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开放式耳道助听器中受话器位置对探头麦克风、性能及主观测量结果的影响。

The effects of receiver placement on probe microphone, performance, and subjective measures with open canal hearing instruments.

作者信息

Alworth Lynzee N, Plyler Patrick N, Reber Monika Bertges, Johnstone Patti M

机构信息

Department of Audiology and Speech Pathology, University of Tennessee, 578 South Stadium Hall, Knoxville, TN 37996-0740, USA.

出版信息

J Am Acad Audiol. 2010 Apr;21(4):249-66. doi: 10.3766/jaaa.21.4.4.

Abstract

BACKGROUND

Open canal hearing instruments differ in method of sound delivery to the ear canal, distance between the microphone and the receiver, and physical size of the devices. Moreover, RITA (receiver in the aid) and RITE (receiver in the ear) hearing instruments may also differ in terms of retention and comfort as well as ease of use and care for certain individuals. What remains unclear, however, is if any or all of the abovementioned factors contribute to hearing aid outcome.

PURPOSE

To determine the effect of receiver location on performance and/or preference of listeners using open canal hearing instruments.

RESEARCH DESIGN

An experimental study in which subjects were exposed to a repeated measures design.

STUDY SAMPLE

Twenty-five adult listeners with mild sloping to moderately severe sensorineural hearing loss (mean age 67 yr).

DATA COLLECTION AND ANALYSIS

Participants completed two six-week trial periods for each device type. Probe microphone, objective, and subjective measures (quiet, noise) were conducted unaided and aided at the end of each trial period.

RESULTS

Occlusion effect results were not significantly different between the RITA and RITE instruments; however, frequency range was extended in the RITE instruments, resulting in significantly greater maximum gain for the RITE instruments than the RITA instruments at 4000 and 6000 Hz. Objective performance in quiet or in noise was unaffected by receiver location. Subjective measures revealed significantly greater satisfaction ratings for the RITE than for the RITA instruments. Similarly, preference in quiet and overall preference were significantly greater for the RITE than for the RITA instruments.

CONCLUSIONS

Although no occlusion differences were noted between instruments, the RITE did demonstrate a significant difference in reserve gain before feedback at 4000 and 6000 Hz. Objectively; no positive benefit was noted between unaided and aided conditions on speech recognition tests. These results suggest that such testing may not be sensitive enough to determine aided benefit with open canal instruments. However, the subjective measures (Abbreviated Profile of Hearing Aid Benefit [APHAB] and subjective ratings) did indicate aided benefit for both instruments when compared to unaided. This further suggests the clinical importance of subjective measures as a way to measure aided benefit of open-fit devices.

摘要

背景

开放式耳道助听器在声音传输到耳道的方式、麦克风与受话器之间的距离以及设备的物理尺寸方面存在差异。此外,耳背式(RITA,受话器置于助听器内)和耳内式(RITE,受话器置于耳内)助听器在佩戴的稳固性、舒适度以及某些个体的使用便利性和护理方面也可能有所不同。然而,尚不清楚上述任何或所有因素是否会影响助听器的使用效果。

目的

确定受话器位置对使用开放式耳道助听器的聆听者的性能和/或偏好的影响。

研究设计

一项实验研究,受试者采用重复测量设计。

研究样本

25名患有轻度斜坡型至中度重度感音神经性听力损失的成年聆听者(平均年龄67岁)。

数据收集与分析

参与者针对每种设备类型完成了两个为期六周的试验期。在每个试验期结束时,分别在未佩戴助听器和佩戴助听器的情况下进行探管麦克风测量、客观测量和主观测量(安静环境、噪声环境)。

结果

耳背式和耳内式助听器的堵耳效应结果无显著差异;然而,耳内式助听器的频率范围有所扩展,导致其在4000Hz和6000Hz时的最大增益显著高于耳背式助听器。安静环境或噪声环境下的客观性能不受受话器位置的影响。主观测量显示,耳内式助听器的满意度评分显著高于耳背式助听器。同样,在安静环境下的偏好以及总体偏好方面,耳内式助听器也显著高于耳背式助听器。

结论

尽管两种仪器之间未发现堵耳差异,但耳内式助听器在4000Hz和6000Hz反馈前的储备增益方面确实存在显著差异。客观上,在言语识别测试中,未佩戴助听器和佩戴助听器的条件之间未发现积极的益处。这些结果表明,此类测试可能不够灵敏,无法确定开放式耳道仪器的助听效果。然而,与未佩戴助听器相比,主观测量(助听器效益简表[APHAB]和主观评分)确实表明两种仪器都有助听效果。这进一步表明了主观测量作为衡量开放式适配设备助听效果的一种方式的临床重要性。

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