Souza Pamela, Hoover Eric, Blackburn Michael, Gallun Frederick
Department of Communication Sciences and Disorders and Knowles Hearing Center, Northwestern University, Evanston, IL.
Auditory & Speech Sciences Laboratory, University of South Florida, Tampa, FL.
J Am Acad Audiol. 2018 Sep;29(8):764-779. doi: 10.3766/jaaa.17050.
Severe hearing loss impairs communication in a wide range of listening environments. However, we lack data as to the specific objective and subjective abilities of listeners with severe hearing loss. Insight into those abilities may inform treatment choices.
The primary goal was to describe the audiometric profiles, spectral resolution ability, and objective and subjective speech perception of a sample of adult listeners with severe hearing loss, and to consider the relationships among those measures. We also considered the typical fitting received by individuals with severe loss, in terms of hearing aid style, electroacoustic characteristics, and features, as well as supplementary device use.
A within-subjects design was used.
Participants included 36 adults aged 54-93 yr with unilateral or bilateral severe hearing loss.
Testing included a full hearing and hearing aid history; audiometric evaluation; loudness growth and dynamic range; spectral resolution; assessment of cochlear dead regions; objective and subjective assessment of speech recognition; and electroacoustic evaluation of current hearing aids. Regression models were used to analyze relationships between hearing loss, spectral resolution, and speech recognition.
For speech in quiet, 60% of the variance was approximately equally accounted for by amount of hearing loss, spectral resolution, and number of dead regions. For speech in noise, only a modest proportion of performance variance was explained by amount of hearing loss. In general, participants were wearing amplification of appropriate style and technology for their hearing loss, but the extent of assistive technology use was low. Subjective communication ratings depended on the listening situation, but in general, were similar to previously published data for adults with mild-to-moderate loss who did not wear hearing aids.
The present data suggest that the range of abilities of an individual can be more fully captured with comprehensive testing. Such testing also offers an opportunity for informed counseling regarding realistic expectations for hearing aid use and the availability of hearing assistive technology.
重度听力损失会在多种聆听环境中影响交流。然而，我们缺乏关于重度听力损失聆听者具体客观和主观能力的数据。深入了解这些能力可能有助于指导治疗选择。
主要目标是描述一组重度听力损失成年聆听者的听力图特征、频谱分辨能力以及客观和主观言语感知，并探讨这些指标之间的关系。我们还考虑了重度听力损失患者通常所使用的助听器类型、电声特性和功能，以及辅助设备的使用情况。
采用受试者内设计。
参与者包括36名年龄在54 - 93岁之间的成年人，他们患有单侧或双侧重度听力损失。
测试包括完整的听力和助听器使用史；听力评估；响度增长和动态范围；频谱分辨；耳蜗死区评估；言语识别的客观和主观评估；以及对当前使用的助听器进行电声评估。使用回归模型分析听力损失、频谱分辨和言语识别之间的关系。
对于安静环境下的言语，约60%的方差大致由听力损失程度、频谱分辨能力和死区数量平均分担。对于噪声环境下的言语，只有一小部分表现方差可由听力损失程度解释。总体而言，参与者佩戴的助听器类型和技术与其听力损失情况相匹配，但辅助技术的使用程度较低。主观交流评分取决于聆听情境，但总体上与之前发表的未佩戴助听器的轻度至中度听力损失成年人的数据相似。
目前的数据表明，通过全面测试可以更全面地了解个体的能力范围。这样的测试还为就助听器使用的现实期望和听力辅助技术的可用性提供明智的咨询提供了机会。
