粘贴式骨导助听器用于单侧外耳道骨性闭锁患儿的效果观察  

Evaluation of adhesive bone conduction hearing aid in pediatric patients with unilateral congenital aural atresia

作　　者：刘宇洁 杨劲松[1] 陈沛维 高梦蝶 赵春丽[1] 王丹妮[1] 任冉[1] 傅新星[2] 赵守琴[1] Liu Yujie;Yang Jinsong;Chen Peiwei;Gao Mengdie;Zhao Chunli;Wang Danni;Ren Ran;Fu Xinxing;Zhao Shouqin(Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Key Laboratory of Otolaryngology,Head and Neck Surgery,Capital Medical University,Ministry of Education,Beijing Institute of Otolaryngology,Beijing 100005,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,100730 [2]北京市耳鼻咽喉科研究所,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),100005

出　　处：《中华耳鼻咽喉头颈外科杂志》2021年第9期936-942,共7页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：北京市科委首都临床特色应用研究基金(Z171100001017079)。

摘　　要：目的初步评估粘贴式骨导助听器对单侧外耳道骨性闭锁患儿双耳聆听效应及主观满意度的影响。方法2019年1—8月就诊于首都医科大学附属北京同仁医院的10例单侧外耳道骨性闭锁患儿,男、女各5例,年龄5~15岁,平均8.3岁。统一于患侧配戴粘贴式骨导助听器,分别于裸耳和助听状态下行自由声场下听力阈值、安静下言语识别率、噪声下言语识别阈和水平方位声源定位能力测试,并发放主观问卷。采用SPSS 26.0统计软件,应用配对t检验和配对Wilcoxon符号秩检验,比较裸耳与助听后效果差异。结果自由声场中,助听后听阈较裸耳改善了(21.9±4.4)dB,差异具有统计学意义(t=15.8,P<0.05)。患儿在安静和噪声下言语识别能力总体均有提高(P值均<0.05),当单独分析中枢冗余、双耳抑噪和头影效应时,双耳抑噪效应助听前后差异无统计学意义(P>0.05),其余两种效应在助听后均有提高(P值均<0.05)。声源定位能力测试中,有6例患儿助听后有改善,但助听前后总体差异无统计学意义(P>0.05)。父母版言语空间特性问卷中,患儿言语感知、空间听力和听力音质及其8项子类别在助听后均有不同程度的提高(P值均<0.05);国际助听器效果问卷平均得分为4.1分。结论粘贴式骨导助听器能显著提升单侧外耳道骨性闭锁患儿安静和噪声环境下言语识别能力,提高患儿生活质量。Objective To evaluate the auditory efficacy and subjective satisfaction of adhesive bone conduction hearing aid in children with unilateral congenital aural atresia(UCAA).Methods Ten subjects(5 males and 5 females)diagnosed with UCAA with an average age of 8.3 years old(ranged from 5 to 15)were included in Beijing Tongren Hospital,Capital Medical University from January to August 2019.The free sound field hearing threshold,word recognition score in quiet,speech reception threshold in noise and sound localization ability(results were measured by RMS error)tests were performed in unaided and aided situation,respectively.Subjective satisfaction questionnaires were also distributed to subjects.Paired t test and Wilcoxon signed rank test were used as statistical analysis methods.Results The average hearing threshold in aided condition was improved by(21.9±4.4)dB(t=15.8,P<0.05).Speech recognition abilities were generally improved both under quiet and noise(P<0.05);however,when the binaural summation,squelch and head shadow effects were analyzed respectively,the binaural squelch effect was not statistically improved(P>0.05),while the other effects were improved in aided condition(P<0.05).In sound localization test,there was no significant difference of the RMS error value between the unaided and aided situation(P>0.05).The subjects got high satisfaction rates in three subjective questionnaires.Conclusion The adhesive bone conduction hearing aid can provide significant audiological benefit for children with UCAA as well as raising the quality of their life.

关 键 词：先天性耳道闭锁 听觉丧失 单侧性 助听器 骨导 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]