Spahr Anthony J, Dorman Michael F
Arizona State University, Department of Speech and Hearing Science, Tempe, Arizona 85287-0102, USA.
Ear Hear. 2005 Aug;26(4 Suppl):2S-6S. doi: 10.1097/00003446-200508001-00002.
The aim of this study was to assess the effects of variations in the settings for minimum stimulation levels on speech understanding for adult cochlear implant recipients using the Med El Tempo+ speech processor.
Fifteen patients served as listeners. The test material included sentences presented at a conversational level in noise (74 dB SPL at +10 dB signal-to-noise ratio), sentences presented at a soft level in a quiet background (54 dB SPL), consonants in "vCv" environment (74 dB SPL re: vowel peaks), and synthetic vowels in "bVt" environment (54 dB SPL re: vowel peaks). The patients' speech processors were programmed with minimum stimulation levels set to behavioral threshold, set to 10% of most comfortable loudness, and set to 0 muA.
The level of speech understanding achieved in the behavioral threshold condition was not significantly different from that achieved in either the 10% of most comfortable loudness or 0 muA conditions for any test material. Only 2 of the 15 patients demonstrated performance differences of greater than 10 percentage points between the 0 muA condition and the behavioral threshold condition on more than a single test.
Our results demonstrate that there are no grievous consequences, in terms of speech understanding, for setting minimum stimulation levels below behavioral thresholds. The time savings from setting thresholds to 10% of MCL or 0 muA may be especially useful during the initial device fitting.
本研究旨在评估使用美迪乐Tempo+言语处理器时,最低刺激水平设置的变化对成年人工耳蜗植入者言语理解的影响。
15名患者作为听众。测试材料包括在噪声环境中以对话水平呈现的句子(信噪比为+10 dB时声压级为74 dB SPL)、在安静背景中以柔和水平呈现的句子(54 dB SPL)、“vCv”环境中的辅音(以元音峰值为参考声压级74 dB SPL)以及“bVt”环境中的合成元音(以元音峰值为参考声压级54 dB SPL)。患者的言语处理器被设置为最低刺激水平,分别设定为行为阈值、最舒适响度的10%以及0 μA。
对于任何测试材料,在行为阈值条件下实现的言语理解水平与在最舒适响度的10%或0 μA条件下实现的言语理解水平没有显著差异。15名患者中只有2名在超过一项测试中,0 μA条件和行为阈值条件之间的表现差异大于10个百分点。
我们的结果表明,将最低刺激水平设置在行为阈值以下,在言语理解方面不会产生严重后果。在初次设备调试期间,将阈值设置为最舒适响度的10%或0 μA所节省的时间可能特别有用。