Kuk Francis, Peeters Heidi, Lau Chi, Korhonen Petri
Office of Research in Clinical Amplification, Widex USA.
J Am Acad Audiol. 2011 May;22(5):265-73. doi: 10.3766/jaaa.22.5.3.
The maximum power output (MPO) of a hearing aid was typically discussed in the context of avoiding loudness discomfort. However, an MPO that is too low, as in the cases to avoid discomfort for people with a severe loudness tolerance problem and hearing losses that exceed the fitting range of the hearing aids, could negatively affect sound quality and speech intelligibility in noise.
The current study was designed to demonstrate the degradation in speech intelligibility in noise on the HINT (Hearing in Noise Test) when the MPO of the wearers' hearing aids was lowered by 10 dB from the default. The interactions with noise reduction (NR) algorithms (classic [NR-classic] and Speech Enhancer [NR-SE]) were also examined.
A single-blinded, factorial repeated-measures design was used to study the effect of noise input level (68 dBC, 75 dBC), MPO setting (default and default-10), and NR algorithm (off, classic, SE) on HINT performance.
Eleven adults with a severe sensorineural hearing loss participated.
Participants were fit with the Widex m4-19 behind-the-ear hearing aids binaurally in the default frequency response and MPO settings. The hearing aids were adjusted to six MPO (default, default-10) by NR (off, classic, SE conditions). Testing was completed within one 2 hr session.
The RTS (reception threshold for speech) for 50% correct on the HINT was measured in each of the six hearing aid conditions at two input levels (68 and 75 dBC) with speech and noise stimuli presented from the front. Repeated-measures ANOVAs were conducted using SPSS software to examine significant differences.
A repeated-measures ANOVA showed that noise level was not significant while NR algorithm and MPO were significant. The interaction between noise level and NR algorithm was also significant. Post hoc analysis with Bonferroni adjustment for the effect of NR algorithm showed that performance with NR-off was significantly poorer than performance with NR-classic and NR-SE (p < 0.05). However, NR-classic and NR-SE were not significantly different from each other (p > 0.05).
An MPO that was 10 dB lower than the default could negatively affect the signal-to-noise ratio (SNR) of the listening environment. However, NR could compensate for the degradation in SNR.
助听器的最大功率输出(MPO)通常是在避免响度不适的背景下进行讨论的。然而,MPO过低,比如在那些为避免响度耐受问题严重以及听力损失超过助听器适配范围的人出现不适的情况下,可能会对声音质量以及噪声环境下的言语可懂度产生负面影响。
本研究旨在证明当佩戴者助听器的MPO从默认值降低10 dB时,在噪声中言语可懂度测试(HINT)中的退化情况。同时还研究了与降噪(NR)算法(经典[NR-经典]和语音增强器[NR-SE])之间的相互作用。
采用单盲析因重复测量设计来研究噪声输入水平(68 dBC、75 dBC)、MPO设置(默认和默认-10)以及NR算法(关闭、经典型、SE型)对HINT测试表现的影响。
11名重度感音神经性听力损失的成年人参与了研究。
为参与者双耳佩戴Widex m4-19耳背式助听器,设置为默认频率响应和MPO。通过NR(关闭、经典型、SE型条件)将助听器调整为六种MPO(默认、默认-10)。测试在一个2小时的时间段内完成。
在六种助听器条件下,于两个输入水平(68和75 dBC)测量HINT测试中50%正确时的言语接受阈(RTS),语音和噪声刺激从前部呈现。使用SPSS软件进行重复测量方差分析以检验显著差异。
重复测量方差分析表明,噪声水平不显著,而NR算法和MPO显著。噪声水平与NR算法之间的交互作用也显著。对NR算法的影响进行Bonferroni校正的事后分析表明,NR关闭时的表现显著差于NR-经典型和NR-SE型(p < 0.05)。然而,NR-经典型和NR-SE型之间没有显著差异(p > 0.05)。
比默认值低10 dB的MPO可能会对聆听环境的信噪比(SNR)产生负面影响。然而,NR可以补偿SNR的退化。