Audiological Acoustics, Department of Otolaryngology, University Hospital Frankfurt, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Department of Otorhinolaryngology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.
HNO. 2024 Jan;72(Suppl 1):10-16. doi: 10.1007/s00106-023-01321-x. Epub 2023 Aug 8.
Although good speech perception in quiet is achievable with cochlear implants (CIs), speech perception in noise is severely impaired compared to normal hearing (NH). In the case of a bimodal CI fitting with a hearing aid (HA) in the opposite ear, the amount of residual acoustic hearing influences speech perception in noise.
The aim of this work was to investigate speech perception in noise in a group of bimodal CI users and compare the results to age-matched HA users and people without subjective hearing loss, as well as with a young NH group.
Study participants comprised 19 bimodal CI users, 39 HA users, and 40 subjectively NH subjects in the age group 60-90 years and 14 young NH subjects. Speech reception thresholds (SRTs) in noise were adaptively measured using the Oldenburg Sentence Test for the two spatial test conditions S0N0 (speech and noise from the front) and multisource-noise field (MSNF; speech from the front, four spatially distributed noise sources) in continuous noise of the Oldenburg Sentence Test (Ol-noise) and amplitude-modulated Fastl noise (Fastl-noise).
With increasing hearing loss, the median SRT worsened significantly in all conditions. In test condition S0N0, the SRT of the CI group was 5.6 dB worse in Ol-noise than in the young NH group (mean age 26.4 years) and 22.5 dB worse in Fastl-noise; in MSNF, the differences were 6.6 dB (Ol-noise) and 17.3 dB (Fastl-noise), respectively. In the young NH group, median SRT in condition S0N0 improved by 11 dB due to gap listening; in the older NH group, SRTs improved by only 3.1 dB. In the HA and bimodal CI groups there was no gap listening effect and SRTs in Fastl-noise were even worse than in Ol-noise.
With increasing hearing loss, speech perception in modulated noise is even more impaired than in continuous noise.
尽管使用人工耳蜗（CI）可以实现良好的安静言语感知，但与正常听力（NH）相比，噪声下的言语感知严重受损。在对侧耳朵佩戴助听器（HA）的双模式 CI 拟合的情况下，残留听觉的数量会影响噪声下的言语感知。
本研究旨在调查一组双模式 CI 用户的噪声下言语感知，并将结果与年龄匹配的 HA 用户和无主观听力损失的人群以及年轻的 NH 组进行比较。
研究参与者包括 19 名双模式 CI 用户、39 名 HA 用户和 40 名主观 NH 受试者，年龄在 60-90 岁之间，以及 14 名年轻的 NH 受试者。使用 Oldenburg 句子测试，通过自适应方法测量了在两种空间测试条件 S0N0（来自前方的言语和噪声）和多源噪声场（MSNF；来自前方的言语，四个空间分布的噪声源）下的噪声中的言语接收阈值（SRTs），测试条件使用 Oldenburg 句子测试的连续噪声（Ol-noise）和调幅 Fastl 噪声（Fastl-noise）。
随着听力损失的增加，所有条件下的中位数 SRT 都显著恶化。在测试条件 S0N0 中，CI 组的 SRT 在 Ol-noise 中比年轻的 NH 组（平均年龄 26.4 岁）差 5.6dB，在 Fastl-noise 中差 22.5dB；在 MSNF 中，差异分别为 6.6dB（Ol-noise）和 17.3dB（Fastl-noise）。在年轻的 NH 组中，由于间隙聆听，条件 S0N0 中的中位数 SRT 提高了 11dB；在年龄较大的 NH 组中，SRT 仅提高了 3.1dB。在 HA 和双模式 CI 组中，没有间隙聆听效应，Fastl-noise 中的 SRT 甚至比 Ol-noise 更差。
随着听力损失的增加，调制噪声下的言语感知甚至比连续噪声下的更差。
