多通道人工耳蜗在语前聋儿童及青少年中的应用

目的 通过对植入人工耳蜗的语前聋儿童和青少年的听力和语言能力的评估,探讨我国儿童在使用人工耳蜗后的听力和言语能力发展规律及影响因素。方法 ２５例行人工耳蜗植入的语前聋儿童及青少年患者参与本组测试。选用《聋儿听觉言语康复评估方法》作为测试材料,分别进行声音,言语声和环境声的辨别,数词,单字词,双字词,３字词,韵母,声母,声调,封闭项列短句的识别,开放项列字词和开放项列短句识别,语言清晰度,模仿句长,     

先天性语前聋中国儿童双耳人工耳蜗植入疗效观察

目的：评估双侧耳人工耳蜗植入对极重度感音神经性语前聋患儿的听觉与言语康复疗效。方法：2例先天性极重度感音神经性聋儿童，单侧耳人工耳蜗植入术后2年和3年分别施行对侧耳人工耳蜗植入。术后1年评估患儿左、右耳单耳及双耳人工耳蜗助听听阈和言语识别率。以及言语清晰度。结果：①双耳人工耳蜗助听与单耳人工耳蜗助听相比。平均听阈降低分别为13dB和11dB；②在安静环境中双耳人工耳蜗植入儿童的言语识别率(开放项列)分别平均提高为9％和10％，2例双耳人工耳蜗植入儿童的言语识别率(开放项列)分别达97％和95％；③在嘈杂环境中对言语的识别能力明显提高；④言语清晰度有明显改善。结论：双耳人工耳蜗植入可明显提高极重度感音神经性语前聋患儿在安静和噪声环境下的言语识别率，对语前聋儿童的言语和语言发育有明显的帮助。     

人工耳蜗植入儿童听力言语辨别能力研究

目的 评估人工耳蜗植入儿童听力言语辨别能力,为听力言语康复训练提供科学依据.方法 应用儿童听力言语康复分类训练及评估的汉语视听系统对32例人工耳蜗植入儿童进行字词长短、声调辨别、元音辨别及辅音辨别测试,通过分析其言语辨别得分情况,评估人工耳蜗植入儿童的听力言语辨别能力.结果 字词长短、声调辨别、元音辨别及辅音辨别得分分别为96.69、81.52、87.96和69.28分,经统计学分析,不同测试项目和不同受试者间的辨别差异均具有统计学意义. 结论 ①人工耳蜗植入儿童对于字词长短、声调辨别、元音辨别及辅音辨别的难易度具有显著性差异,听力言语康复训练应遵从难易程度循序渐进的开展;②人工耳蜗植入儿童在声调辨别、元音辨别及辅音辨别测试中呈现出较大的个体差异;③人工耳蜗植入儿童声调辨别得分与其在语音学中难易程度相比明显下降.     

语前聋儿童人工耳蜗植入效果的评估

目的探索语前聋儿童人工耳蜗植入效果的评估方法.方法受试者为18名接受人工耳蜗植入的语前聋儿童,耳蜗植入时平均年龄6岁.按人工耳蜗使用时间长短分为四个阶段进行评估:第一阶段18名患儿,使用人工耳蜗1～12个月;第二阶段12名,使用人工耳蜗13～24个月;第三阶段8名,使用人工耳蜗25～36个月;第四阶段6名,使用人工耳蜗在36个月以上.描述性分析,以问卷的形式了解儿童在人工耳蜗植入后声音接受、言语表达及行为等方面的变化;言语测试,进行言语识别能力和发声能力测试.结果第一阶段患儿,能够感知和辨别来自家庭和环境中的声音;第二阶段患儿,封闭项词识别率是51%,开放项词识别开始启动;第三阶段患儿,封闭项词识别率达到72%,开放项词识别率是40%,能正确发出的单词数是42%;第四阶段患儿,封闭项词识别率和开放项词识别率分别达到84%和53%,能正确发出的单词数达62%,部分患儿已有自发的口语表达.结论人工耳蜗植入对语前聋患儿的言语发育有帮助,患儿的言语能力随着人工耳蜗使用时间的推移不断进步.     

