非对称性听力损失使用信号对传式助听器干预效果研究

Interventive effect of BICROS hearing aid on asymmetric hearing loss

目的采用真耳分析和不同信噪比下的言语识别率测试初步评价双耳信号对传式(BICROS)助听器的助听效果。方法选自2019年2月~2020年1月20例一侧全聋、一侧听力为中度听力损失(简称听损)患者在通过真耳分析验证达到验配公式目标值后,分别在单耳佩戴助听器和双耳佩戴BICROS助听器干预前后的安静环境和噪声环境进行言语测试和声场助听听阈评估。结果患者单耳佩戴助听器与双耳佩戴BICROS助听器在0.5~4 kHz的声场助听听阈高度相关(P值均<0.001);声场下65 dB SPL言语识别率测试显示:安静环境、噪声环境(信噪比为5 dB)下双耳佩戴BICROS助听器与仅较好耳佩戴助听器相比差异均有统计学意义(P值均<0.001)。安静环境下裸耳和双耳佩戴BICROS的最大言语识别率显著相关(r=0.911,P<0.001)。结论安静环境、噪音环境下单耳极重度非对称性听损患者通过较好耳单侧佩戴助听器和使用BICROS助听器均能受益,双耳佩戴BICROS助听器在噪声环境下受益更明显。

Objective To evaluate the hearing aid effect of bilateral contralateral routing of signals(BICROS)by using real ear measurement and speech recognition rate test under different signal-to-noise ratios.Methods Twenty patients with total deafness on one side and moderate hearing loss on the other side reached the target value of the verification formula by real ear measurement.Speech test and acoustic field hearing threshold assessment were performed in quiet environment and noise environment before and after the intervention with hearing aid in one ear and BICROS hearing aid in both ears.Results There was no significant difference in hearing threshold between single ear wearing hearing aid and both ears wearing BICROS hearing aid at 0.5-4 kHz(P<0.01).The speech recognition rate of 65 dB SPL under sound field was tested.The rate of BICROS hearing aid in either quiet environment or noise environment[signal noise ratio(SNR)=5 dB]was all significantly different from that only aided in the better ear(P<0.001).The maximum speech recognition rate was significantly correlated between bare ear and binaural wearing BICROS in quiet environment(r=0.911,P<0.001).Conclusions Patients with very severe asymmetric hearing loss in one ear in quiet environment and noise environment can benefit from unilateral wearing of hearing aid in good ear and using BICROS hearing aid.Patients who wear BICROS hearing aid in both ears could benefit especially in noisy environment.