助听器耳模的堵耳效应及解决方案  

Occlusion effect of hearing aid earmold and its solution

作　　者：郗昕[1] 薛伟[2] 张微[2] 洪梦迪[1] 冀飞[1] 

机构地区：[1]解放军总医院耳鼻咽喉科,北京100853 [2]北京市同仁医院,北京100005

出　　处：《中华耳科学杂志》2004年第1期8-11,共4页Chinese Journal of Otology

摘　　要：目的分析佩带助听器耳模造成的堵耳效应的特点,并寻求适宜的解决方案。方法应用真耳探管传声器测量系统,用两种给声方式(受试者自主发出低频元音、或以骨振器振动颅骨给声),测试了用海绵耳塞、助听器耳模堵耳后的堵耳效应增益曲线。实验分三个部分1.以海绵耳塞堵耳,骨振器给声强度逐渐增强,了解堵耳效应值是否随骨导信号强度而变化;2.以海绵耳塞和助听器耳模堵耳,骨振器给声强度为35dBHL,了解堵耳效应的频率特征。3.由受试者自主发出低频元音,在耳模上施加不同尺寸的通气孔,评价其解决堵耳效应的实际效果。结果1.探管麦克风在外耳道中记录的堵耳响应REOR随骨导强度增强呈1∶1线性增长;2.堵耳效应主要表现在1000Hz以下的低频,250Hz、500Hz、1000Hz的堵耳效应依次为24.1±1.6dB,19.3±0.8dB,9.7±0.5dB(n=10),性别间差异不显著;3.配戴助听器耳模后的堵耳效应在400Hz以下的低频最为显著。普通的2mm平行通气孔可使该频带的堵耳效应平均下降15dB以上,短的2mm通气孔则可使堵耳效应降低约20dB。结论堵耳效应不因骨导信号的强度变化而改变,主要集中在1000Hz以下的低频;配戴助听器耳模后,堵耳效应在400Hz以下最为显著,加开通气孔可显著解决堵耳效应问题。Objective To investigate the features of hearing aid earmold occlusion effect, then to seek a feasible solution.Methods The occlusion effects induced by foam eartip insertion or hearing aid earmold placement were tested by real-ear probe microphone measurement system. By comparing the open ear canal SPL from a bone-conducted signal to the ear canal SPL when the canal was occluded with a hearing aid earmold, the frequency responses of occlusion effect can be obtained. Two sound stimuli approaches (patient's own voice of closed vowels 'eee' and 'ooo'; vibration of bone-conduction oscillator placing on forehead) were applied in the study. The experiment consisted of three parts. I. Increasing the intensity of bone conduction when the canal was occluded with foam eartip in order to check whether the occlusion effect was regardless of bone conduction energy or not.II.To investigate the frequency spectral features of occlusion effect when the canal was occluded with a foam eartip or hearing aid earmold while applying 35 dB HL bone conduction signal of 250, 500, 1000, 2000Hz on forehead. III. To evaluate the effect of two kinds of vent in reducing the occlusion effect of hearing aid earmold when the patient produced the closed vowels of low frequency.Results I.The REOR (real ear occluded response) recorded in the ear canal by probe microphone was linearly increased with the intensity of bone conduction with 1∶1 slope. II. The occlusion effect was observed on the low frequency region below 1000Hz for both two sound stimulating conditions. The occlusion effect dB value of 250, 500 and 1000Hz was 24.1±1.6 dB, 19.3±0.8dB, 9.7±0.5dB(n=10) individually. III. The hearing aid earmold occlusion effect was significantly focused on the low frequency range below 400Hz. While the 2mm parallel vent reduced the occlusion effect more than15dB, the short 2mm vent decrease that about 20dB. Conclusion The occlusion effect is observed below 1000Hz and is regardless with the intensity of bone conduction. The hearing aid earmold occlusi

关 键 词：助听器 耳模 堵耳效应 探管传声器 真耳测量 外耳道 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]