自适应非线性频率压缩助听器对成人耳聋患者音素感知和助听听阈的影响及验证
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摘要
目的探讨自适应非线性频率压缩(adaptive nonlinear frequency compression, ANFC)技术助听器对成人耳聋患者音素感知和助听听阈的影响,并使用真耳分析进行验证。方法 20例轻度到极重度感音神经性聋成人患者双耳选配带有ANFC功能的助听器,分别在ANFC功能打开和关闭两种条件下(测试条件顺序随机),分别测试"搭"、"发"、"哈"、"喀"、"妈"、"沙(3 kHz)"、"沙(5 kHz)"、"虾"、"撒(6 kHz)"以及"撒(9 kHz)"10种不同频率的音素感知阈及助听听阈,并通过真耳分析软件获得/s/、/sh/两音的曲线频谱响应。结果在ANFC功能打开和关闭两种条件下,20例患者0.25～4 kHz助听听阈无统计学差异(P>0.05),而ANFC功能打开时6 kHz和8 kHz助听听阈均值分别较ANFC关闭时降低约23和28 dB,差异有统计学意义(P<0.05);音素感知测试结果示,ANFC功能打开时四个高频音阈值"沙(5 kHz)"、"虾"、"撒(6 kHz)"和"撒(9 kHz)"音素感知阈均值较ANFC关闭时分别降低约6、12、15和16 dB,差异有统计学意义(P<0.05),其余6个音"搭"、"发"、"哈"、"喀"、"妈"和"沙(3 kHz)"的音素感知阈ANFC打开或关闭时差异无统计学意义(P>0.05),与真耳分析验证结果一致。结论 ANFC助听器可改善成人耳聋患者5 kHz以上的音素感知阈和助听听阈。
Objective To investigate the influence of adaptive nonlinear frequency compression hearing aids on the phoneme perception and aided hearing of Chinese people with hearing loss.Methods A total of 20 adults with mild to profound sensorineural hearing loss and bilaterally fitted with hearing aids were included in this study. With the presence or absence of ANFC(in a random order), their aided hearing thresholds and spectrum responses from real ear test to 10 phonemes of different frequencies( "da", "fa", "ha", "ka", "ma", "sha(3 kHz)", "sha(5 kHz)", "xia", "sa(6 kHz)" and "sa(9 kHz)") were tested, respectively.Results Under the conditions of ANFC-on or ANFC-off, no significant differences were found( P>0.05) in the 20 patients' aided hearing thresholds at 0.25～4 kHz,while it reduced about 23 and 28 dB respectively from the conditions of ANFC-off to ANFC-on in their aided hearing thresholds of 6 kHz and 8 kHz. This was statistically significant(P<0.05). The results of phoneme perception threshold test revealed that there were significant differences at four high frequencies( "sha(5 kHz)", "xia", "sa(6 kHz)" and "sa(9 kHz)"), which roughly decreased by 6, 12, 15 and 16 dB respectively from the conditions of ANFC-off to ANFC-on, and no statistical significances were found in the other 6 phonemes( P>0.05). The results were accorded with real ear verification.Conclusion ANFC hearing aids could help improve the phoneme perception and aided hearing(especially in frequencies above 5 kHz) of deaf adults in China.
Objective To investigate the influence of adaptive nonlinear frequency compression hearing aids on the phoneme perception and aided hearing of Chinese people with hearing loss.Methods A total of 20 adults with mild to profound sensorineural hearing loss and bilaterally fitted with hearing aids were included in this study. With the presence or absence of ANFC(in a random order), their aided hearing thresholds and spectrum responses from real ear test to 10 phonemes of different frequencies( "da", "fa", "ha", "ka", "ma", "sha(3 kHz)", "sha(5 kHz)", "xia", "sa(6 kHz)" and "sa(9 kHz)") were tested, respectively.Results Under the conditions of ANFC-on or ANFC-off, no significant differences were found( P>0.05) in the 20 patients' aided hearing thresholds at 0.25～4 kHz,while it reduced about 23 and 28 dB respectively from the conditions of ANFC-off to ANFC-on in their aided hearing thresholds of 6 kHz and 8 kHz. This was statistically significant(P<0.05). The results of phoneme perception threshold test revealed that there were significant differences at four high frequencies( "sha(5 kHz)", "xia", "sa(6 kHz)" and "sa(9 kHz)"), which roughly decreased by 6, 12, 15 and 16 dB respectively from the conditions of ANFC-off to ANFC-on, and no statistical significances were found in the other 6 phonemes( P>0.05). The results were accorded with real ear verification.Conclusion ANFC hearing aids could help improve the phoneme perception and aided hearing(especially in frequencies above 5 kHz) of deaf adults in China.
