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单侧聋患者耳鸣及耳聋时间对噪声下声音定位和言语识别的影响。

Effect of Tinnitus and Duration of Deafness on Sound Localization and Speech Recognition in Noise in Patients With Single-Sided Deafness.

机构信息

1 Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.

2 NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.

出版信息

Trends Hear. 2018 Jan-Dec;22:2331216518813802. doi: 10.1177/2331216518813802.

Abstract

Patients with single-sided deafness (SSD) often experience poor sound localization, reduced speech understanding in noise, reduced quality of life, and tinnitus. The present study aims to evaluate effects of tinnitus and duration of deafness on sound localization and speech recognition in noise by SSD subjects. Sound localization and speech recognition in noise were measured in 26 SSD and 10 normal-hearing (NH) subjects. Speech was always presented directly in front of the listener. Noise was presented to the deaf ear, in front of the listener, or to the better hearing ear. Tinnitus severity was measured using visual analog scale and Tinnitus Handicap Inventory. Relative to NH subjects, SSD subjects had significant deficits in sound localization and speech recognition in all listening conditions ( p < .001). For SSD subjects, speech recognition in noise was correlated with mean hearing thresholds in the better hearing ear ( p < .001) but not in the deaf ear. SSD subjects with tinnitus performed poorer in sound localization and speech recognition in noise than those without tinnitus. Shorter duration of deafness was associated with greater tinnitus and sound localization difficulty. Tinnitus visual analog scale and Tinnitus Handicap Inventory were highly correlated; the degree of tinnitus was negatively correlated with sound localization and speech recognition in noise. Those experiencing noticeable tinnitus may benefit more from cochlear implantation than those without; subjective tinnitus reduction may be correlated with improved sound localization and speech recognition in noise. Subjects with longer duration of deafness demonstrated better sound localization, suggesting long-term compensation for loss of binaural cues.

摘要

单侧聋(SSD)患者常伴有声音定位差、噪声下言语理解能力降低、生活质量下降和耳鸣等问题。本研究旨在评估 SSD 患者的耳鸣和耳聋持续时间对声音定位和噪声下言语识别的影响。对 26 名 SSD 患者和 10 名正常听力(NH)患者进行了声音定位和噪声下言语识别测试。言语始终直接呈现给听众。噪声呈现于患耳、听众前方或对侧好耳。采用视觉模拟量表和耳鸣残疾量表评估耳鸣严重程度。与 NH 组相比,SSD 组在所有听力条件下的声音定位和噪声下言语识别能力均显著降低(p<.001)。对于 SSD 患者,噪声下的言语识别与对侧好耳的平均听阈相关(p<.001),但与患耳无关。有耳鸣的 SSD 患者在噪声下的声音定位和言语识别能力比无耳鸣的患者差。耳聋持续时间越短,耳鸣和声音定位困难越严重。耳鸣视觉模拟量表和耳鸣残疾量表高度相关;耳鸣程度与噪声下的声音定位和言语识别呈负相关。那些有明显耳鸣的患者可能比没有耳鸣的患者从人工耳蜗植入中获益更多;主观耳鸣减轻可能与噪声下声音定位和言语识别能力的改善有关。耳聋持续时间较长的患者声音定位能力更好,提示长期对双耳线索缺失的代偿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20ce/6291880/35aef1a89ec7/10.1177_2331216518813802-fig1.jpg

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