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中度听力损失儿童:不同语音强度下佩戴助听器进行阈上言语测听的重要性。

Children with moderate hearing loss: importance of suprathreshold speech audiometry with hearing aids at different voice intensities.

作者信息

Colin Elisabeth, Grinand Marilyne, Roman Stéphane, Alshawareb Fadi

机构信息

Department of ENT, Avignon General Hospital, 305 rue Raoul Follereau, Avignon, 84000, France.

Department of Clinical Research, Avignon General Hospital, 305 rue Raoul Follereau, Avignon, 84000, France.

出版信息

Eur Arch Otorhinolaryngol. 2025 Jul 18. doi: 10.1007/s00405-025-09564-w.

Abstract

PURPOSE

Moderate hearing loss (41-55dB HL) in children is an increasing subject of research. This study aimed to evaluate the auditory performance of these children with correctly fitted hearing aids (HA) by comparing their aided pure tone thresholds and aided speech perception in suprathreshold speech audiometry.

METHODS

This retrospective study included 24 children with moderate bilateral hearing loss. Aided and unaided pure tone thresholds were determined. Aided and unaided suprathreshold speech audiometry was assessed using Lafon's phonetic test at 65, 55, and 45dB HL.

RESULTS

At diagnosis, median pure tone threshold with headphones was 48 and 50dB HL for the right and left ears, respectively. Median aided threshold was 29dB HL for both ears. Using Lafon's phonetic test at 65, 55, and 45dB HL, the unaided children respectively had 45%, 11%, and 1% of phonemic recognition, increasing to 95%, 84%, and 69% with HA. With HA, 18 children correctly repeated 100% of phonemes at 65dB HL compared with 10 children at 55dB HL and 2 at 45dB HL. Correlation tests showed that children fitted with HA at a younger age performed better at Lafon's test.

CONCLUSION

HA undeniably improve the auditory perceptions of children with permanent moderate bilateral hearing loss and should always be prescribed as soon as possible. Their performances in Lafon's test still fall short of the results of children with "normal" hearing, especially in overhearing situations. Children with late fitting have a higher risk of partial auditory rehabilitation. Systematic supra threshold speech audiometry is required.

摘要

目的

儿童中度听力损失(41 - 55dB HL)是一个日益受到研究的课题。本研究旨在通过比较佩戴合适助听器(HA)的这些儿童的助听听阈和阈上言语测听中的助听言语感知,来评估他们的听觉表现。

方法

这项回顾性研究纳入了24名双侧中度听力损失的儿童。测定了助听和未助听的纯音听阈。使用拉方语音测试在65、55和45dB HL下评估助听和未助听的阈上言语测听。

结果

诊断时,右耳和左耳使用耳机的纯音听阈中位数分别为48dB HL和50dB HL。双耳的助听听阈中位数为29dB HL。在65、55和45dB HL下使用拉方语音测试,未佩戴助听器的儿童音素识别率分别为45%、11%和1%,佩戴助听器后分别提高到95%、84%和69%。佩戴助听器后,18名儿童在65dB HL时能正确重复100%的音素,而在55dB HL时有10名儿童,在45dB HL时有2名儿童。相关性测试表明,较年轻时佩戴助听器的儿童在拉方测试中表现更好。

结论

不可否认,助听器能改善永久性双侧中度听力损失儿童的听觉感知,应尽早处方。他们在拉方测试中的表现仍不及听力“正常”儿童的结果,尤其是在偷听情况下。佩戴助听器较晚的儿童听觉部分康复的风险更高。需要进行系统的阈上言语测听。

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