Kuk Francis, Lau Chi-Chuen, Korhonen Petri, Crose Bryan
Widex Office of Research in Clinical Amplification (ORCA-USA), Lisle, IL.
J Am Acad Audiol. 2015 Mar;26(3):275-88. doi: 10.3766/jaaa.26.3.7.
Although the benefits of hearing aids are generally recognized for soft- and conversational-level sounds, most studies have reported negative benefits (i.e., poorer aided than unaided performance) at high noise inputs. Advances in digital signal processing such as compression, noise reduction, and directional microphone could improve speech perception at high input levels. This could alter our view on the efficacy of hearing aids in loud, noisy situations.
The current study compared the aided versus the unaided speech intelligibility performance of hearing-impaired (HI) listeners at various input levels (from 50-100 dB SPL) and signal-to-noise ratios (SNRs; quiet, +6, +3, and -3 dB) in order to document the benefits of modern hearing aids. In addition, subjective preference between aided and unaided sounds (speech and music) at various input levels was also compared.
The experiment used a factorial repeated-measures design.
A total of 10 HI adults with symmetrical moderate to severe hearing losses served as test participants. In addition, speech intelligibility scores of five normal-hearing (NH) listeners were also measured for comparison.
Speech perception was studied at 50 and 65 dB SPL input levels in quiet and also in noise at levels of 65, 85, and 100 dB SPL with SNRs of +6, +3, and -3 dB. This was done for all participants (HI and NH). In addition, the HI participants compared subjective preference between the aided and unaided presentations of speech and music stimuli at 50, 65, 85, and 100 dB SPL in quiet.
The data were analyzed with repeated-measures analysis of variance.
The results showed a decrease in aided benefits as input levels increased. However, even at the two highest input levels (i.e., 85 and 100 dB SPL), aided speech scores were still higher than the unaided speech scores. Furthermore, NH listeners and HI listeners in the aided condition showed stable speech-in-noise performance between 65 and 100 dB SPL input levels, except that the absolute performance of the NH listeners was higher than that of the HI listeners. Subjective preference for the unaided sounds versus the aided sounds increased as input level increased, with a crossover intensity at approximately 75 dB SPL for speech and 80 dB SPL for music.
The results supported the hypothesis that the study hearing aid can provide aided speech-in-noise benefit at very high noise inputs in a controlled environment.
尽管助听器对轻柔声音和对话级声音的益处已得到普遍认可,但大多数研究报告称,在高噪声输入情况下,助听器会带来负面效果(即助听后表现比未助听时更差)。数字信号处理技术的进步,如压缩、降噪和定向麦克风,可能会改善高输入水平下的言语感知。这可能会改变我们对助听器在嘈杂环境中功效的看法。
本研究比较了听力受损(HI)受试者在不同输入水平(50 - 100 dB SPL)和信噪比(SNR;安静、+6、+3和 - 3 dB)下助听与未助听时的言语可懂度表现,以记录现代助听器的益处。此外,还比较了不同输入水平下助听和未助听声音(言语和音乐)的主观偏好。
本实验采用析因重复测量设计。
共有10名患有对称性中度至重度听力损失的HI成年人作为测试参与者。此外,还测量了5名听力正常(NH)受试者的言语可懂度得分以作比较。
在安静环境以及65、85和100 dB SPL的噪声环境中,分别以+6、+3和 - 3 dB的信噪比,对所有参与者(HI和NH)在50和65 dB SPL输入水平下的言语感知进行了研究。此外,HI参与者还比较了在50、65、85和100 dB SPL安静环境下言语和音乐刺激助听与未助听呈现之间的主观偏好。
采用重复测量方差分析对数据进行分析。
结果显示,随着输入水平的增加,助听益处有所下降。然而,即使在两个最高输入水平(即85和100 dB SPL)下,助听后的言语得分仍高于未助听时。此外,在65至100 dB SPL输入水平下,NH受试者和助听条件下的HI受试者在噪声中的言语表现稳定,只是NH受试者的绝对表现高于HI受试者。随着输入水平的增加,对未助听声音与助听声音的主观偏好增加,言语的交叉强度约为75 dB SPL,音乐为80 dB SPL。
结果支持了以下假设:在受控环境中,本研究中的助听器在非常高的噪声输入情况下能提供助听的噪声中言语益处。