of a hearing aid may be beneficial to the wearer     

影响老年听障患者助听器验配满意度的相关因素分析

目的探析影响老年听力障碍患者助听器配戴满意度的相关因素。方法收集我院2017年8月~2020年9月100例配戴助听器老年听障患者,利用日常生活助听满意度量表(the satisfaction with amplification indaily life,SADL)对患者助听满意度情况进行评估,并根据年龄、性别、学历等进行分组,完成单因素分析后进行多因素相关性分析。结果SADL积极作用评分方面,听力损失<61 dB、双耳配戴、高中及以上学历、每日配戴时长≥8 h、无认知功能障碍者显著高于听力损失≥61 dB、单耳配戴、高中以下学历、每日配戴<8 h、有轻度认知功能障碍、耳背式者(P<0.05);服务价格评分方面,月收入≥5000元、高中及以上学历者显著高于月收入<5000元、高中以下学历者(P<0.05);负面作用评分方面,有轻度认知功能障碍、配戴时间≥1年者显著高于无轻度认知功能障碍、配戴时间<1年者(P<0.05);自我形象和外观评分方面,高中以下学历、配戴时间<1年者显著高于高中及以上学历、配戴时间≥1年者(P<0.05);总均分方面,听力损失<61 dB、无轻度认知功能障碍者显著高于听力损失≥61 dB、有认知功能障碍者(P<0.05)。结论影响老年听力障碍患者助听器配戴满意度的因素较多,包括学历、月收入、有无认知功能障碍等,需针对此类患者进行相应干预,以提高助听满意度。