普通话单音节测听表在人工耳蜗植入者中的初步应用

Application of Mandarin monosyllable audiometric lists in Mandarin-speaking cochlear implant recipients

目的采用新编普通话单音节测听表,评估人工耳蜗植入者的言语识别能力。方法选取8名语前聋儿童(甲组)及13名语后聋(乙组)人工耳蜗植入者作为研究对象,男12名,女9名。甲组植入年龄为1.6～11.9岁(中位数2.7岁),使用年限>3.4年。乙组植入年龄为3.2～30.9岁(中位数12.0岁),使用年限>0.7年以上。在声场中测试人工耳蜗日常使用状态下的啭音听阈,并55dB SPL言语强度下的单音节识别率。部分受试者还接受了65、80dB SPL言语强度下单音节识别率的测试。结果甲乙2组受试者的0.5、1、2、4kHz四频率平均(4 Frequency Average,4FA)声场啭音听阈分别为32.5±3.4dB HL、35.9±4.9dB HL,t检验显示P=0.1046。甲乙2组受试者55dB SPL下的单音节识别率分别为56.8±9.0%、31.4±17.1%,t检验显示P=0.001。结论新编普通话单音节测听表,可有效地用来评价人工耳蜗植入者的言语识别能力。使用年限较短的语后聋患者的单音节识别率尚不及使用年限较长的语前聋儿童。人工耳蜗植入者的单音节识别率-言语声强(Performance-Intensity,P-I)函数曲线较正常成人平均右移30 dB以上,提示人工耳蜗使用者的言语听力补偿水平较正常人仍有差距。

Objective To evaluate the speech perception abilities of cochlear implant recipients via Mandarin monosyllable audiometric lists. Methods Eight pre-lingual severely hearing impaired pediatric cochlear implant recipients （Group A） and thirteen post-lingual severely hearing impaired cochlear implant recipients （Group B）, 12 males and 9 female, were participated the study. The participants in Group A aged 1.6-11.9 （median 2.7） had experiences of 3.4 years at least; the participants in Group B aged 3.2-30.9 （median 12.0） had experiences of 0.7 years at least. The warble tone audiometric thresholds and speech recognition score regarding to Mandarin monosyllable audiometric lists on the intensity of 55dB SPL were measured in sound-treated booth with ambient noise below 17dBA. Part of participants were assessed the speech recognition score on the intensity of 65 and 80riB SPL, then plot the performance-intensity （P-l） function. Results The four audiometric frequency of 0.5, 1, 2, 4kI-Iz average （4FA） thresholds for Group A and B, were 32.5±3.4, 35.9±4.9dB HL individually （t test, P=0.1046）. The speech recognition scores on the intensity of 55dB SPL for Group A and B, were 56.8±9.0%, 31.4±17.1%, individually （t test, P=0.001）. Conclusion The Mandarin monosyllable audiometric lists were feasible for the assessment of speech recognition abilities of Mandarin-speaking cochlear implant recipients. With the respect of monosyllable recognition scores, the post-lingual severely hearing impaired participants with short-term use were worse than the prelingual severely hearing impaired participants with long-term use. All cochlear implant recipients showed a gap of more than 30dB with the norm of monosyllable audiometric P-I function.