语前聋成年患者接受人工耳蜗植入的手术效果评估

通过客观及主观听力学评估来确定人工耳蜗植入是否对语前聋成年患者言语发育有促进作用。采用回顾分析患者术后的开放式言语识别率等客观指标及患者生活质量等主观指标。结果是 1989～ 1999年共完成 198例成年患者人工耳蜗植入手术 ,其中4 4例为语前聋 ,分别植入美国Nucleus 2 2、Nucleus2 4或Clarion人工耳蜗装置。患者平均手术年龄 34岁 (14～ 6 2岁 ) ,通过开放式言语识别率测试 (包括字词、短语和短句识别 )可以发现自幼接受不同听力训练的语前聋患者之间存在显著性差异。结论 :接受人工耳蜗植入手术的语前聋患者手术效果的确不如语后…     

语前聋儿童人工耳蜗植入术后听觉言语识别能力发展水平评估

目的 通过对语前聋儿童人工耳蜗植入术后不同康复时段的听觉言语识别能力评估,探索人工耳蜗植入儿童术后听觉言语识别能力的获得规律,为评价及预测聋儿康复效果提供参考.方法 采用标准化的儿童言语听觉测试环境及测试词库,对863例不同年龄、不同康复时段的语前聋人工耳蜗植入儿童进行听觉言语识别能力评估,包括自然环境声响、声母、韵母...     

语后聋成人人工耳蜗植入后言语感知能力的测评

目的通过对植入人工耳蜗的语后聋成人听力言语感知能力的测评,探讨人工耳蜗对语后聋成人言语康复的作用.方法受试者为14名语后聋成人患者,男性9例,女性5例;耳蜗植入年龄22岁～67岁,平均46岁;耳聋时间6年-42年,平均16年.在人工耳蜗植入6个月、12个月及24个月时,进行开放性单词和短句言语感知测试.分别在三种模式下进行:只听模式(开放人工耳蜗)、听觉加视觉模式(开放人工耳蜗加唇读)及视觉模式(关闭人工耳蜗只用唇读).结果在听觉模式及听觉加视觉模式下,患者对单词和句子的正确感知随人工耳蜗使用时间而不断改善.术后6个月,听觉模式下的开放性单词和短句的正确感知率分别是38%和54%;听觉加视觉模式下的开放性单词和短句的正确感知率分别是70%和76%.术后24个月,听觉模式下的开放性单词和短句的正确感知率分别是65%和72%;听觉加视觉模式下的开放性单词和短句的正确感知率分别是84%和88%.结论人工耳蜗植入能显著改善语后聋成人的言语感知能力,并随着人工耳蜗使用时间的增加,言语感知能力逐渐得到提高.     

语前聋青少年人工耳蜗满意度问卷设计和调查分析

目的：人工耳蜗植入技术(Cochlear Implant)使双侧重度及极重度感音神经性耳聋的语后聋患者和年龄较小的语前聋患者在言语识别方面改善较大，但对语前聋青少年人工耳蜗植入患者术后是否受益尚存在争议。本文研究语前聋青少年人工耳蜗的获益情况。方法：以语前聋青少年为研究对象，关注交流能力和生活质量改善等情况，设计语前聋青少年CI使用效果和满意度的调查问卷并分析患者人工耳蜗术后获益效果和满意度以及相关影响因素。结果：调查结果显示所有家长均对孩子植入人工耳蜗后的声音获得非常满意，且认为人工耳蜗对整体综合交流能力的改善有一定帮助，患者本人及家长都愿意选择CI。结论：对语前聋青少年CI植入者不应把言语测试识别率得分的提高作为评判人工耳蜗获益情况的唯一标准，还应考虑人工耳蜗在提高患者综合交流能力和生活质量方面的帮助效果。     

儿童人工耳蜗植入的发展现状

本文复习在儿童中开展人工耳蜗植入的文献。无论语前聋儿童，还是语后聋儿童，耳蜗植入手术时间越早，术后进行一定时间有效的听力言语训练效果越好。耳蜗植入的最大益处有可能在聋儿中获得一定听同和语言能力。     

42例语前聋儿童人工耳蜗植入术后效果分析

目的初步分析语前聋儿童人工耳蜗植入后听觉言语的康复进程。方法通过对42例行人工耳蜗植入的语前聋儿童进行重建听阈测试、双音节词封闭项识别，主题对话测试及智力评估，以了解他们术后的听力水平、听觉言语能力及智力情况。结果受试者术后平均听阈在35 dB HL左右，在术后6个月以上的聋儿中扬扬格双音节词识别率≥80％的占95．45％；主题对话达到3～4级水平的占70．83％。双音节词识别率≥80％的聋儿言语能力为3～4级水平的占70．97％。结论对于智力发育正常，术后及时在康复机构接受科学、系统的康复训练的语前聋人工耳蜗植入的患儿，术后半年以上大多数患儿的听觉和言语能力的提高是较为明显的。     

试论言语功能评估的标准及方法

本文旨在讨论言语功能评估标准及方法，阐述言语功能评估的一个基本理念：夯实基础，循序渐进，螺旋上升，即言语评估、测量与矫治是一个动态的过程。言语矫治以言语评估和测量为起点，在言语矫治中或训练一个阶段后，应再次进行言语评估和测量，从而监控言语矫治方案的有效性，调整言语矫治方案或提出更高的言语矫治目标。     

