改良Contour试验测试正常听力与感音神经性听力损失儿童响度增长

Loudness growth functions between children with normal hearing and sensorineural hearing loss by the modified Contour test

目的应用改良Contour试验测试听力正常与感音神经性听力损失儿童的响度增长，探讨改良Contour试验的临床应用价值。方法对26例（26耳）听力正常儿童、25例（25耳）感音神经性听力损失儿童采用临床对照试验用改良Contour试验进行响度测试。在初测2～3周后进行复测。采用多因素方差分析进行统计学分析。结果在听力正常组、不同程度听力损失组间（F=1386．32，P值〈0．001）及不同响度分级间（F=682．21，P〈0．001）响度的差异均有统计学意义。听力正常组与听力损失组动态范围间差异有统计学意义（F=214．26，P〈0．001）。感音神经性听力损失儿童响度增长特征：听力损失越重，响度增长越快，动态范围越小。听力正常组与听力损失组初复测结果高度相关（r值分别为0．97和0．91），可信度较高。结论儿童助听器验配应尽可能获取个体的响度测试结果以帮助助听器调试到最适合该患儿使用。改良Contour试验易为儿童接受、可靠性好，值得进一步研究用于临床，以帮助提高助听器验配质量。

Objective To compare the loudness growth of normal hearing children and children with sensorineural hearing loss（SNHL） by the modified Contour test. Methods The loudness growth function were obtained in 26 ears with normal hearing and 25 ears with SNHL using the modified Contour test. Retesting were carried out 2 or 3 weeks later after the initial test. The results were analyzed by the univariate analysis of variance. Results There was significant difference in loudness growth between normal hearing group and groups with SNHL of different degrees （F = 1368.32,P 〈 0. 001 ）, and also between different loudness categories（F =682.21 ,P 〈0. 001 ）. Large differences were observed in the dynamic range between normal hearing children and children with sensorineural hearing loss（ F = 214. 26 ,P 〈 0. 001 ）. The following results were found in the loudness growth in children with SNHL：the more serious the hearing loss was, the more rapid the loudness growth and the smaller the dynamic range. The test-retest reliability of loudness growth function obtained in normal hearing and hearing-impaired group was highly correlated. The results of modified contour test showed good reliability. Conclusions When fitting hearing aids for a child the result of individual loudness growth should be obtained as possible as it could be drawn to reach the best listening saturation for the child. The modified contour test was a vivid and easy-to-do test for children, also with good reliability. In order to fit hearing aids properly for children, it was worth applying the modified contour test in clinic.