Zaltz Yael, Bugannim Yossi, Zechoval Doreen, Kishon-Rabin Liat, Perez Ronen
The Department of Communication Disorders, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel.
Department of Otolaryngology and Head and Neck Surgery, Shaare Zedek Medical Center Affiliated to The Hebrew University Medical School, Jerusalem 9190501, Israel.
J Clin Med. 2020 May 8;9(5):1381. doi: 10.3390/jcm9051381.
Cochlear implants (CIs) are the state-of-the-art therapy for individuals with severe to profound hearing loss, providing them with good functional hearing. Nevertheless, speech understanding in background noise remains a significant challenge. The purposes of this study were to: (1) conduct a novel within-study comparison of speech-in-noise performance across ages in different populations of CI and normal hearing (NH) listeners using an adaptive sentence-in-noise test, and (2) examine the relative contribution of sensory information and cognitive-linguistic factors to performance. Forty CI users (mean age 20 years) were divided into "early-implanted" <4 years ( = 16) and "late-implanted" >6 years ( = 11), all prelingually deafened, and "progressively deafened" ( = 13). The control group comprised 136 NH subjects (80 children, 56 adults). Testing included the Hebrew Matrix test, word recognition in quiet, and linguistic and cognitive tests. Results show poorer performance in noise for CI users across populations and ages compared to NH peers, and age at implantation and word recognition in quiet were found to be contributing factors. For those recognizing 50% or more of the words in quiet ( = 27), non-verbal intelligence and receptive vocabulary explained 63% of the variance in noise. This information helps delineate the relative contribution of top-down and bottom-up skills for speech recognition in noise and can help set expectations in CI counseling.
人工耳蜗（CI）是针对重度至极重度听力损失患者的先进治疗手段，能为他们提供良好的功能性听力。然而，在背景噪声中理解言语仍然是一项重大挑战。本研究的目的是：（1）使用自适应噪声句子测试，在不同人群（人工耳蜗使用者和正常听力（NH）听众）中对不同年龄的噪声中言语表现进行新颖的研究内比较，以及（2）研究感官信息和认知语言因素对表现的相对贡献。40名人工耳蜗使用者（平均年龄20岁）被分为“早期植入”（<4岁，n = 16）和“晚期植入”（>6岁，n = 11），均为语前聋，以及“渐进性耳聋”（n = 13）。对照组包括136名正常听力受试者（80名儿童，56名成人）。测试包括希伯来矩阵测试、安静环境下的单词识别以及语言和认知测试。结果显示，与正常听力的同龄人相比，不同人群和年龄的人工耳蜗使用者在噪声中的表现较差，并且植入年龄和安静环境下的单词识别被发现是影响因素。对于那些在安静环境中能识别50%或更多单词的人（n = 27），非言语智力和接受性词汇解释了噪声中63%的方差。这些信息有助于描绘自上而下和自下而上技能对噪声中语音识别的相对贡献，并有助于在人工耳蜗咨询中设定期望。
