双侧人工耳蜗植入者在噪声环境下的言语辨别能力

目的探讨双侧人工耳蜗植入患者的言语辨别能力.方法用2例双侧人工耳蜗植入者比较双侧与单侧人工耳蜗在不同信噪比下对广东话声调的辨别能力.结果在+15,+10和+5的信噪比下, 双侧人工耳蜗的平均能力为96%, 92%和88%, 而左耳及右耳单侧人工耳蜗的平均成绩为86%,83%和74%. 在0,-5,-10及-15的信噪比下,单侧人工耳蜗的平均能力近于0%,而双侧人工耳蜗的平均成绩为80%,72%,68%和54%.结论在不同信噪比下,双侧人工耳蜗植入更有助于提高对广东话声调的辨别能力. 进一步证明了双侧人工耳蜗植入患者运用双耳听力的优势.     

耳蜗植入可提高言语的识别能力

耳蜗植入可提高言语的识别能力ＢＳＷｉｌｓｏｎ，ＣＣＦｉｎｌｅｙ，ＤＴＬａｗｓｏｎ，ＲＤＷｏｌｆｏｒｔＤＫＥｄｄｉｎｇ，ＷＭＲａｂｉｎｏｗｉｔｚ采用具有最新声信息处理方案的多电极人工耳蜗可获得高水平的言语识别率。人工耳蜗植入系统由一个或多个植入电极组成...     

双侧人工耳蜗植入患者早期言语识别率的特点

目的 通过对两例双侧人工耳蜗植入患者早期言语识别率的分析,探讨双侧人工耳蜗植入对言语识别率的影响及中枢对双侧信号的处理机制。方法 2例先天性聋的双恻人工耳蜗植入的患儿参与测试。第二次植入术后一个月开机时,分别测定双耳、左耳、右耳对数字、单宇词、双字词的言语识别率。结果 新近植入侧单独开机时,各种方法下的言语识别率均为零。分别采用数字,单字词、双字词测试获得的言语识别率各不相同,其差异有显著性(P<0.01)。双侧同时开机可以明显提高患儿对双字词的的识别率,但对数字和单字词的影响不大。在对1例患儿不同时期的言语识别率的观察中,随着双侧人工耳蜗使用时间的延长,无论先植入耳、后植入耳及双耳的言语识别率均有所提高。结论 对数字、单字词、双字词的中枢识别机制有所不同,每一种单独方法都不能完整反映受试者的实际言语听觉能力。证实了双侧人工耳蜗植入术可以明显提高患者的言语识别率;接受双侧人工耳蜗植入术的患者双耳听力效应的重建需要一个重新学习和适应的过程。而耳蜗植入后听力训练则在其中起着极为重要的作用。     

儿童人工耳蜗植入者的言语识别

1　引言在过去的 30年中 ,人工耳蜗 ( cochlearimplant,CI)已从早期的临床试用阶段发展到今天国际上作为重度耳聋的常规治疗方法。美国洛杉矶House耳研所在早期单通道装置的研制和应用方面做了大量的工作 ,他们的 3M/House单道装置于1 984年得到美国食品药品管理局 ( FDA)批准 ,使CI首次作为一种治疗方法正式应用于临床。近 1 0多年来随着微电子学、计算机科学等高新科技的发展 ,多通道 CI在提高使用者的语音识别方面取得了重大突破。1 990年以墨尔本大学 Clark研究中心为代表的多道装置又被 FDA批准应用于临床〔1〕。多通道 CI在重…     

人工耳蜗使用者噪声环境下言语识别能力研究

目的:评估人工耳蜗(CI)植入者在噪声环境下的言语识别能力。方法:利用普通话版噪声下言语测试(MHINT)为言语测试工具,选取22例CI受试者,按照MHINT适应性得分规则,首先确定受试者在噪声下识别50%～74%的句子内容(评分规则3),达到该水平则继续进行75%以上难度内容(评分规则2或规则1),否则停止。获得受试个体在噪声下言语识别能力的语句接受阈、言语识别率和PI function曲线。结果:22例受试者中,5例在噪声下识别能力达80%～90%,3例可达60%～70%,7例达到50%,7例未能达到MHINT评分规则3测试。获得15例受试者的PI function并与听力正常人进行比较。结论:MHINT适应性得分规则测试法,可有效地获得CI植入者在噪声下的言语识别能力。与听力正常者相比,CI植入者的PI function显示右移10dB以上,在噪声环境下仍需要更好的信噪比。     

