人工耳蜗植入者对侧耳佩戴助听器的效果评价

摘要

背景:双耳聆听能够更好地进行声源定位,感受立体声,提高听阈5～10dB及增强噪声环境中的言语辨别能力.目的:探讨人工耳蜗植入者对侧耳佩戴助听器的意义和作用.设计:自身和相互对照研究.地点和对象:实验在第一军医大学珠江医院耳鼻咽喉科全军听力中心完成,对象为本科收治的语前聋患者6例,男4例,女2例,年龄7～18岁.方法:均为单耳使用Nucleus24人工耳蜗系统,采用ACE编码策略.于术后开机半年时在不同助听方式下(人工耳蜗+助听器和单独使用人工耳蜗)分别进行声场(啭音)测听、言语功能评估和问卷调查,将结果进行统计分析.主要观察指标:①两种助听方式下测试125,250,500,1 000,2 000,4 000和8 000 Hz的啭音听阈.②言语功能评估.③问卷调查.结果:人工耳蜗+助听器各频率听阈均值(18.89 Hz)较单独使用人工耳蜗声场(啭音)测试的各频率听阈均值(24.17 Hz)为低(t=4.647,P＜0.01),频率特性好.50个常用词汇及音节复述得分,人工耳蜗+助听器平均86分,单用人工耳蜗平均84分,说明患者利用两种助听方式均能获得较好的聆听效果.问卷调查显示使用人工耳蜗+助听器比单独使用人工耳蜗在辨别方向,噪声环境中聆听具有更好的效果,但在安静环境下聆听,两者无明显差异.结论:使用人工耳蜗者对侧耳佩戴助听器有助于更好地聆听.%BACKGROUND: Binaural hearing can localize sound, perceive stereo,and help to improve auditory threshold by 5 - 10 dB and the ability to distinguish sounds in noisy environment.OBJECTIVE: To investigate the effects of contralateral hearing aid for cochlear implant users.DESIGN: Auto-control and mutual control study.SETTING and PARTICIPANTS: The experiment was conducted at the PLA Hlearing Center of Department of Otorhinolarynagology, Zhujiang Hospital, First Military Medical University. The subjects were 6 prelingually deafened patients (4 males and 2 females, aged 7 - 18) who were treated in the department.METHODS: The patients received unilateral implantation of artificial cochlear of type Nucleus 24 and ACE coding strategy. Six months after the operation, the free field measurement, language-function evaluation and questionnaire were performed in the patients under different conditions: with cochlear implant and contralateral hearing aid(CI-a), or cochlear implant only(CI).conditions at 125,250,500, 1 000, 2 000, 4 000 and 8 000 Hz, respecRESULTS: The mean auditory threshold of CI-a hearing mode(18. 89 Hz)was lower than that of CI mode(24. 17 Hz) at each test frequency(t=4. 647, P ＜ 0. 01 ) with better frequency characteristics. Scores were gained in retelling of the 50 commonly used words and syllables. The average score of word-identification in the 2 modes was 86 and 84, respectively, with no significant differences between the two groups ( P ＞ 0. 05). The questionnaire showed that CI-a mode was better in perceiving stereo and distinguishing sound. However, these 2 modes showed no differences in quiet environment.CONCLUSION: Contralateral hearing aid for cochlear implant users can improve the effect of their hearing.