引文
1 Monson BB,Hunter EJ,Lotto AJ,et al.The perceptual significance of high-frequency energy in the human voice[J].Frontiers in Psychology,2014,5:587.
2 Moore BCJ.A review of the perceptual effects of hearing loss for frequencies above 3 kHz[J].International Audiology,2016,55:707.
3 Stelmachowicz PG,Pittman AL,Hoover BM,et al.Aided perception of /s/ and /z/ by hearing-impaired children[J].Ear & Hearing,2002,23:316.
4 Stelmachowicz PG,Pittman AL,Hoover BM,et al.The importance of high-frequency audibility in the speech and language development of children with hearing loss[J].Archives of Otolaryngology-Head & Neck Surgery,2004,130:556.
5 Amos NE,Humes LE.Contribution of high frequencies to speech recognition in quiet and noise in listeners with varying degrees of high-frequency sensorineural hearing loss[J].Speech Lang Hear Res,2007,50:819.
6 Ching TYC,Dillon H,Byrne D.Speech recognition of hearing-impaired listeners:predictions from audibility and the limited role of high-frequency amplification[J].Journal of the Acoustical Society of America,1998,103:1128.
7 Boothroyd A,Medwetsky L.Spectral distribution of /s/ and the frequency response of hearing aids[J].Ear & Hearing,1992,13:150.
8 Moore BC.Dead regions in the cochlea:conceptual foundations,diagnosis,and clinical applications[J].Ear & Hearing,2004,25:98.
9 Kimlinger C,Mccreery R,Lewis D.High-frequency audibility:the effects of audiometric configuration,stimulus type,and device[J].Journal of the American Academy of Audiology,2015,26:128.
10 Simpson A.Frequency-lowering devices for managing high-frequency hearing loss:a review[J].Trends in Amplification,2009,13:87.
11 尤妍颜,陈雪清,徐立,等.非线性频率压缩助听器对汉语耳聋患者音质感知的影响[J].听力学及言语疾病杂志,2017,25:640.
12 尤妍颜,陈雪清,徐立,等.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[J].听力学及言语疾病杂志,2017,25:288.
13 Schmitt N,Winkler A,Boretzki M,et al.A phoneme perception test method for high-frequency hearing aid fitting[J].Journal of the American Academy of Audiology,2016,27:367.
14 Parsa V,Scollie S,Glista D,et al.Nonlinear frequency compression:effects on sound quality ratings of speech and music[J].Trends in Amplification,2013,17:54.
15 Glista D,Hawkins M,Bohnert A,et al.The effect of adaptive nonlinear frequency compression on phoneme perception[J].American Journal of Audiology,2017,26:1.
16 Hopkins K,Khanom M,Dickinson AM,et al.Benefit from non-linear frequency compression hearing aids in a clinical setting:the effects of duration of experience and severity of high-frequency hearing loss[J].International Audiology,2014,53:219.
17 Simpson A,Hersbach AA,Mcdermott HJ.Frequency-compression outcomes in listeners with steeply sloping audiograms.[J].International Audiology,2006,45:619.
18 Johnson EE,Light KC.A patient-centered,provider-facilitated approach to the refinement of nonlinear frequency compression parameters based on subjective preference ratings of amplified sound quality[J].Journal of the American Academy of Audiology,2015,26:689.
19 Scollie S,Glista D,Seto J,et al.Fitting frequency-lowering signal processing applying the American academy of audiology pediatric amplification guideline:updates and protocols[J].Journal of the American Academy of Audiology,2016,27:219.
20 Alexander J.Individual variability in recognition of frequency-lowered speech[J].Semin Hear,2013,34:086.
21 Mao Y,Jing Y,Hahn E,et al.Auditory perceptual efficacy of nonlinear frequency compression used in hearing aids:a review[J].Journal of Otology,2017,12:97.
