Dai J S, Wei L, Li J Y, Wang X, He X L, Nie S, Zhang J
Department of Otolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jul 7;60(7):785-791. doi: 10.3760/cma.j.cn115330-20240707-00406.
This study evaluates the horizontal sound localization ability of young and middle-aged individuals with symmetric sensorineural hearing loss (SNHL) in noisy environments. It also examines the impact of hearing loss severity and signal-to-noise ratio (SNR) on localization accuracy. In this cross-sectional study, conducted from April 2023 to April 2024, 135 young and middle-aged patients (73 males and 62 females, aged 18-60 years) with SNHL who sought care at Beijing Chaoyang Hospital, were categorized into mild, moderate, and moderate-to-severe hearing loss groups (45 per group), with 45 normal-hearing controls (23 males and 22 females, aged 20-60 years). Participants completed localization tasks in quiet and noisy environments with SNR levels of 5 dB, 0 dB, -5 dB, and-10 dB. Root mean square error (RMSE) was used to measure localization accuracy. Repeated measures ANOVA assessed the effects of hearing loss and SNR on RMSE, while, Pearson correlation evaluated the relationship between binaural 4-frequency pure-tone average (4fPTA) and RMSE. Multiple linear regression analyzed the predictive role of 4fPTA and age. (1) Two-way repeated measures ANOVA showed that both hearing loss severity and SNR significantly affected RMSE (=92.67,<0.01;=430.29,<0.01), with a significant interaction between the two factors(=92.67,<0.01). (2) RMSE increased with hearing loss severity. At SNRs of 5 dB, 0 dB, and-5 dB, the moderate-to-severe group had significantly higher RMSE than the mild and moderate groups (<0.01). No significant differences were found between mild and moderate groups (=0.53, 0.57, 0.22). At-10 dB SNR, significant differences were observed across all groups (<0.01). (3) RMSE increased non-linearly as SNR decreased. Mean RMSE values under quiet conditions and at SNRs of 5 dB, 0 dB, -5 dB, and-10 dB were (7.43±5.01)°, (9.80±5.74)°, (11.60±6.22)°, (14.56±7.07)°, and (18.74±8.02)°, respectively. (4) RMSE was significantly positively correlated with binaural 4fPTA (=0.54-0.58, <0.01). Multiple linear regression analysis indicated that the binaural average 4fPTA significantly predicted RMSE (<0.01), explaining 30.5%-34.1% of RMSE variance. Age did not significantly contribute to RMSE variation. The degree of hearing loss and background noise SNR significantly affect horizontal sound localization in young and middle-aged SNHL patients. RMSE increases with hearing loss severity and decreases with higher SNR. The interaction between hearing loss and SNR is significant, and RMSE correlates with binaural 4fPTA. However, the regression model based on 4fPTA and age explains only part of the RMSE variance, suggesting other contributing factors.
本研究评估了患有对称性感音神经性听力损失（SNHL）的中青年个体在嘈杂环境中的水平声音定位能力。它还研究了听力损失严重程度和信噪比（SNR）对定位准确性的影响。在这项于2023年4月至2024年4月进行的横断面研究中，135名在北京朝阳医院就诊的患有SNHL的中青年患者（73名男性和62名女性，年龄在18至60岁之间）被分为轻度、中度和中重度听力损失组（每组45人），另有45名听力正常的对照组（23名男性和22名女性，年龄在20至60岁之间）。参与者在安静和信噪比分别为5 dB、0 dB、 -5 dB和 -10 dB的嘈杂环境中完成定位任务。均方根误差（RMSE）用于衡量定位准确性。重复测量方差分析评估听力损失和信噪比对RMSE的影响，而Pearson相关性评估双耳4频率纯音平均听阈（4fPTA）与RMSE之间的关系。多元线性回归分析4fPTA和年龄的预测作用。（1）双向重复测量方差分析表明，听力损失严重程度和信噪比均显著影响RMSE（F = 92.67，P < 0.01；F = 430.29，P < 0.01），且这两个因素之间存在显著交互作用（F = 92.67，P < 0.01）。（2）RMSE随着听力损失严重程度的增加而增加。在信噪比为5 dB、0 dB和 -5 dB时，中重度组的RMSE显著高于轻度和中度组（P < 0.01）。轻度和中度组之间未发现显著差异（P = 0.53、0.57、0.22）。在信噪比为 -10 dB时，所有组之间均观察到显著差异（P < 0.01）。（3）RMSE随着信噪比的降低呈非线性增加。安静条件下以及信噪比为5 dB、0 dB、 -5 dB和 -10 dB时的平均RMSE值分别为（7.43±5.01）°、（9.80±5.74）°、（11.60±6.22）°、（14.56±7.07）°和（18.74±8.02）°。（4）RMSE与双耳4fPTA显著正相关（r = 0.54 - 0.58，P < 0.01）。多元线性回归分析表明，双耳平均4fPTA显著预测RMSE（P < 0.01），解释了RMSE方差的30.5% - 34.1%。年龄对RMSE变化没有显著贡献。听力损失程度和背景噪声信噪比显著影响中青年SNHL患者的水平声音定位。RMSE随着听力损失严重程度的增加而增加，随着信噪比的升高而降低。听力损失和信噪比之间的交互作用显著，且RMSE与双耳4fPTA相关。然而，基于4fPTA和年龄的回归模型仅解释了部分RMSE方差，表明存在其他影响因素。