人工耳蜗植入的言语评估

人工耳蜗作为使深度听障者复聪的主要方法近年来日益得到重视，我国的人工耳蜗从植入数量、科研水平上均与10年前不可同日而语。耳蜗植入的最终目的是使用者能够自如地与他人进行言语交流，其康复成功的第一个标志应该是听懂言语。与国外术前、术后言语评估大量的报告相比．我国的研究相对较少。这不仅影响了国人术后效果与全球各地的比较，而且难以解释现有的多道装置和编码策略对汉     

104例人工耳蜗植入儿童在噪声环境中选择性听取能力的研究

目的 通过对104例6以下植入人工耳蜗的听力障碍儿童在噪声环境中言语识别能力的评估,探讨其在术后不同康复阶段选择性听取能力的发展及其影响因素.方法 采用模拟城市噪声和双音节词识别词表,对人工耳蜗植入儿童分别进行噪声环境下及安静环境下的言语识别能力评估.结果 噪声环境下与安静环境下的言语识别有相似的发展趋势,但得分有显著性差异(P<0.05);术后第1年内不同康复阶段的选择性听取能力差异非常显著(P<0.001).结论 噪声环境下较安静环境下的言语识别难度大,儿童的选择性听取能力在人工耳蜗植入后1年一直有较大幅度的提高,可见术后第1年内是听觉言语康复强化训练的关键期,这一时期对听力障碍儿童的选择性听取能力的发展有显著的促进作用.     

电子耳蜗再植入是否影响言语识别能力

对于语后聋的成人和语前聋的儿童来说,耳蜗植入术已被证明是十分有效的康复方法。但是,人工耳蜗做为一种电子装置,由于技术更新、电极错位、局部感染、操作失误等原因,偶尔仍会受损或失效,此时有必     

人工耳蜗植入者噪声环境下普通话言语测听测试方案的优化研究

目的探讨适宜临床应用的人工耳蜗植入者噪声环境下普通话言语测听(mandarin hearing in noisetest,MHINT)方案。方法对10名母语为普通话的语后聋人工耳蜗植入者进行MHINT测试。测试方案1:由易到难的顺序进行安静环境言语识别率测试(speech recognition scores,SRS)→固定信噪比SRS测试→言语识别阈测试(reception threshold of sentences,RTS);测试方案2:由难到易的顺序进行RTS测试→固定信噪比SRS测试→安静环境SRS测试。优化测试方案:预测试→对象以言语识别率得分高低分级→正式测试。结果①测试方案1:全体受试者安静环境SRS测试的完成率100%(10/10),固定信噪比SRS测试的完成率50%(5/10);4名可完成固定信噪比SRS测试的受试者接受RTS测试,2名完成测试(50%,2/4);②测试方案2:全体受试者依次接受RTS测试(完成率20%,2/10)、噪声环境SRS测试(完成率50%,5/10)和安静环境SRS测试(完成率为100%,10/10);③优化测试方案:10名对象根据预测试SRS得分分级后,5名受试者接受并完成安静环境SRS测试(完成率100%,5/5);5名受试者接受并完成噪声环境SRS测试(完成率100%,5/5),其中4名进一步接受自适应RTS测试,2名完成测试(完成率50%,2/4)。结论根据预测试结果对受试者的言语能力进行分级,选取难度适中的测试方案进行测试,可提高言语测试的效率。根据助听装置使用者的言语能力为其制定个性化的测试参数和合理的评估流程,将有利于MHINT测试在临床言语识别评估工作的推广使用。     

人工耳蜗植入儿童术后长期言语识别及语言理解表达能力研究

目的 评估人工耳蜗植入儿童术后长期的听觉、语言能力,探讨两种言语、语言测评结果之间的相关性。方法 以72例人工耳蜗植入儿童为研究对象,测试时平均生理年龄为7.88±1.24岁,平均植入年龄为2.84±1.04岁,人工耳蜗使用时长为5.03±0.52年,按植入年龄分为≤3岁组(43例)和>3岁组(29例)。分别采用普通话词汇相邻性测试(Mandarin lexical neighborhood test, MLNT)、《修订学前(学龄)儿童语言障碍评量表》(以下简称《量表》)及有意义言语使用量表(meaningful use of speech scale, MUSS)评估两组儿童的言语识别、言语及语言能力,分析《量表》与MUSS结果的相关性。结果 72例植入儿童的MLNT识别率由高到低分别为双音节易词85.00%±6.19%、单音节易词80.57%±6.20%、双音节难词76.56%±6.36%、单音节难词71.97%±6.85%(P<0.05);语言理解得分(72.43%±6.39%)优于口语表达得分(62.86%±7.50%)(P<0.05)。72例儿童MLNT得...     

