双耳双模式助听患者汉语普通话声调识别特征

摘要

目的 比较双耳双模式助听患者在安静环境和不同背景噪声下的声调识别率,探讨不同信噪比和不同基频噪声下的双模式优势.方法 12例一侧植入人工耳蜗、对侧佩戴助听器[双模式(CIHA)]的汉语普通话患者参加本研究,所有患者双模式使用时间均为半年以上.使用天使语训i-CAST测试软件的人工耳蜗科研项目模块,采用闭合式测试方法,分别测试受试者在安静环境和不同背景噪声环璋下单独使用人工耳蜗(CI)、单独使用助听器(HA)和双模式下(CIHA)的声调识别率,测试环境包括安静环境、男信号男背景、男信号女背景三种,每种背景噪声包含10、5和0 dB三种信噪比(以下将6种背景噪声简称为男男10、男男5、男男0、男女10、男女5和男女0),即每位患者进行21组测试;每组分别测试/Ba/、/Bi/、/Bo/、/Bu/4个音的一、二、三、四4个声调;测试声通过扬声器发出,强度为65 dB SPL;记录患者上述三种模式下的助听听阈及助听侧裸耳听阈.结果 患者在CIHA与CI模式下的助听听阈差异无统计学意义(P>0.05),但均与HA模式和非植入侧的裸耳听阈差异有统计学意义(P<0.05).声调识别率受背景环境的显著影响(F=24.77,P<0.001),安静环境、男男5和男男0背景噪声环境下双模式无明显优势(P>0.05),在男男10、男女10、男女5和男女0背景噪声环境下双模式均有显著优势(P值分别为0.010,0.012,0.015和0.001).结论 本组患者在安静环境下的声调识别双模式无显著优势,信号声与背景噪声基频不同时,双模式优势显著.%Objective To study the benefits of combined electric and acoustic stimulation in Chinese Mandarin cochlear implantation users in the fields of tone recognition ,and to determine the effect of different signal noise rati-os (SNR) ,different fundamental frequency (F0) background noise to tone .Methods Twelve Mandarin -speaking bimodal patients participated in this study .Subjects were native speakers of Mandarin Chinese .All subjects had more than six months of experience with their devices at the time of testing .Closed -set identification tasks were used to measure Chinese tone recognition (16-alternative ,forced-choice) .The subjects were tested with cochlear implants (CI) ,hearing aids (HA) and CIHA .There were SNR 10 ,5 and 0 dB ,and two kind of background signals (a man and woman speaking /Ba/,respectively) .In all ,the number of tests was 21[=3 listening (CI ,CI+ HA , HA)× [quiet+2 background maskers × 3 SNR (10 dB ,5 dB ,0 dB)] .Their basic demographic and audiologic in-formation was recorded .The subjects'pure -tone thresholds at 0 .25 ,0 .5 ,1 ,2 ,and 4 kHz were tested with CIHA ,CI ,HA and naked ear of the HA side ,respectively .Results There was no significant difference betweenthe CIHA and CI aided threshold (P>0 .05) .But the differences were significant between CIHA and HA as well as naked ear of the HA side (P<0 .05) .No significant bimodal benefits were found in quiet conditions .But Significant bimodal benefits were observed when maskers and targets have different F0 in all SNR conditions(P<0 .05) ,and the lower the SNR ,the greater the bimodal benefits .Conclusion Bimodal is greatly benefit for tone recognition informa-tion when target and masker have different F0 .