同期双侧人工耳蜗植入者言语识别长期效果研究  

A long term effect on speech recognition in the patients with simultaneous bilateral cochlear implants

作　　者：王斌[1] 魏朝刚[2] 曹克利[1] 金昕[3] 王轶[1] 王宁宇[4] Wang Bin, Wei Chaogang, Cao Keli, Jin Xin, Wang Yi, Wang Ningyu(1 Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Peking Union Medical College, Belting 100730, China ;2 Department of Otorhinolaryngology Head and Neck Surgery, Peking University First Hospital, Beifing 100034, China ; 3Chinese Medical Association Publishing House, Beijing 100710, China ; 4Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Bering 100020, Chin)

机构地区：[1]中国医学科学院北京协和医学院,北京协和医院耳鼻咽喉科,100730 [2]北京大学第一医院耳鼻咽喉头颈外科,100034 [3]中华医学会杂志社,北京100710 [4]首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科,100020

出　　处：《中华耳鼻咽喉头颈外科杂志》2018年第3期189-195,共7页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：首都临床特色应用研究基金（Z1T1100001017218）;首都医学发展科研基金（2016-1-2035）

摘　　要：目的通过比较同期双侧人工耳蜗植入者和单侧人工耳蜗植入者术后远期听觉言语识别得分，探讨同期双侧植入人工耳蜗对听觉及言语识别能力发展的影响。方法选取2007年在北京协和医院接受同期双侧人工耳蜗植入的患者9例（双侧组），并根据年龄、性别、耳聋时间等因素配对选取单侧人工耳蜗植入者9例（单侧组），收集术前听力学资料，随访术后人工耳蜗使用情况。测试两组受试者在安静环境下佩戴人工耳蜗的助听听阈，测试在安静环境和噪声环境下的单音节词、双音节词和短句识别率；设置三种不同声源位置的噪声环境模式（分别模拟头影效应、双侧抑噪效应和中枢冗余效应），测试不同噪声模式及不同信噪比下的短句识别率。使用SPSS 19.0软件进行统计学分析。结果安静环境下，相比于单侧人工耳蜗植入组，双侧人工耳蜗植组的平均助听听阈下降（7.2±3.0）dB，差异具有统计学意义（P〈0.05）。安静环境下两组单音节词、双音节词和短句的识别率接近，差异无统计学意义（P值均〉0.05）；噪声环境下，双侧植入者的言语识别率明显好于单侧植入者，差异具有统计学意义（P值均〈0.05）。同一信噪比（＋8 dB）噪声环境下短句测试：头影效应模式，双侧组的识别率明显好于单侧组，差异有统计学意义（P〈0.01）；中枢冗余模式，双侧组的识别率明显好于单侧组，差异具有统计学意义（P〈0.01）；双侧抑噪模式，双侧组的识别率与单侧组相比，差异无统计学意义（P〉0.05）。不同信噪比（＋8 dB、＋4 dB）噪声环境下短句测试，三种噪声给声模式均表现为信噪比越高，言语识别率越高（P值均〈0.01）。对比三种噪声给声模式下短句识别率的变化值，头影效应较双侧抑噪和中枢冗余模式受信噪比变化的影响更大，差异有统计学意义（F值�Objective To investigate an effect on speech recognition after bilateral cochlear implants （CI） simultaneously. Methods Nine subjects who underwent bilateral CI operation simultaneously in Peking Union Hospital in 2007 were assigned as bilateral group, another 9 subjects with unilateral CI were chosen as unilateral group according to the age, gender, duration of deafness. Hearing threshold, speech recognition of phrases, disyllabic words, single word in quiet and noise environment were calculated, respectively. Three different sound source positions were set up to simulate the three effects of binaural hearing （head shadow, binaural redundancy and binaural squelch） in noise environment. The speech signal intensity was 70 dBSPL, the signal to noise ratio （SNR） was 0 dB, ＋ 4 dB, ＋ 8 dB, and the speech recognition of phrases were examined in bilateral CI group. All the data was analyzed by SPSS 19. 0 software. Results In quiet environment, the average aid-hearing threshold was significantly reduced as （7. 2 ＋- 3. 0） dB in bilateral CI group compared to unilateral CI group （P 〈 0.05 ）. However, the speech recognition of phrases, disyllabic words, and single word in quiet and noise environment did not show significant differences between bilateral CI and unilateral CI groups （ P 〉 0.05 ）. In the testing under noise environment, the speech recognition of bilateral CI group was significantly higher than that of unilateral CI group （P 〈 0.05）. In the estimation of noise environment （ SNR = ＋ 8） , the phrase test and speech recognition of head shadow model in bilateral groups were significantly better than that of unilateral group （P 〈 0.01 ）. Further, bilateral CI group showed statistical signifieances in binaural redundancy and binaural squelch models（ P 〈0.01 ） , there was statistically significant were also found difference between two groups （P 〈0.01 ） ; Bilateral CI group did not reveal significant difference compared with unbilateral CI group in binaur

关 键 词：耳蜗植入术 言语识别测验 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]