Sound-direction identification with bilateral cochlear implants

OBJECTIVE: The purpose of this study was to compare the accuracy of sound-direction identification in the horizontal plane by bilateral cochlear implant users when localization was measured with pink noise and with speech stimuli. DESIGN: Eight adults who were bilateral users of Nucleus 24 Contour devices participated in the study. All had received implants in both ears in a single surgery. Sound-direction identification was measured in a large classroom by using a nine-loudspeaker array. Localization was tested in three listening conditions (bilateral cochlear implants, left cochlear implant, and right cochlear implant), using two different stimuli (a speech stimulus and pink noise bursts) in a repeated-measures design. RESULTS: Sound-direction identification accuracy was significantly better when using two implants than when using a single implant. The mean root-mean-square error was 29 degrees for the bilateral condition, 54 degrees for the left cochlear implant, and 46.5 degrees for the right cochlear implant condition. Unilateral accuracy was similar for right cochlear implant and left cochlear implant performance. Sound-direction identification performance was similar for speech and pink noise stimuli. CONCLUSIONS: The data obtained in this study add to the growing body of evidence that sound-direction identification with bilateral cochlear implants is better than with a single implant. The similarity in localization performance obtained with the speech and pink noise supports the use of either stimulus for measuring sound-direction identification.     

Speech perception learning in patients with cochlear implants

A model of speech apprehensibility of postlingual patients after cochlear implantation has been developed. The study of filtrated speech comprehension by persons with normal hearing has used speech material in three 50 Hz spectral bands. The central frequencies were selected by tonotopics of the basilar cochlear membrane. Characteristics of speech comprehension and apprehensibility by recipients of cochlear implants are demonstrated. The model reveals problems of acoustic comprehension facing the implanted patients and shows importance of learning and personality features of the implanted patients for early rehabilitation.     

Speech understanding in post-lingual adults with cochlear implants

It is well recognised that multi-channel cochlear implants are highly effective in gaining or regaining auditory perceptual skills of severe to profound hearing-impaired people. Research shows that adults rapidly improve in speech understanding after cochlear implantation. This study reports on speech understanding from two Spanish Clinics. 32 post-lingually deafened adults were fitted with either a MED-EL COMBI 40 or COMBI 40+ cochlear implant at the Hospital Universitario San Cecilio, at the Granada or Hospital Universitario La Fe, Valencia Clinic, Spain. Subjects were assessed at 1, 3, 6 and 12 months post-fitting on a number of speech perception tests. Results showed a highly significant improvement on all speech perception tests over the time. These ratify other studies in saying that cochlear implantation is a viable and successful treatment in post-lingually deafened adults.     

Central auditory development in children with bilateral cochlear implants

OBJECTIVE: To examine the time course of maturation of P1 latencies in infant sequential and simultaneous bilateral cochlear implant recipients. DESIGN: Retrospective case series. SETTING: Pediatric collaborative cochlear implant program. PATIENTS: Four children who received bilateral cochlear implants prior to age 2 years. INTERVENTION: Cortical auditory evoked potential was completed to determine the latency of the P1 response in 4 children with bilateral cochlear implants. MAIN OUTCOME MEASURES: Longitudinal development of the latency of the P1 cortical auditory evoked potential in children who received bilateral cochlear implants prior to age 2 years. RESULTS: In 2 patients who received sequential bilateral implants, P1 latencies recorded from the first implanted ear were within normal limits after 3 to 6 months of implant use. By comparison, P1 latencies from the second implanted ear reached normal limits as early as 1 month after implant use. In 2 patients who received simultaneous bilateral implants, P1 latencies from both ears were also within normal limits in a very short time frame (ie, by 1 month poststimulation). CONCLUSIONS: Our data suggest a high degree of plasticity of the central auditory pathways after early bilateral implantation. We find that P1 latencies provide a clinically useful biomarker of central auditory system development in children after cochlear implantation.     

