非线性频率压缩助听器对耳聋患者噪声下言语识别的影响

目的 探讨非线性频率压缩(nonlinear frequency compression, NLFC)助听器对以汉语普通话为母语的耳聋患者噪声下言语识别的影响,为耳聋患者助听器选配及助听效果评估提供参考.方法 25例以汉语普通话为母语的感音神经性聋患者,均双耳佩戴助听器,根据患者是否有NLFC助听经验分为A、B两组:A组13例有NLFC助听经验,日常使用NLFC技术;B组12例无NLFC助听经验,日常使用传统放大(conventional process, CP)技术.所有患者分别在NLFC和CP条件下进行噪声下句子识别测试,比较其结果.结果 A组患者在NLFC和CP条件下的噪声下言语识别率分别为82.33%±16.06%、76.70%±18.08%,前者高于后者,差异有显著统计学意义(P<0.01);B组分别为83.04%±12.56%、81.79%±20.07%(P=0.19),差异无统计学意义.A组患者在NLFC和CP条件下的高频(4、6、8 kHz)助听听阈分别为53.54±7.30、57.01±6.81 dB SPL,B组分别为57.42±8.38和61.21±7.42 dB SPL,两组NLFC条件下的助听听阈低于CP条件,差异均有统计学意义(P<0.01).经统计学回归处理,患者在NLFC和CP条件下的高频助听听阈差值与言语识别率差值呈线性相关(r=0.63,t=3.89,P=0.007).结论 NLFC技术可改善患者高频可听度及噪声下言语识别,一定的NLFC使用经验可使NLFC助听效果最大化.

The Effect of Nonlinear Frequency Compression on Speech Recognition in Noise for Hearing-Impaired Listeners with Hearing Aids

Objective The purpose of this study is to investigate the effects of activating NLFC (nonlinear frequency compression, NLFC) on speech recognition in noise for listeners with high-frequency hearing loss.The results from the present study will provide guidance for clinical practice of fitting hearing aids to hearing impaired listeners.Methods Twenty-five hearing-impaired listeners participated in this study.They all wore binaural hearing aids.The subjects were divided into two groups based on whether NLFC was used in their hearing aids or not.Subjects who used NLFC were in group A and the others who used conventional process (CP) instead of NLFC were in group B.Both groups were tested with speech recognition in noise under the conditions of NLFC and CP.The statistical method of paired samples test was conducted to assess the effect of NLFC and CP on speech recognition in noise.Results The average performance in group A was 82.33%±16.06% and 76.70%±18.08 with NLFC and CP, respectively (P<0.01).It suggested that NLFC had a significant effect on subjects' speech recognition in noise in group A.However, the average performance in group B was 83.04%±12.56% and 81.79%±20.07% with NLFC and CP, respectively (P=0.19).It suggested that there was no significant effect of NLFC on subjects' speech recognition in noise in group B.The average high frequency threshold in group A was 53.54±7.30 and 57.01±6.81 dB SPL with NLFC and CP, respectively(P<0.01).And the average high frequency threshold in group B was 57.42±8.38 and 61.21±7.42 dB SPL with NLFC and CP, respectively(P=0.03).The significant correlativity in statistics on the speech recognition score in noise(y) verse the difference of high frequency hearing threshold (4,6,8 kHz) under the condition of NLFC activated and deactivated (x) in the subjects was y=1.21x-0.40 (r=0.63, t=3.89, P=0.007).Conclusion NLFC technology is beneficial to improving hearing aid users' audibility of high frequency and speech recognition in noise.Certain acclimatization period may be necessary to maximize the potential benefit for NLFC.