语后聋人工耳蜗植入患者音乐音调感知能力的评价

Music Pitch Perception in Postlingually-Deafened Adult Cochlear Implant Users

目的探讨语后聋成人人工耳蜗使用者感知音乐音调的能力。方法使用慕尼黑音乐经验问卷(Munich music questionnaire,MUMU)评估12例听力正常受试者(听力正常组,男5例,女7例)与12例人工耳蜗使用者(人工耳蜗组,男5例,女7例)的年龄与音乐经验的匹配程度。使用Fitzgerald等开发的人工耳蜗音乐评估软件(MuSIC)中的音调辨差阈值测试、旋律辨别与和弦辨别测试评估人工耳蜗使用者的音乐音调感知能力。结果听力正常组与人工耳蜗组的年龄与音乐经验相匹配。人工耳蜗组F3调的音调辨差阈值平均为16.2个1/4音,C4调的音调辨差阈值平均为6.2个1/4音,均显著高于听力正常组(P<0.05)。人工耳蜗组的旋律辨别测试平均正确率为69.8%,和弦辨别测试的平均正确率为72.4%,与听力正常组比较差异无统计学意义(P>0.05)。人工耳蜗组耳蜗植入前助听器使用时间与其植入后聆听音乐的经验均与其音调辨差阈值显著相关(P<0.05)。结论语后聋成人人工耳蜗使用者的音调辨差阈值显著高于听力正常人,但个体差异较大,其音乐音调感知能力与人工耳蜗植入前助听器佩戴时间以及植入后聆听音乐的经验相关。

Objective To evaluate the ability of music pitch perception by postlingually-deafened adult co- chlear implant users. Methods Twelve normal hearing and 12 adult cochlear implant users participated in this study, Munich music questionnaire （MUMU） was used to match the age and music experience between normal- hearing and cochlear implant subjects. Pitch discrimination threshold, melody discrimination, and chord discrimina tion measurements in Musical Sounds in Cochlear Implants （MUSIC） test battery were used to assess the pitch per ception ability for both normal hearing and cochlear implant users. Results Normal- hearing listeners met the matching criteria in terms of the age and music experience before hearing loss of the cochlear implant subjects. For cochlear implant subjects, the average pitch discrimination threshold at F3 was 16.2 quarter tone, and the average pitch discrimination threshold at C4 was 6.2 quarter tone. Both these thresholds were significantly higher than those for normal--hearing subjects （P〉0.05）. The average scores of melody discrimination test and chord discrimination test for cochlear implant subjects was 69.8% and 72.4%, respectively. The performance of both melody and chorddiscrimination tests was not significantly different from normal-hearing subjects. Both duration of hearing aid use and the music experience after cochlear implantation were found to be correlated with pitch discrimination ability of cochlear implant users. Oonclusiorl Post-lingually deafened cochlear implant subjects on average performed significantly poorer in pitch discrimination tasks in comparison with normal-hearing listeners, but with a large variability.