目的:词汇语调对人工耳蜗(CI)使用者提出了挑战,尤其是在噪声条件下。双峰听觉利用对侧的残余声学听觉,并且可以为噪声中的音调识别提供益处。本研究的目的是通过语前耳聋的声音来评估稳态噪声和多说话者胡言乱语中的音调识别,具有单峰CI或双峰听力的普通话儿童。
方法:53例语前耳聋,接受CI的普通话儿童参加了这项研究。其中22名是单侧CI用户,31名在侧耳佩戴助听器(HA)(即,双峰听力)。所有受试者都在安静和两种类型的屏蔽器中进行了普通话语音识别测试:语音频谱形噪声(SSN)和两个说话的胡言乱语(TTB),具有四个信噪比(-6、0、6和12dB)。
结果:虽然两组之间在安静的音调识别方面没有差异,在噪声条件下,双峰组的表现优于单峰组。在SSN条件下,在0、+6和+12dB的SNR处,两组之间的差异均有统计学意义(均p<0.05),并且在SNR为+6和+12dB的TTB条件下(均p<0.01),但在其他条件下不显著(p>0.05)。在单边CI组和双峰组中,在所有测试的SNR处,TTB对音调识别表现出比SSN更大的掩蔽效应(所有p<0.05)。在人口统计或听力测量变量中,在SSN条件下,只有植入时的年龄与平均音调识别性能有弱但显着相关性(r=-0.276,p=0.045)。然而,当Bonferroni校正应用于相关分析结果时,弱相关性变得不显著。
结论:在嘈杂的环境中,患有CI的失聪儿童在音调感知方面面临挑战,特别是当噪声的振幅波动时,如多说话者的胡言乱语。在剩余听力允许的情况下,在对侧佩戴HA有利于噪声中的音调识别。
OBJECTIVE: Lexical tone presents challenges to cochlear implant (CI) users especially in noise conditions. Bimodal hearing utilizes residual acoustic hearing in the contralateral side and may offer benefits for tone recognition in noise. The purpose of the present study was to evaluate tone recognition in both steady-state noise and multi-talker babbles by the prelingually-deafened, Mandarin-speaking children with unilateral CIs or bimodal hearing.
METHODS: Fifty-three prelingually-deafened, Mandarin-speaking children who received CIs participated in this study. Twenty-two of them were unilateral CI users and 31 wore a hearing aid (HA) in the contralateral ear (i.e., bimodal hearing). All subjects were tested for Mandarin tone recognition in quiet and in two types of maskers: speech-spectrum-shaped noise (SSN) and two-talker babbles (TTB) at four signal-to-noise ratios (-6, 0, +6, and +12 dB).
RESULTS: While no differences existed in tone recognition in quiet between the two groups, the Bimodal group outperformed the Unilateral CI group under noise conditions. The differences between the two groups were significant at SNRs of 0, +6, and +12 dB in the SSN conditions (all p < 0.05), and at SNRs of +6 and +12 dB of TTB conditions (both p < 0.01), but not significant at other conditions (p > 0.05). The TTB exerted a greater masking effect than the SSN for tone recognition in the Unilateral CI group as well as in the Bimodal group at all SNRs tested (all p < 0.05). Among demographic or audiometric variables, only age at implantation showed a weak but significant correlation with the mean tone recognition performance under the SSN conditions (r = -0.276, p = 0.045). However, when Bonferroni correction was applied to the correlation analysis results, the weak correlation became not significant.
CONCLUSIONS: Prelingually-deafened children with CIs face challenges in tone perception in noisy environments, especially when the noise is fluctuating in amplitude such as the multi-talker babbles. Wearing a HA on the contralateral side when residual hearing permits is beneficial for tone recognition in noise.