Hartel B P, Agterberg M J H, Snik A F, Kunst H P M, van Opstal A J, Bosman A J, Pennings R J E
Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, The Netherlands.
Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Clin Otolaryngol. 2017 Aug;42(4):805-814. doi: 10.1111/coa.12775. Epub 2016 Nov 6.
Usher syndrome is the leading cause of hereditary deaf-blindness. Most patients with Usher syndrome type IIa start using hearing aids from a young age. A serious complaint refers to interference between sound localisation abilities and adaptive sound processing (compression), as present in today's hearing aids. The aim of this study was to investigate the effect of advanced signal processing on binaural hearing, including sound localisation.
In this prospective study, patients were fitted with hearing aids with a nonlinear (compression) and linear amplification programs. Data logging was used to objectively evaluate the use of either program. Performance was evaluated with a speech-in-noise test, a sound localisation test and two questionnaires focussing on self-reported benefit.
Data logging confirmed that the reported use of hearing aids was high. The linear program was used significantly more often (average use: 77%) than the nonlinear program (average use: 17%). The results for speech intelligibility in noise and sound localisation did not show a significant difference between type of amplification. However, the self-reported outcomes showed higher scores on 'ease of communication' and overall benefit, and significant lower scores on disability for the new hearing aids when compared to their previous hearing aids with compression amplification.
Patients with Usher syndrome type IIa prefer a linear amplification over nonlinear amplification when fitted with novel hearing aids. Apart from a significantly higher logged use, no difference in speech in noise and sound localisation was observed between linear and nonlinear amplification with the currently used tests. Further research is needed to evaluate the reasons behind the preference for the linear settings.
尤塞氏综合征是遗传性聋哑失明的主要病因。大多数IIa型尤塞氏综合征患者从小就开始使用助听器。一个严重的问题是,目前的助听器存在声音定位能力与适应性声音处理(压缩)之间的干扰。本研究的目的是调查先进信号处理对双耳听力(包括声音定位)的影响。
在这项前瞻性研究中,为患者配备了具有非线性(压缩)和线性放大程序的助听器。使用数据记录客观评估每个程序的使用情况。通过噪声中的言语测试、声音定位测试以及两份关注自我报告益处的问卷来评估性能。
数据记录证实助听器的报告使用率很高。线性程序的使用频率(平均使用率:77%)明显高于非线性程序(平均使用率:17%)。噪声中言语清晰度和声音定位的结果在放大类型之间没有显示出显著差异。然而,自我报告的结果显示,与之前使用压缩放大的助听器相比,新型助听器在“沟通便利性”和总体益处方面得分更高,而在残疾方面得分显著更低。
IIa型尤塞氏综合征患者在佩戴新型助听器时,更喜欢线性放大而非非线性放大。除了记录的使用率显著更高外,使用当前测试方法在线性放大和非线性放大之间未观察到噪声中言语和声音定位方面的差异。需要进一步研究以评估偏好线性设置背后的原因。