成年人工耳蜗使用者的音质感受和音乐感知

The music quality feeling and music perception of adult cochlear implant recipients

目的:评估成年人工耳蜗使用者的音质主观感受和音乐感知能力并探讨二者之间的相关性。方法:招募首都医科大学附属北京同仁医院的40例成年人工耳蜗植入者参加研究。40例人工耳蜗植入者(实验组),男27例,女13例;年龄(36.13±13.33)岁。40例听力正常受试者(对照组),男21例,女19例;年龄(26.53±6.94)岁。(1)使用人工耳蜗音乐评估软件中的音调辨差阈值测试、旋律辨别测试、乐器识别测试从客观方面分别评估2组受试者的音调、旋律、音色3个基本元素的感知能力;(2)从聆听音乐音质感受的3个方面(自然度、舒适度、清晰度)来获得2组受试者的音质主观感受;(3)使用慕尼黑音乐问卷中有关调查音乐背景和聆听习惯的若干问题来评估2组受试者的音乐经验得分。结果:(1)实验组的A4音调辨差阈值、C4音调辨差阈值、旋律辨别正确率和乐器识别正确率分别为11.00±9.68(1/4音)、18.38±12.58(1/4音)、(68.86±8.23)%、(50.23±20.23)%,均与对照组差异有统计学意义(P<0.05);(2)实验组的音质主观感受得分为(4.75±2.76)分,与对照组[(8.33±1.47)分]差异有统计学意义(P<0.05);(3)耳蜗品牌对音质主观感受得分无显著影响(P>0.05);(4)相关性分析:实验组音质主观感受得分与A4音调辨差阈值、C4音调辨差阈值均呈负相关(P<0.05),与旋律识别正确率、乐器识别正确率之间无相关性(P>0.05)。结论:成年人工耳蜗植入者的音质主观感受和音乐感知能力均明显落后于听力正常者;人工耳蜗植入者的音质主观感受和音调感知能力相关,与音色、旋律感知能力无关。

Objective:To assess the music quality feeling and music perception abilities of adults with cochlear implants and to probe the correlation between the two.Method:Forty adult cochlear implant recipients recruited from the Bejing Tongren Hosipital(27 males,13 females,average ages at 36.13±13.33)and 40 normal-hearing subjects(21 males,19 females,average ages at 26.53±6.94)participated in this study.Musical Sounds In Cochlear Implant were used to assess the pitch,melody and timbre perception for both normal-hearing subjects and adult cochlear implant recipients.To assess the self-reported music quality feeling of normal-hearing subjects and adult cochlear implant recipients from three aspects of listening music quality(Naturalness,comfort,and clarity).Using some questions about musical background and listening habits of the Munich Music questionnaire(MUMU)to assess the musical experience scores of all subjects.Result:For cochlear implant recipients,the pitch discrimination thresholds at A4 and C4 and the correction rate of melody discrimination and instrument identification test were significantly different from those for normal-hearing subjects(P<0.05).The average music quality feeling scores of the cochlear implant recipients and normal-hearing subjects were 4.75±2.76 and 8.33±1.47,respectively.The differences between the two groups were significant(P<0.05).Type of CI had no significant influence on the results of musical quality feeling(P>0.05).The scores of music quality feeling was significantly related with the pitch discrimination thresholds at A4 and C4(P<0.05),but had no significant correlation with the correlation rate of melody discrimination test and instrument identification test(P>0.05).Conclusion:For adult cochlear implant recipients,the music quality feeling and the music perception ability are weaker than normal-hearing subjects.The music quality feeling is related to the pitch perception,but had no relationship with the melody and timbre perception ability.