老年性聋患者单音节识别特征分析*--附24例报告

目的研究老年人单音节言语识别能力,分析高龄老年性聋患者单音节言语识别的特征.方法12例(22耳)80岁以上男性老年性聋患者作为研究组(以下简称80+组),12例(24耳)80岁以下男性老年性聋患者作为对照组(以下简称80-组),两组分别接受普通话单音节识别率测试,测试强度采用最优测试强度,即0.5 kHz、1 kHz、2 kHz、4 kHz 4个频率纯音听阈的平均值(4FA)以上30 dB或最大舒适强度.比较80+组和80-组的最优言语识别得分.对单音节最优识别得分与预测最大言语识别率(PBmax预测)进行相关分析.结果在最优测试条件下,80-组平均得分为(76.5±19)%,80+组平均得分为(54.1±26)%,80-组得分显著高于80+组(P=0.0015).80-组的单音节识别得分与PBmax预测显著相关(r=0.721,P<0.001).80+组的单音节识别得分与PBmax预测相关(r=0.602,P=0.003).结论80岁以上高龄老年性聋患者言语识别得分与纯音听力相关性低于80岁以下老年性聋患者.     

舌系带过短儿童发音障碍及矫治效果分析

目的 探讨舌系带过短对儿童发音的影响及有效的矫治方法.方法采用多媒体Dr.Speech软件对163例确诊为舌系带过短的患儿行语音评估,对有发音错误的136例行舌系带松解术,术后复查语音情况,已恢复者不再语训,对没有改善的85例进行语训并对其发音清晰度进行观察分析.结果舌系带过短引起发音错误有136例,占83.43%（136/163）,手术配合发音训练后发音改善有效率达97.64%.结论舌系带过短导致舌前部运动障碍,影响儿童的语音发育.舌系带松解术有利于语音清晰度的改善,配合有效的语音训练疗效更好.     

French adaptation of the “Frenchay Dysarthria Assessment 2” speech intelligibility test

ObjectivesSpeech intelligibility can be defined as “the degree to which a speaker's intended message is recovered by a listener”. Loss of intelligibility is one of the most frequent complaints in patients suffering from speech disorder, impairing communication. Measurement of intelligibility is therefore an important parameter in follow-up. We developed a French version of the “Frenchay Dysarthria Assessment, 2nd edition” (FDA-2), an intelligibility test recognized internationally in its English version. The present study details the construction of the test and its preliminary validation.Materials and methodsWe first compiled a set of words and phrases in French, based on the criteria defined in FDA-2. In a second step, we validated the test in healthy subjects in normal and noisy conditions, to check sensitivity to speech signal degradation.ResultsThe test proved valid and sensitive, as scores were significantly lower for noise-degraded stimuli.ConclusionThis French-language intelligibility test can be used to evaluate speech disorder: for example, in dysarthria, head and neck cancer or after cochlear implantation.     

The Singer's Formant and Speaker's Ring Resonance: A Long-Term Average Spectrum Analysis

Objectives

We previously showed that a trained tenor''s voice has the conventional singer''s formant at the region of 3 kHz and another energy peak at 8-9 kHz. Singers in other operatic voice ranges are assumed to have the same peak in their singing and speaking voice. However, to date, no specific measurement of this has been made.

Methods

Tenors, baritones, sopranos and mezzo sopranos were chosen to participate in this study of the singer''s formant and the speaker''s ring resonance. Untrained males (n=15) and females (n=15) were included in the control group. Each subject was asked to produce successive /a/ vowel sounds in their singing and speaking voice. For singing, the low pitch was produced in the chest register and the high notes in the head register. We collected the data on the long-term average spectra of the speaking and singing voices of the trained singers and the control groups.

Results

For the sounds produced from the head register, a significant energy concentration was seen in both 2.2-3.4 kHz and 7.5-8.4 kHz regions (except for the voices of the mezzo sopranos) in the trained singer group when compared to the control groups. Also, the chest register had a significant energy concentration in the 4 trained singer groups at the 2.2-3.1 kHz and 7.8-8.4 kHz. For speaking sound, all trained singers had a significant energy concentration at 2.2-5.3 kHz and sopranos had another energy concentration at 9-10 kHz.

Conclusion

The results of this study suggest that opera singers have more energy concentration in the singer''s formant/speaker''s ring region, in both singing and speaking voices. Furthermore, another region of energy concentration was identified in opera singer''s singing sound and in sopranos'' speaking sound at 8-9 kHz. The authors believe that these energy concentrations may contribute to the rich voice of trained singers.     

