增益训练功能开启时间对助听器选配效果的影响

Timing Considerations in Trainable Hearing Aids

目的探究可训练助听器增益训练功能开启的时间对可听度及噪声下言语理解度的影响。方法采用双盲试验将36名助听器初戴者随机分为两组，实验组的增益训练功能在助听器验配当天开启，而对照组的增益训练功能在验配1个月之后开启。经过三个阶段为期10周的增益调节和听觉适应后，采用言语清晰度指数（speech intelligibility index，SII）、噪声下言语测试（Hearing In Noise Test，HINT）、助听响度问卷调查表（Profile of Aided Loudness，PAL）和助听器效果国际性调查问卷（International Outcome Inventory for HearingAids，IOI—HA）对助听器效果进行评估。结果两组在验配后第8周的轻声可听度有明显差异，但主观言语测试结果无显著差异；61％的受试者更倾向于使用增益训练后得到的优化增益，并且希望继续使用增益训练功能。结论提前开启增益训练功能虽然对最终获得的优选增益有影响，但对助听后言语理解度没有影响。

Previous investigations have explored the auditory adaptation to changed audibility after amplification, and a number of approaches that lead to preferred gain by the hearing aid users during the adaptation process have been examined. However, the relationship between the preferred gain and adaptation process is still unclear. The purpose of this study was to determine the impact of the timing of implementing a gain learning on the final preferred gain. Thirty-six first-time hearing aid users participated in a double-blinded field triM. They were randomly assigned to one of two groups. The control group had the preferred gain learning feature turned off for the first month of new amplification and the experimental group had the preferred gain learning feature turned on from the first day of fitting. Objective and subjective outcomes were measured. Results showed that the decrease in audibility as represented by the calculated SII for soft speech at the end of the 8th week was significantly larger when the gain learning feature was turned on immediately than when it was turned on 4 weeks after the initial hearing aid fitting. There was no significant difference on mean scores of the PAL or the IOI-HA under the final preferred gain setting between the two groups. 22 out of the 36 （61%） participants stated that they preferred continuing to use the final trained gain regardless of which group they were in;the same amount of participants chose to keep the gain learning feature on.