轻中度听力损失对老年人水平方位声源定位的影响  

The Impact of Mild to Moderate Hearing Loss on Horizontal Sound Localization in Older Adults

作　　者：商嘉琪 王兴 付欣[2] 李欢 刘佳星 吴俊志 聂帅 赵子慧 赵雪雷 张娟 SHANG Jiaqi;WANG Xing;FU Xin;LI Huan;LIU Jiaxing;WU Junzhi;NIE Shuai;ZHAO Zihui;ZHAO Xuelei;ZHANG Juan(School of Special Education,Binzhou Medical University,Yantai,264000;Department of Otorhinolaryngology Head&Neck Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing,100020)

机构地区：[1]滨州医学院特殊教育学院,烟台264000 [2]首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科,北京100020

出　　处：《中华耳科学杂志》2023年第2期188-193,共6页Chinese Journal of Otology

基　　金：国家重点研发计划项目(2020YFC 2005200);多学科临床研究创新团队项目(CYDXK202201)。

摘　　要：目的探讨轻中度听力损失对60岁及以上老年人水平方位声源定位能力的影响。方法纳入45例60~85周岁双耳听力对称老年人,根据平均纯音听阈(pure-tone average,PTA)分为老年听力正常组(PTA<20 dB HL)、老年轻度听损组(20≤PTA<35 dB HL)、老年中度听损组(35≤PTA<50 dB HL),每组15人,并匹配15例听力正常青年人作对照。采用角度偏差法对所有受试者进行水平方位声源定位能力测试,刺激声为白噪声,持续时间为500ms,声强为65 dB SPL,扬声器位置包括±90°、±45°和0°共5个方位。刺激声随机播放30次,要求受试者指出播放声源的扬声器编号,计算均方根误差(root-mean-square error,RMSE)作为结果。采用单因素方差分析比较各组受试者声源定位能力差异,重复测量方差分析对比不同位置声源定位表现差异,Pearson相关性分析检验声源定位与听力损失的关系。结果老年人声源定位RMSE与听力损失程度显著相关(r=0.76,P<0.001)。老年三组和青年组受试者声源定位RMSE比较差异具有显著性(F=68.776,P<0.001)。其中,老年听力正常组、老年轻度听损组和青年听力正常组受试者之间差异无显著性(P>0.05),RMSE均为0°。老年中度听损组与以上三组相比水平方位声源定位能力显著下降(P<0.001),RMSE为19.81°±9.25°。老年中度听损组水平方位不同角度声源定位RMSE之间差异具有显著性(F=7.161,P<0.001),其中侧方误差显著高于正前方。结论听力正常和轻度听损老年人水平方位声源定位能力与青年人无显著差异,PTA超过35dB HL的老年人声源定位能力显著下降,与正前方相比,侧方下降更为明显。Objective To investigate the impact of mild to moderate hearing loss on horizontal sound localization ability in adults over 60 years of age.Methods A total of 45 adults between 60 to 85 years old with symmetrical hearing thresholds were included.Participants were divided into three groups according to their pure-tone average(PTA)thresholds:normal hearing(<20 dB HL),mild hearing loss(20-35 dB HL),and moderate hearing loss(36-50 dB HL)(15 in each group).Young adults with normal hearing(n=15)served as controls.Horizontal sound localization ability was tested using the angle deviation method.The stimulus was white noise(500 ms duration at 65 dB SPL)through loudspeakers positioned at 5 locations(±90°,±45°and 0°).The stimulus was presented 30 times randomly and the subject was instructed to indicate the location of the loudspeaker presenting the stimulus.Root-mean-square errors(RMSE)repre‐senting sound localization ability were compared via one-way ANOVA among the groups.Repeated measures ANOVA were used to compare sound localization performances at different azimuths.The relationship between hearing loss and localization performance was analyzed using Pearson's correlation coeffitient.Results RMSE of sound localization was significantly correlated with the degree of hearing loss in the elderly(r=0.76,P<0.001)and greater than in the young controls(F=68.776,P<0.001),although there was no significant difference among older subjects with normal hearing or mild hearing loss and the normal controls(P>0.05).RMSE was 19.81°±9.25°in older subjects with moderate hearing loss,compared with 0°in the above mentioned three groups(P<0.001).RMSE showed significant differences in older subjects with moderate hearing loss at different azimuths(F=7.161,P<0.001),with RMSEs for lateral sound source localization higher than for localization of front sound source.Conclusion Older adults with normal hearing or mild hearing loss do not appear to show significant horizontal sound localization ability impairment,as compared with you

关 键 词：声源定位 空间听觉 老年性听力损失 

分 类 号：R764[医药卫生—耳鼻咽喉科]