Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, USA.
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Ear Hear. 2019 Jul/Aug;40(4):887-904. doi: 10.1097/AUD.0000000000000667.
(1) Measure sentence recognition in co-located and spatially separated target and masker configurations in school-aged children with unilateral hearing loss (UHL) and with normal hearing (NH). (2) Compare self-reported hearing-related quality-of-life (QoL) scores in school-aged children with UHL and NH.
Listeners were school-aged children (6 to 12 yrs) with permanent UHL (n = 41) or NH (n = 35) and adults with NH (n = 23). Sentence reception thresholds (SRTs) were measured using Hearing In Noise Test-Children sentences in quiet and in the presence of 2-talker child babble or a speech-shaped noise masker in target/masker spatial configurations: 0/0, 0/-60, 0/+60, or 0/±60 degrees azimuth. Maskers were presented at a fixed level of 55 dBA, while the level of the target sentences varied adaptively to estimate the SRT. Hearing-related QoL was measured using the Hearing Environments and Reflection on Quality of Life (HEAR-QL-26) questionnaire for child subjects.
As a group, subjects with unaided UHL had higher (poorer) SRTs than age-matched peers with NH in all listening conditions. Effects of age, masker type, and spatial configuration of target and masker signals were found. Spatial release from masking was significantly reduced in conditions where the masker was directed toward UHL subjects' normal-hearing ear. Hearing-related QoL scores were significantly poorer in subjects with UHL compared to those with NH. Degree of UHL, as measured by four-frequency pure-tone average, was significantly correlated with SRTs only in the two conditions where the masker was directed towards subjects' normal-hearing ear, although the unaided Speech Intelligibility Index at 65 dB SPL was significantly correlated with SRTs in four conditions, some of which directed the masker to the impaired ear or both ears. Neither pure-tone average nor unaided Speech Intelligibility Index was correlated with QoL scores.
As a group, school-aged children with UHL showed substantial reductions in masked speech perception and hearing-related QoL, irrespective of sex, laterality of hearing loss, and degree of hearing loss. While some children demonstrated normal or near-normal performance in certain listening conditions, a disproportionate number of thresholds fell in the poorest decile of the NH data. These findings add to the growing literature challenging the past assumption that one ear is "good enough."
（1）在单侧听力损失（UHL）和正常听力（NH）的学龄儿童中，测量在共定位和空间分离的目标和掩蔽器配置中的句子识别。（2）比较单侧听力损失和正常听力学龄儿童的自我报告听力相关生活质量（QoL）评分。
听众为学龄儿童（6 至 12 岁），患有永久性单侧听力损失（n = 41）或正常听力（n = 35），以及正常听力成年人（n = 23）。使用 Hearing In Noise Test-Children 句子在安静环境中和在 2 人儿童闲聊或语音噪声掩蔽器存在下，在目标/掩蔽器空间配置 0/0、0/-60、0/+60 或 0/±60 度方位下测量句子接收阈值（SRT）。掩蔽器以 55 dBA 的固定水平呈现，而目标句子的水平则自适应变化以估计 SRT。对于儿童受试者，使用听力环境和生活质量反思（HEAR-QL-26）问卷测量听力相关 QoL。
作为一个群体，未助听的单侧听力损失受试者的 SRT 高于（较差）年龄匹配的正常听力同龄人，在所有听力条件下均如此。发现了年龄、掩蔽器类型以及目标和掩蔽器信号空间配置的影响。当掩蔽器指向单侧听力损失受试者的正常听力耳时，掩蔽释放显著降低。与正常听力者相比，单侧听力损失者的听力相关 QoL 评分明显较差。四频纯音平均测度的单侧听力损失程度仅与两个掩蔽器指向受试者正常听力耳的条件下的 SRT 显著相关，尽管 65 dB SPL 时未助听的言语可懂度指数与四个条件中的 SRT 显著相关，其中一些条件将掩蔽器指向受损耳或双耳。纯音平均测度和未助听的言语可懂度指数均与 QoL 评分无相关性。
作为一个群体，单侧听力损失的学龄儿童在掩蔽语音感知和听力相关 QoL 方面表现出显著降低，无论性别、听力损失的侧别以及听力损失程度如何。尽管一些儿童在某些听力条件下表现出正常或接近正常的表现，但相当数量的阈值落在正常听力数据的最差十分位数中。这些发现增加了越来越多的文献，挑战了过去单侧听力损失一只耳朵“足够好”的假设。
