Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH 45229;
Department of Communication Sciences & Disorders, University of Cincinnati, Cincinnati, OH 45267.
Proc Natl Acad Sci U S A. 2019 Nov 19;116(47):23753-23759. doi: 10.1073/pnas.1903315116. Epub 2019 Nov 4.
Young healthy adults can hear tones up to at least 20 kHz. However, clinical audiometry, by which hearing loss is diagnosed, is limited at high frequencies to 8 kHz. Evidence suggests there is salient information at extended high frequencies (EHFs; 8 to 20 kHz) that may influence speech intelligibility, but whether that information is used in challenging listening conditions remains unknown. Difficulty understanding speech in noisy environments is the most common concern people have about their hearing and usually the first sign of age-related hearing loss. Digits-in-noise (DIN), a widely used test of speech-in-noise perception, can be sensitized for detection of high-frequency hearing loss by low-pass filtering the broadband masking noise. Here, we used standard and EHF audiometry, self-report, and successively higher cutoff frequency filters (2 to 8 kHz) in a DIN test to investigate contributions of higher-frequency hearing to speech-in-noise perception. Three surprising results were found. First, 74 of 116 "normally hearing," mostly younger adults had some hearing loss at frequencies above 8 kHz. Early EHF hearing loss may thus be an easily measured, preventive warning to protect hearing. Second, EHF hearing loss correlated with self-reported difficulty hearing in noise. Finally, even with the broadest filtered noise (≤8 kHz), DIN hearing thresholds were significantly better ( < 0.0001) than those using broadband noise. Sound energy above 8 kHz thus contributes to speech perception in noise. People with "normal hearing" frequently report difficulty hearing in challenging environments. Our results suggest that one contribution to this difficulty is EHF hearing loss.
年轻健康的成年人可以听到至少 20 kHz 的音调。然而,用于诊断听力损失的临床听力测试在高频时仅限于 8 kHz。有证据表明,在扩展高频(EHF;8 至 20 kHz)范围内存在显著的信息,这些信息可能会影响言语可懂度,但在具有挑战性的聆听条件下是否使用这些信息尚不清楚。在嘈杂环境中理解言语的困难是人们对听力最常见的担忧,通常也是与年龄相关的听力损失的第一个迹象。在噪声环境中理解言语的困难是人们对听力最常见的担忧,通常也是与年龄相关的听力损失的第一个迹象。数字噪声测试(Digits-in-Noise,DIN)是一种广泛用于测试噪声下言语感知的测试,可以通过对宽带掩蔽噪声进行低通滤波来提高对高频听力损失的检测灵敏度。在这里,我们使用标准和 EHF 听力测试、自我报告以及在 DIN 测试中依次使用更高截止频率的滤波器(2 至 8 kHz)来研究更高频率的听力对噪声下言语感知的贡献。我们发现了三个令人惊讶的结果。首先,在 116 名“正常听力”的人中,有 74 人在 8 kHz 以上的频率存在一些听力损失。因此,早期的 EHF 听力损失可能是一种易于测量的、预防性的听力保护预警。其次,EHF 听力损失与自我报告的在噪声中听力困难相关。最后,即使使用最宽的滤波噪声(≤8 kHz),DIN 听力阈值也明显优于使用宽带噪声的阈值(<0.0001)。因此,8 kHz 以上的声能有助于噪声中的言语感知。有“正常听力”的人经常报告在具有挑战性的环境中听力困难。我们的结果表明,造成这种困难的一个原因是 EHF 听力损失。