Department of ENT, Head and Neck Surgery, Inselspital Bern, University of Bern, 3010 Bern, Switzerland.
Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern 3008, Switzerland.
Biomed Res Int. 2021 Oct 22;2021:1518385. doi: 10.1155/2021/1518385. eCollection 2021.
Bone-anchored hearing systems (BAHS) transmit sound via osseointegrated implants behind the ear. They are used to treat patients with conductive or mixed hearing loss, but speech understanding may be limited especially in users with substantial additional cochlear hearing losses. In recent years, BAHS with higher maximum power output (MPO) and more advanced digital processing including loudness compression have become available. These features may be useful to increase speech understanding in users with mixed hearing loss. We have tested the effect of 4 combinations of two different MPO levels (highest level available and level reduced by 12 dB) and two different compression thresholds (CT) levels (50 dB and 65 dB sound pressure level) in 12 adult BAHS users on speech understanding in quiet and in noise. We have found that speech understanding was not influenced significantly by any of the changes in these two fitting parameters. In contrast, in users with average bone-conduction (BC) threshold of 25 dB or more, speech understanding was improved by +0.8 dB to +1.1 dB ( < 0.03) when using the higher MPO level. In this user group, there may be an additional, but very small benefit of +0.1 dB to +0.4 dB when using the lower rather than the higher CT value, but the difference was not statistically significant ( > 0.27). In users with better average BC thresholds than 25 dB, none of the improvement was statistically significant. Higher MPOs and possibly, to a lesser degree, lower CTs seem to be able to improve speech understanding in noise in users with higher BC thresholds, but even their combined effect seems to be limited.
骨锚式听力系统（BAHS）通过耳后的骨整合植入物传输声音。它们用于治疗传导性或混合性听力损失的患者，但言语理解能力可能有限，尤其是在有实质性额外耳蜗听力损失的患者中。近年来，具有更高最大输出功率（MPO）和更先进数字处理功能的 BAHS 已投入使用，包括响度压缩。这些功能可能有助于提高混合性听力损失患者的言语理解能力。我们已经测试了两种不同 MPO 水平（最高水平和降低 12dB 的水平）和两种不同压缩阈值（CT）水平（50dB 和 65dB 声压级）的 4 种组合对 12 名成人 BAHS 用户在安静和噪声环境下言语理解的影响。我们发现，这些两个适配参数中的任何一个变化都没有显著影响言语理解能力。相比之下，在平均骨导（BC）阈值为 25dB 或更高的患者中，使用更高的 MPO 水平可将言语理解提高+0.8dB 至+1.1dB（<0.03）。在这群患者中，使用较低的 CT 值而非较高的 CT 值可能会带来额外的、但非常小的益处+0.1dB 至+0.4dB，但差异没有统计学意义（>0.27）。在平均 BC 阈值高于 25dB 的患者中，没有任何改善具有统计学意义。较高的 MPO 和可能程度较低的 CT 值似乎能够提高较高 BC 阈值患者的噪声言语理解能力，但即使是它们的联合效应似乎也有限。
