Munro K J, Nind L, Cleaver V C
Regional Audiology Clinic, ISVR Hearing and Balance Centre, University of Southampton, UK.
Br J Audiol. 1996 Aug;30(4):275-85. doi: 10.3109/03005369609076774.
It is generally agreed that the maximum output from a hearing aid should not exceed the subject's uncomfortable loudness level (ULL). However, this relationship is not easily defined as electroacoustic data are usually measured in a 2 cc coupler and auditory measurements are usually obtained from supra-aural transducers calibrated in a 6 cc coupler. The aim of the study was to investigate this relationship in 21 adults who were being fitted with a hearing aid for the first time. A probe-tube microphone system was used to measure the sound pressure level of both variables in the ear canal. The measurement of ULL was determined using the method recommended by the British Society of Audiology (1987). The ULL values were around 110 dB SPL (+/-10) when measured in the ear canal. The maximum output of the hearing aid was obtained by correcting the SSPL90 with the subject's own real ear to coupler difference. The results revealed that the real ear saturation response (RESR) of the newly fitted hearing aid was typically 115-120 dB SPL (+/-8). The RESR exceeded the ULL for 19 (90%) subjects on average at five of the seven frequencies and by 12 dB. While further research is needed to determine whether discomfort occurred in real life situations, the implications are that the subject may use the hearing aid at less than optimum settings to prevent loudness discomfort or may ultimately reject the hearing aid altogether.
人们普遍认为，助听器的最大输出不应超过受试者的不舒适响度级（ULL）。然而，这种关系并不容易界定，因为电声数据通常在2立方厘米耦合器中测量，而听觉测量通常是通过在6立方厘米耦合器中校准的耳上式换能器获得的。该研究的目的是调查21名首次佩戴助听器的成年人的这种关系。使用探管麦克风系统测量耳道中两个变量的声压级。ULL的测量采用英国听力学学会（1987年）推荐的方法。在耳道中测量时，ULL值约为110 dB SPL（±10）。通过用受试者自身的真耳到耦合器差值校正SSPL90来获得助听器的最大输出。结果显示，新佩戴助听器的真耳饱和反应（RESR）通常为115 - 120 dB SPL（±8）。在七个频率中的五个频率上，平均有19名（90%）受试者的RESR超过ULL，差值为12 dB。虽然需要进一步研究以确定在现实生活中是否会出现不适，但这意味着受试者可能会以低于最佳设置使用助听器以防止响度不适，或者最终可能会完全拒绝使用助听器。
