聋病患者使用 Radioear B71 和 B81 时乳突和额部的振动觉阈值

1Department of Signals and Systems, Chalmers University of Technology, Göteborg, Sweden; and 2Department of Otorhinolaryngology, Head and Neck Surgery University Hospital, Halle (Saale), Germany.

Ear Hear. 2017 Nov/Dec;38(6):714-723. doi: 10.1097/AUD.0000000000000456.

OBJECTIVES

The main objective of this study was to measure the vibrotactile thresholds on the mastoid process and forehead positions using patients with bilateral deafness and to compare the results from the two bone conduction vibrators Radioear B71 and B81.

DESIGN

There is a possibility that the vibrotactile sensation on the skin makes it difficult to discriminate between sound and vibration. The risk is highest for patients who have bone conduction hearing thresholds in proximity to or worse than their vibrotactile thresholds. All measurements were performed similar to regular bone conduction threshold testing using an audiometer-driven bone conduction vibrator and pulsed warble tones, but the patients were instructed to respond only when feeling vibrations of the bone conduction vibrator instead of when hearing sound. Both the posterior forehead position and the mastoid process position on the temporal bone were tested for comparative reasons. In total, 16 patients participated in the study, 31% females and 69% males of age 29 to 77 years. All subjects were cochlear implant recipients, either uni- or bilaterally implanted. They were selected based on their audiogram data showing unmeasurable unaided hearing.

RESULTS

The force level at which the vibrotactile thresholds were reached, increased with frequency from 125 up to 500 Hz, but remained constant for higher frequencies up to 2 kHz. A statistically significant difference was found between the 2 devices at 125 Hz at both the mastoid process and forehead position, where the vibrotactile threshold seem to be more sensitive for B71, possibly due to contribution of distortion components. There was no statistically significant difference in vibrotactile thresholds between the mastoid process and forehead position in absolute values (force level in dB re 1 µN), but in terms of hearing levels (dB HL) there was an average difference of 10 and 9 dB for B71 and B81, respectively.

CONCLUSIONS

The results indicate that the vibrotactile thresholds can be confounded with bone conduction hearing thresholds measurements up to 500 Hz when using a standard audiometer and in particular when measuring on the forehead position.

目的

本研究的主要目的是测量双侧耳聋患者乳突和额部位置的振动觉阈值，并比较两种骨导振动器 Radioear B71 和 B81 的结果。

设计

皮肤的振动觉可能会使声音和振动之间的区分变得困难。对于骨导听阈接近或低于振动觉阈值的患者，风险最高。所有测量均使用听力计驱动的骨导振动器和脉冲颤音进行，类似于常规骨导听阈测试，但患者被指示仅在感觉到骨导振动器的振动时而不是听到声音时做出响应。出于比较的原因，还测试了颞骨的后额部位置和乳突位置。共有 16 名患者参与了这项研究，其中女性占 31%，男性占 69%，年龄在 29 至 77 岁之间。所有受试者均为单侧或双侧植入的人工耳蜗植入者。他们是根据其听力图数据选择的，这些数据显示无法测量的未助听听力。

结果

振动觉阈值达到的力水平随频率从 125Hz 增加到 500Hz 而增加，但对于高达 2kHz 的更高频率保持不变。在 125Hz 时，在乳突和额部位置，两种设备之间的差异具有统计学意义，B71 的振动觉阈值似乎更敏感，这可能是由于失真分量的贡献。在绝对值（以 1µN 为单位的 dB 重新）方面，乳突和额部位置之间的振动觉阈值没有统计学上的显著差异，但在听力水平（dB HL）方面，B71 和 B81 分别有平均 10 和 9dB 的差异。