Speech based optimization of cochlear implants

Abstract

Objective: This study describes an innovative method to optimize cochlear implant (CI) devices for individual patients using speech stimuli. Design: Baseline performance of clinically created CI settings was evaluated objectively (CNC and BKB-SIN) and subjectively (listening situation questionnaire). Participants underwent the Clarujust optimization procedure during two sessions, each two weeks apart, allowing for acclimatization and experience with each group of programs. Outcome testing was completed on both optimization settings during the two week follow-up session. CNC and BKB-SIN scores were compared within participants across test sessions. Study sample: Twenty adult experienced CI users were reprogrammed using the Clarujust? fitting procedure. Results: Significant improvements (p <?0.05) on CNC words and BKB-SIN sentences were observed with optimized maps compared to maps programmed using standard methods. Subjective performance also showed increased satisfaction with the optimized maps. The maps for individual users varied significantly and no single fitting applied for all patients. Conclusions: The Clarujust optimization method of programming CIs shows promise to improve patient performance and increase patient satisfaction in a shorter clinical test time.     

Speech intelligibility of Mandarin-speaking deaf children with cochlear implants

OBJECTIVE: Speech intelligibility, the extent to which the speakers can be understood verbally by their listeners, is an evaluator for the effectiveness of cochlear implantation. Thus, our goals were to evaluate the result of a tonal language through comparing the speech intelligibility between normal-hearing and implanted children who speak Mandarin, and to evaluate the relationship between speech intelligibility and duration of implants use. The effects of the age at implantation were also evaluated. METHODS: Twenty-six children (mean age of 5.9 years), who were congenitally deaf and implanted age at 3.5 years, were compared with 26 normal-hearing children (mean age of 5.84 years). The average post-implanted time was more than 6 months. Speech intelligibility was represented with the speech intelligibility ratings (SIR) and the correct percentage of dictation. The relationships between speech intelligibility, age at implantation and duration of implant were evaluated by linear regression analysis. RESULTS: Speech intelligibility of most subjects ranked from SIR category 3-5. The average correct perception rate (CI group/normal group) of words, consonants, vowels, and tones were 42.5%, 64.9%, 73.5%, and 72.3%, respectively. These differences were statistically significant (p<0.001). Speech intelligibility was positively correlated with age only in the normal-hearing group. Speech intelligibility in the implanted group was negatively correlated with age at implantation but positively correlated with the duration of implant. CONCLUSIONS: Speech intelligibility of tonal language was poorer in implanted children than normal-hearing children, but their communication outcomes were satisfactory when measured with SIR. Speech intelligibility is better if the age at implantation is younger or duration of implants use is longer.     

Speech intelligibility and prosody production in children with cochlear implants

ObjectivesThe purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants.MethodsThe Beginner's Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal hearing. Adult listeners with normal hearing judged the intelligibility of the words in the BIT sentences, identified the PUP sentences as one of four grammatical or emotional moods (i.e., declarative, interrogative, happy, or sad), and rated the PUP sentences according to how well they thought the child conveyed the designated mood.ResultsPercent correct scores were higher for intelligibility than for prosody and higher for children with normal hearing than for children with cochlear implants. Declarative sentences were most readily identified and received the highest ratings by adult listeners; interrogative sentences were least readily identified and received the lowest ratings. Correlations between intelligibility and all mood identification and rating scores except declarative were not significant.DiscussionThe findings suggest that the development of speech intelligibility progresses ahead of prosody in both children with cochlear implants and children with normal hearing; however, children with normal hearing still perform better than children with cochlear implants on measures of intelligibility and prosody even after accounting for hearing age. Problems with interrogative intonation may be related to more general restrictions on rising intonation, and the correlation results indicate that intelligibility and sentence intonation may be relatively dissociated at these ages.Learning outcomes: As a result of this activity, readers will be able to describe (1) methods for measuring speech intelligibility and prosody production in children with cochlear implants and children with normal hearing, (2) the differences between children with normal hearing and children with cochlear implants on measures of speech intelligibility and prosody production, and (3) the relations between speech intelligibility and prosody production in children with cochlear implants and children with normal hearing.     

Speech perception performance in prelingually deaf children with cochlear implants

The goals of this study were to report on mean values of speech perception performance in prelingually deaf children implanted with a Combi 40/40 + cochlear implant. A total of 31 patients were included in the study. The time span ranged over 3 years, during which time the Evaluation of Auditory Responses to Speech (EARS) test battery was used with the children. The EARS battery contains four measures of closed-set speech perception and three open-set tests. The mean test results exhibited steady improvement on all parts of the EARS test battery, even up to 3 years post-implantation. The preoperative scores for the Listening Progress Profile (LiP) were 4%, rising to 93% at 36 months post-implantation. Results for the open-set testing measures were most encouraging, with some children reaching fairly high levels of speech perception, receiving scores as high as 100%, by the 36-month evaluation. The congenitally and prelingually deaf children in our study showed continuous improvement in both closed and open set speech perception following cochlear implantation, although variability in individual performance among the children was noted.