耳蜗性聋患者在噪声竞争下言语测听的探讨  

A Clinical Study of Chinese Speech Audiometry in Noise for Cochlear Deafness

作　　者：广华平[1] 杨强[1] 

机构地区：[1]湖北医科大学附一医院耳鼻咽喉-头颈外科

出　　处：《听力学及言语疾病杂志》1998年第1期11-14,共4页Journal of Audiology and Speech Pathology

摘　　要：为了观察耳蜗性聋患者噪声竞争下言语清晰度曲线与正常听力者的区别、不同噪声对清晰度曲线的不同影响,以及该测试方法对听力障碍的评价能力,文中报道了29名耳蜗性聋(其中14例为单纯高频听力损失,即2000Hz以上听力下降,而250～2000Hz气导听阈不大于25dBHL),在3种不同噪声竞争下测得的言语识别率结果.选用竞争噪声有白噪声(white noise,WN)、言语噪声(speech noise,SN)和自行录制合成的多人谈话声(babble noise,BN);并将测得言语识别率结果用两个参数的数学模型来表达信噪比(signal-to-noise ratio,SNR)与识别率间的关系.绘出清晰度曲线.测试结果发现:耳蜗性聋患者识别率结果随SNR的变化而变化,与我们先测得的正常听力者相比,同一SNR下言语识别率皆有不同程度下降,清晰度曲线右移,曲线斜率亦发生变化.高频听力下降者在各噪声竞争下言语清晰度曲线亦不同程度右移.在不同噪声竞争下,清晰度曲线右移幅度不同,其中SN>WN>BN.本研究说明:噪声下汉语言语测听能有效地评价耳聋者言语识别率水平.不同噪声竞争对不同听力损失者的言语识别率有不同的影响;因SN竞争下言语识别率结果较稳定、对听力损失敏感,是开展噪声竞争下言语测听的首选竞争噪声.A designed Chinese monosyllabic speech test in noise through headphone was performed on two groups 15 cochlear deafness (CD) listeners and 14 high - frequency hearing loss listeners (HHLoss group). Three noises, speech noise (SN),white noise (WN) and babble noise (BN) were used. Classical psychophysical ogive curve was used to model speech recognition as function of signal - to - noise ratio (SNR). Two hearing loss groups underwent speech test in three noises of 4 to 6 SNRs. The results of hearing-repaired was compared with normal hearing group which we reported early. The speech discrimination scores (DS) was related to SNR and it was poorer than in normal group in the same noise and same SNR. Comparing with Norm group, the speech recognition curves of the other two groups were shifted to right.the slope of curve varied. In the same noise,the curve shifted results of different hearing - impaired group also varied. SH-Loss group>CD group. In same hearing-impaired group,the curve shifted results in different noise were also varied,SN>WN>BN. It meant that the speech recognition curve in noise was respectively affected by different noises and hearing-impaired. It is evident that the result of Chinese speech test in noise can be used as an effective means to test speech discrimination level for hearing-impaired. Different noise produce different effects on speech recognition for different hearing loss group. This speech test method has an important value of clinical application.

关 键 词：耳蜗性耳聋 言语测听 噪声 耳聋 听力检查 

分 类 号：R764.43[医药卫生—耳鼻咽喉科] R764.04[医药卫生—临床医学]