22 Danielle G,Susan S,Marlene B,et al.Evaluation of nonlinear frequency compression:Clinical outcomes[J].International Audiology,2009,48:632.
23 Mccreery RW,Alexander J,Brennan MA,et al.The influence of audibility on speech recognition with nonlinear frequency compression for children and adults with hearing loss[J].Ear & Hearing,2014,35:440.
2 Moore BCJ.A review of the perceptual effects of hearing loss for frequencies above 3 kHz[J].International Audiology,2016,55:707.
3 Stelmachowicz PG,Pittman AL,Hoover BM,et al.Aided perception of /s/ and /z/ by hearing-impaired children[J].Ear & Hearing,2002,23:316.
4 Stelmachowicz PG,Pittman AL,Hoover BM,et al.The importance of high-frequency audibility in the speech and language development of children with hearing loss[J].Archives of Otolaryngology-Head & Neck Surgery,2004,130:556.
5 Amos NE,Humes LE.Contribution of high frequencies to speech recognition in quiet and noise in listeners with varying degrees of high-frequency sensorineural hearing loss[J].Speech Lang Hear Res,2007,50:819.
6 Ching TYC,Dillon H,Byrne D.Speech recognition of hearing-impaired listeners:predictions from audibility and the limited role of high-frequency amplification[J].Journal of the Acoustical Society of America,1998,103:1128.
7 Boothroyd A,Medwetsky L.Spectral distribution of /s/ and the frequency response of hearing aids[J].Ear & Hearing,1992,13:150.
8 Moore BC.Dead regions in the cochlea:conceptual foundations,diagnosis,and clinical applications[J].Ear & Hearing,2004,25:98.
9 Kimlinger C,Mccreery R,Lewis D.High-frequency audibility:the effects of audiometric configuration,stimulus type,and device[J].Journal of the American Academy of Audiology,2015,26:128.
10 Simpson A.Frequency-lowering devices for managing high-frequency hearing loss:a review[J].Trends in Amplification,2009,13:87.
11 尤妍颜,陈雪清,徐立,等.非线性频率压缩助听器对汉语耳聋患者音质感知的影响[J].听力学及言语疾病杂志,2017,25:640.
12 尤妍颜,陈雪清,徐立,等.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[J].听力学及言语疾病杂志,2017,25:288.
13 Schmitt N,Winkler A,Boretzki M,et al.A phoneme perception test method for high-frequency hearing aid fitting[J].Journal of the American Academy of Audiology,2016,27:367.
14 Parsa V,Scollie S,Glista D,et al.Nonlinear frequency compression:effects on sound quality ratings of speech and music[J].Trends in Amplification,2013,17:54.
15 Glista D,Hawkins M,Bohnert A,et al.The effect of adaptive nonlinear frequency compression on phoneme perception[J].American Journal of Audiology,2017,26:1.
16 Hopkins K,Khanom M,Dickinson AM,et al.Benefit from non-linear frequency compression hearing aids in a clinical setting:the effects of duration of experience and severity of high-frequency hearing loss[J].International Audiology,2014,53:219.
17 Simpson A,Hersbach AA,Mcdermott HJ.Frequency-compression outcomes in listeners with steeply sloping audiograms.[J].International Audiology,2006,45:619.
18 Johnson EE,Light KC.A patient-centered,provider-facilitated approach to the refinement of nonlinear frequency compression parameters based on subjective preference ratings of amplified sound quality[J].Journal of the American Academy of Audiology,2015,26:689.
19 Scollie S,Glista D,Seto J,et al.Fitting frequency-lowering signal processing applying the American academy of audiology pediatric amplification guideline:updates and protocols[J].Journal of the American Academy of Audiology,2016,27:219.
20 Alexander J.Individual variability in recognition of frequency-lowered speech[J].Semin Hear,2013,34:086.
21 Mao Y,Jing Y,Hahn E,et al.Auditory perceptual efficacy of nonlinear frequency compression used in hearing aids:a review[J].Journal of Otology,2017,12:97.
22 Danielle G,Susan S,Marlene B,et al.Evaluation of nonlinear frequency compression:Clinical outcomes[J].International Audiology,2009,48:632.
23 Mccreery RW,Alexander J,Brennan MA,et al.The influence of audibility on speech recognition with nonlinear frequency compression for children and adults with hearing loss[J].Ear & Hearing,2014,35:440.