目的:声音定位在我们的日常生活中起着至关重要的作用,使我们能够识别声音,应对令人震惊的情况,避免危险,并导航到特定的信号。然而,这种能力在单侧耳聋(SSD)和不对称听力损失(AHL)患者中受损,对他们的日常工作产生负面影响。该研究的主要目的是使用耳蜗植入物(CI)量化单侧耳聋或不对称听力损失患者的声源定位程度,并比较两个亚组。
方法:这是一个前瞻性的,纵向,观察,单中心研究涉及诊断为重度单侧或不对称感音神经性耳聋并接受人工耳蜗植入的成年患者。在配备有从-90º到90º均匀分布的七个扬声器的腔室中评估了声音定位。刺激在1000Hz和强度为65dB时出现,70dB,75dB。每个刺激只出现一次,每个扬声器,共21个演讲记录不同强度下正确反应的数量,计算角度误差以确定患者指示的说话者和呈现刺激的说话者之间的平均角度距离。两种评估都是在没有人工耳蜗植入的情况下术前和植入后两年进行的。
结果:总样本包括20名患者,其中9个分配给SSD组,11个分配给AHL组。SSD组自由场的术前纯音平均(PTA)为31.7dB,AHL组为41.8dB。在SSD和AHL亚组中,在所有强度下使用耳蜗植入物,声音定位能力和角度误差均有统计学上的显着改善。
结论:SSD和AHL患者的人工耳蜗植入增强了声音定位,减少平均角度误差和增加正确的声音定位响应的数量。
OBJECTIVE: Sound localization plays a crucial role in our daily lives, enabling us to recognize voices, respond to alarming situations, avoid dangers, and navigate towards specific signals. However, this ability is compromised in patients with Single-Sided Deafness (SSD) and Asymmetric Hearing Loss (AHL), negatively impacting their daily functioning. The main objective of the study was to quantify the degree of sound source localization in patients with single-sided deafness or asymmetric hearing loss using a Cochlear Implant (CI) and to compare between the two subgroups.
METHODS: This was a prospective, longitudinal, observational, single-center study involving adult patients diagnosed with profound unilateral or asymmetric sensorineural hearing loss who underwent cochlear implantation. Sound localization was assessed in a chamber equipped with seven speakers evenly distributed from -90º to 90º. Stimuli were presented at 1000 Hz and intensities of 65 dB, 70 dB, and 75 dB. Each stimulus was presented only once per speaker, totaling 21 presentations. The number of correct responses at different intensities was recorded, and angular error in degrees was calculated to determine the mean angular distance between the patient-indicated speaker and the speaker presenting the stimulus. Both assessments were conducted preoperatively without a cochlear implant and two years post-implantation.
RESULTS: The total sample comprised 20 patients, with 9 assigned to the SSD group and 11 to the AHL group. The Preoperative Pure Tone Average (PTA) in free field was 31.7 dB in the SSD group and 41.8 dB in the AHL group. There was a statistically significant improvement in sound localization ability and angular error with the use of the cochlear implant at all intensities in both SSD and AHL subgroups.
CONCLUSIONS: Cochlear implantation in patients with SSD and AHL enhances sound localization, reducing mean angular error and increasing the number of correct sound localization responses.