Ribeiro Nunes Rui, Migueis António Carlos
Rev Laryngol Otol Rhinol (Bord). 2008;129(1):65-71.
Hearing aids are becoming very complex instruments with amplification combining numerous signal processing. Digital equipment allows a transposition of acute frequencies towards lower frequencies. The goal of this study is to extend the possibilities of this transposition based on results obtained on 8 patients.
With these new systems, the frequential transposition involves tiny artifacts but the relation of frequency between the various components of the original signal is preserved. The transposition must be done only in the frequencies which are necessary and must as selective as possible. The structure of the original sound must be preserved which implies a certain flexibility and specificity to guarantee the individual needs of the patient. These complex adjustments are assisted by a linear transposition algorithm; Audibility Extender (Widex). This system was used to fit 8 patients presenting a significant acute frequency loss.
The improvement is evident on the level of perception of sounds of the environment and consonant recognition. The improvement is significant as well on the tonal sensitivity as on the threshold of vocal intelligibility with a conservation of the percentage of speech discrimination for monosyllabic words.
The frequential transposition is an alternative to cochlear implants in certain indications and has its place alongside hybrid implants. The indications are reserved to patients presenting dead cochlear zones in the acute frequencies. The algorithm with its various adjustments allows an adaptation preserving the characteristics of the transposed sounds. The adaptation to such a system of hearing amplification requires an adaptation, and rehabilitation is essential in all the cases.
助听器正变得非常复杂,其放大功能结合了众多信号处理。数字设备可将高频向低频转换。本研究的目的是基于对8名患者的研究结果来扩展这种转换的可能性。
对于这些新系统,频率转换会涉及微小伪像,但原始信号各成分之间的频率关系得以保留。转换必须仅在必要的频率上进行,且必须尽可能具有选择性。原始声音的结构必须得以保留,这意味着要有一定的灵活性和特异性以保证患者的个体需求。这些复杂的调整由线性转换算法——可听度扩展器(唯听)辅助完成。该系统用于为8名存在明显高频听力损失的患者验配。
在对环境声音的感知和辅音识别水平上改善明显。在音调敏感度以及语音清晰度阈值方面的改善也很显著,同时单音节词的语音辨别百分比得以保留。
在某些适应症中,频率转换是人工耳蜗植入的一种替代方法,并且在混合植入方面也有其应用空间。适应症限于在高频存在耳蜗死区的患者。带有各种调整功能的算法能够实现一种保留转换后声音特征的适配。适应这样一种听力放大系统需要进行适应,并且在所有情况下康复都是必不可少的。