Kurz Anja, Zanzinger Maren, Hagen Rudolf, Rak Kristen
Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany.
Eur Arch Otorhinolaryngol. 2021 Jun;278(6):2067-2077. doi: 10.1007/s00405-020-06450-5. Epub 2020 Nov 3.
Cochlear implantation has become a well-accepted treatment option for people with single-sided deafness (SSD) and has become a clinical standard in many countries. A cochlear implant (CI) is the only device which restores binaural hearing. The effect of microphone directionality (MD) settings has been investigated in other CI indication groups, but its impact on speech perception in noise has not been established in CI users with SSD. The focus of this investigation was, therefore, to assess binaural hearing effects using different MD settings in CI users with SSD.
Twenty-nine experienced CI users with SSD were recruited to determine speech reception thresholds with varying target and noise sources to define binaural effects (head shadow, squelch, summation, and spatial release from masking), sound localization, and sound quality using the SSQ12 and HISQUI questionnaires. Outcome measures included the MD settings "natural", "adaptive", and "omnidirectional".
The 29 participants involved in the study were divided into two groups: 11 SONNET users and 18 OPUS 2/RONDO users. In both groups, a significant head shadow effect of 7.4-9.2 dB was achieved with the CI. The MD setting "adaptive" provided a significant head shadow effect of 9.2 dB, a squelch effect of 0.9 dB, and spatial release from masking of 7.6 dB in the SONNET group. No significant summation effect could be determined in either group with CI. Outcomes with the omnidirectional setting were not significantly different between groups. For both groups, localization improved significantly when the CI was activated and was best when the omnidirectional setting was used. The groups' sound quality scores did not significantly differ.
Adaptive directional microphone settings improve speech perception and binaural hearing abilities in CI users with SSD. Binaural effect measures are valuable to quantify the benefit of CI use, especially in this indication group.
人工耳蜗植入已成为单侧耳聋（SSD）患者广泛接受的治疗选择，并在许多国家成为临床标准。人工耳蜗（CI）是唯一能恢复双耳听力的设备。在其他人工耳蜗适应证组中已对麦克风方向性（MD）设置的效果进行了研究，但在SSD人工耳蜗使用者中，其对噪声中语音感知的影响尚未明确。因此，本研究的重点是评估不同MD设置对SSD人工耳蜗使用者双耳听力的影响。
招募了29名有经验的SSD人工耳蜗使用者，通过改变目标声源和噪声源来确定言语接受阈值，以使用SSQ12和HISQUI问卷定义双耳效应（头影效应、静噪效应、总和效应和掩蔽空间释放）、声音定位和声音质量。结果测量包括MD设置“自然”、“自适应”和“全向”。
参与研究的29名参与者分为两组：11名SONNET使用者和18名OPUS 2/RONDO使用者。在两组中，人工耳蜗均产生了7.4 - 9.2 dB的显著头影效应。在SONNET组中，MD设置“自适应”产生了9.2 dB的显著头影效应、0.9 dB的静噪效应和7.6 dB的掩蔽空间释放。两组使用人工耳蜗均未确定有显著的总和效应。全向设置的结果在两组之间无显著差异。对于两组，人工耳蜗激活后定位显著改善，使用全向设置时最佳。两组的声音质量得分无显著差异。
自适应方向性麦克风设置可改善SSD人工耳蜗使用者的语音感知和双耳听力能力。双耳效应测量对于量化人工耳蜗使用的益处很有价值，尤其是在该适应证组中。
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