Asp Filip, Jakobsson Anne-Marie, Berninger Erik
Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Sweden; Karolinska University Hospital, Department of ENT, Section of Cochlear Implants, Sweden; Chalmers University of Technology, Department of Electrical Engineering, Sweden.
Karolinska University Hospital, Department of Audiology and Neurotology, Sweden.
Hear Res. 2018 Jan;357:54-63. doi: 10.1016/j.heares.2017.11.008. Epub 2017 Nov 22.
Unilateral hearing loss (UHL) occurs in 25% of cases of congenital sensorineural hearing loss. Due to the unilaterally reduced audibility associated with UHL, everyday demanding listening situations may be disrupted despite normal hearing in one ear. The aim of this study was to quantify acute changes in recognition of speech in spatially separate competing speech and sound localization accuracy, and relate those changes to two levels of temporary induced UHL (UHL and UHL; suffixes denote the average hearing threshold across 0.5, 1, 2, and 4 kHz) for 8 normal-hearing adults. A within-subject repeated-measures design was used (normal binaural conditions, UHL and UHL). The main outcome measures were the threshold for 40% correct speech recognition and the overall variance in sound localization accuracy quantified by an Error Index (0 = perfect performance, 1.0 = random performance). Distinct and statistically significant deterioration in speech recognition (2.0 dB increase in threshold, p < 0.01) and sound localization (Error Index increase of 0.16, p < 0.001) occurred in the UHL condition. Speech recognition did not significantly deteriorate further in the UHL condition (1.0 dB increase in speech recognition threshold, p > 0.05), while sound localization was additionally impaired (Error Index increase of 0.33, p < 0.01) with an associated large increase in individual variability. Qualitative analyses on a subject-by-subject basis showed that high-frequency audibility was important for speech recognition, while low-frequency audibility was important for horizontal sound localization accuracy. While the data might not be entirely applicable to individuals with long-standing UHL, the results suggest a need for intervention for mild-to-moderate UHL.
单侧听力损失（UHL）发生于25%的先天性感音神经性听力损失病例中。由于与UHL相关的单侧可听度降低，尽管一只耳朵听力正常，但日常的高要求听力情境仍可能受到干扰。本研究的目的是量化8名听力正常的成年人在空间上分离的竞争性言语中言语识别的急性变化以及声音定位准确性，并将这些变化与两种水平的临时诱发UHL（UHL和UHL；后缀表示0.5、1、2和4千赫的平均听力阈值）相关联。采用了受试者内重复测量设计（正常双耳条件、UHL和UHL）。主要结局指标是40%正确言语识别的阈值以及通过误差指数量化的声音定位准确性的总体方差（0 = 完美表现，1.0 = 随机表现）。在UHL条件下，言语识别出现了明显且具有统计学意义的恶化（阈值增加2.0分贝，p < 0.01），声音定位也出现恶化（误差指数增加0.16，p < 0.001）。在UHL条件下，言语识别没有进一步显著恶化（言语识别阈值增加1.0分贝，p > 0.05），而声音定位进一步受损（误差指数增加0.33，p < 0.01），且个体变异性大幅增加。基于个体的定性分析表明，高频可听度对言语识别很重要，而低频可听度对水平声音定位准确性很重要。虽然这些数据可能不完全适用于长期患有UHL的个体，但结果表明对轻度至中度UHL需要进行干预。
