耳蜗死区的诊断和临床应用

Diagnosis and clinical implications of cochlear dead regions

近些年来，由于听力学及现代科学技术的飞速发展，促进了助听器和人工耳蜗技术不断发展，耳聋患者可以通过佩戴助听器和人工耳蜗植入来改善听力，提高言语交流能力，因此，助听器和人工耳蜗成为耳聋患者接受耳聋教育和进行社会交流不可缺少的工具。然而，仅有部分耳聋患者反应佩戴助听器或行人工耳蜗植入术后，听力改善效果较好，有些患者表示听力仍较差，不能获得很好的听力及言语理解力[1-3]。这些问题引起了听力师和临床耳鼻咽喉科医生极大地关注和研究。Moore等[2]于2000年提出重度至极重度聋患者的耳蜗存在“死区”，该死区的存在导致助听器增益无效，

Summary The cochlear dead regions are common exist in the case of moderate to profound sensorineural hearing loss. Patients with dead regions have demonstrated poor understanding of speech in noise and report less satisfaction with hearing aids than patients with no dead regions. Dead regions are assumed to occur if a hearing- impaired listener can be shown to be using off-place listening. Acorrectly diagnosed dead regions facilitates accu- rate and informed aural rehabilitation.