语前聋患儿一侧人工耳蜗植入对侧佩戴助听器聆听效果分析

目的：分析语前聋患儿一侧人工耳蜗植入（cochlear implant ，CI）对侧佩戴助听器模式下的聆听效果，以及非植入耳残余听力对聆听效果的影响。方法选取一侧人工耳蜗植入对侧佩戴助听器的语前聋患儿18例，分别测试其在单侧人工耳蜗植入、一侧人工耳蜗植入对侧佩戴助听器的双耳聆听模式（ bimodal fitting ，BIM ）安静环境及稳态噪声环境下标准中文短句、双音节词、单音节词的识别率。结果安静状态下本组患儿CI、BIM 模式单音节词言语识别率分别为82．67％±12．23％、83．61％±12．22％，双音节词分别为76．00％±16．13％、78．11％±14．84％，标准中文短句分别为60．11％±17．18％、65．43％±16．76％；信噪比10 dB环境下CI、BIM 助听模式患儿单音节词识别率分别为75．50％±14．12％、76．83％±14．15％，双音节词分别为68．22％±17．15％、77．18％±16．83％，标准中文短句分别为49．39％±19．26％、56．33％±19．55％，除两种模式下单音节词外其余言语识别率差异均有统计学意义（P＜0．05），且非植入耳250、500 Hz助听听阈与BIM 模式言语识别率呈负相关。结论语前聋患儿双耳双模式聆听时有一定优势，这种优势可能主要来自低频残余听力。

Speech Perception in Patients with Cochlear Implants and Hearing Aids in Opposite Ears

Objective The aim of the present study was to investigate the ability to perceive syllables phrases ,mono-syllabic words ,disyllabic words ,when using a CI and an HA in non -implanted ears (bimodal fitting) ,and the relationship be-tween aided thresholds in the HA ear and bimodal effectiveness .Methods Eighteen children who consistently used a bimodal fitting participated in the study .The loudness of speech in the HA ear matched that with implanted ear ,and the aided thresh-olds in the HA ear were obtained .The recognition rate of syllables phrases ,monosyllabic words ,and disyllabic words was tested under the aforementioned two modes in both the quiet and noisy backgrounds .Results The speech performance of children for monosyllabic words were 82 .67% ± 12 .23% ,83 .61% ± 12 .22% ,for disyllabic words 76 .00% ± 16 .13% ,78 .11% ± 14 .84% , for syllables phrases 60 .11% ± 17 .18% ,65 .43% ± 16 .76% ,with a CI alone or with bimodal fitting in a quiet environment ,re-spectively .In a noisy environment ,monosyllabic words were 75 .50% ± 14 .12% ,76 .83% ± 14 .15% ,and disyllabic words were 68 .22% ± 17 .15% ,77 .18% ± 16 .83% ,and syllables phrases were 49 .39% ± 19 .26% ,56 .33% ± 19 .55% .The results sug-gested that speech performance in a quiet or a noisy environment was significantly better with bimodal hearing than with a CI a-lone .All were statistically significant except the recognition rate of monosyllabic words in quiet background (P<0 .05) .Signifi-cant negative correlations were found between aided thresholds at 250 and 500 Hz ,and the bimodal advantages were noticeable for the some speeching perception .Conclusion Bimodal hearing enhances speech performance for deaf patients .The low -fre-quency residual hearing in the HA ear may play a major role in enhancing auditory and speech performance .