1 Instituto de Neurociencias de Castilla y León, University of Salamanca, Spain.
2 Instituto de Investigación Biomédica de Salamanca, University of Salamanca, Spain.
Trends Hear. 2017 Jan-Dec;21:2331216517730526. doi: 10.1177/2331216517730526.
Over 360 million people worldwide suffer from disabling hearing loss. Most of them can be treated with hearing aids. Unfortunately, performance with hearing aids and the benefit obtained from using them vary widely across users. Here, we investigate the reasons for such variability. Sixty-eight hearing-aid users or candidates were fitted bilaterally with nonlinear hearing aids using standard procedures. Treatment outcome was assessed by measuring aided speech intelligibility in a time-reversed two-talker background and self-reported improvement in hearing ability. Statistical predictive models of these outcomes were obtained using linear combinations of 19 predictors, including demographic and audiological data, indicators of cochlear mechanical dysfunction and auditory temporal processing skills, hearing-aid settings, working memory capacity, and pretreatment self-perceived hearing ability. Aided intelligibility tended to be better for younger hearing-aid users with good unaided intelligibility in quiet and with good temporal processing abilities. Intelligibility tended to improve by increasing amplification for low-intensity sounds and by using more linear amplification for high-intensity sounds. Self-reported improvement in hearing ability was hard to predict but tended to be smaller for users with better working memory capacity. Indicators of cochlear mechanical dysfunction, alone or in combination with hearing settings, did not affect outcome predictions. The results may be useful for improving hearing aids and setting patients' expectations.
全球有超过 3.6 亿人患有听力障碍,其中大多数人可以通过助听器进行治疗。然而,助听器的使用效果和患者从中获得的收益因人而异,差异较大。在这里,我们将探讨造成这种差异的原因。我们采用标准程序为 68 名助听器使用者或候选者双耳配备非线性助听器。通过测量时间反转双说话者背景下的助听言语可懂度和自我报告的听力改善情况来评估治疗效果。使用包括人口统计学和听力学数据、耳蜗机械功能障碍指标和听觉时处理技能、助听器设置、工作记忆能力以及治疗前自我感知听力能力在内的 19 个预测因素的线性组合来获得这些结果的统计预测模型。在安静环境中助听言语可懂度较好、且具有良好的时间处理能力的年轻助听器使用者的助听言语可懂度往往更好。对于低强度声音,增加放大增益有助于提高可懂度,而对于高强度声音,使用更线性的放大增益则有助于提高可懂度。自我报告的听力改善难以预测,但对于工作记忆能力较好的使用者,改善程度往往较小。耳蜗机械功能障碍的指标,无论是单独使用还是与听力设置结合使用,都不会影响预后预测。这些结果可能有助于改进助听器并设定患者的预期。