喉部分切除术后发音功能的微机检测分析

应用ＨＧＦ－Ｉ型喉发音微机分析系统对２８例不同术式喉部分切除术后患者的发音功能进行了观察和分析，结果显示各患者间的发音部位及发音功能差异有显著性，发音功能与发音部位密切相关，“新声带”形成的患者和水平半喉切除术的患者发音功能接近正常人；声门上结构参与发音者和发音管发音者发音功能明显受损，声波曲线周期不明显，频谱曲线噪音水平高，共振峰出现蜂族现象。此微机系统包括频谱分析、自相关、互相关分析和声图，可用于喉部分切除术后发音功能的研究。     

Sentence recognition in noise: Variables in compilation and interpretation of tests

Abstract

Tests of sentence recognition in noise constitute an essential tool for the assessment of auditory abilities that are representative of everyday listening experiences. A number of recent articles have reported on the development of such tests, documenting different approaches and methods. However, both the development and interpretation of these tests require careful consideration of many variables. This article reviews and categorizes the stimulus, presentation, subject, response, and performance variables influencing the development and interpretation of tests of sentence recognition in noise. A systematic framework is utilized to document published findings on these variables. Recommendations and guidelines, based on test performance requirements and test objectives, are provided concerning the interpretation of results and the development of new test materials.

Sumario

La ECoG ha mostrado desde hace mucho que complementa el diagnóstico de la MD, primariamente por la medición de la tasa de amplitud SP/AP. Aunque se reporta en la literatura como una prueba de alta especificidad para este trastorno, la sensibilidad de la ECoG, en la población general de MD, se mantiene relativamente baja (rango de 20-65%), El presente estudio evaluó la sensibilidad y la especificidad del protocolo de ECoG que empleamos para pacientes con sospecha de MD, que incluyó la medición de la amplitud y las áreas de los SP y AP ante clicks (para derivar las tasas de amplitud y de área de SP/AP) y la amplitud del SP ante bursts tonales de 1000 y 2000 Hz. Se condujo un cuadro de revisión retrospectivo para comparar los resultados de de la ECoG de 178 pacientes sospechosos de MD, con su diagnóstico eventual. Las medidas de la mayor sensibilidad y especificidad (determinadas utilizando un análisis logístico de regresión) incluyeron: amplitud del PS, área del PS, tasa de área SP/AP y área total de SP-AP. Los valores de sensibilidad y especificidad asociados con esas medidas fueron de 92% y 84%, respectivamente. El valor de sensibilidad fue considerablemente mayor que el previamente reportado y esto es atribuible a la inclusión de mediciones de área en nuestro protocolo.     

Adaptation of the HINT (hearing in noise test) for adult Canadian Francophone populations

The HINT provides an efficient and reliable method of assessing speech intelligibility in quiet and in noise by using an adaptive strategy to measure speech reception thresholds for sentences, thus avoiding ceiling and floor effects that plague traditional measures performed at fixed presentation levels. A strong need for such a test within the Canadian Francophone population, led us to develop a French version of the HINT. Here we describe the development of this test. The Canadian French version is composed of 240-recorded sentences, equated for intelligibility, and cast into 12 phonemically balanced 20-sentence lists. Average headphone SRTs, measured with 36 adult Canadian Francophone native speakers with normal hearing, were 16.4?dBA in quiet, ?3.0?dBA SNR in a 65?dBA noise front condition and ?11.4?dBA SNR in a 65?dBA noise side condition. Reliability was established by means of within-subjects standard deviation of repeated SRT measurements over different lists and yielded values of 2.2 and 1.1?dB for the quiet and noise conditions, respectively.     

Speech-evoked brainstem response in normal adolescent and children speakers of Brazilian Portuguese

This study aimed to analyze the coding responses of speech sounds (syllable/da/) in children and adolescent speakers of Brazilian Portuguese with typical development and normal hearing, aged between 8 and 16 years, in order to establish normative data of speech ABR response. This normative data can be used as a reference for speech ABR responses and also to enable the diagnosis in individuals with different pathologies. The analyze for absolute latency of speech sounds, more specifically the syllable/da/, for speech-ABR in children and adolescent speakers of Brazilian Portuguese with typical development were: right ear - wave V (6,43–6,57), wave A (7,35–7,57), wave C (18,19–18,46), wave D (21,99–22,42), wave E (30,73–31,05), wave F (39,19–39,55) and wave O (47,75–48,24) and left ear - wave V (6,44–6,57), wave A (7,36–7,59), wave C (18,26–18,55), wave D (22,22 -22,50), wave E (30,58–30,97), wave F (39,05–39,35) and wave O (47,78–48,13). For the amplitude values (μv), the responses were within the following ranges: right ear - wave V (0,10–0,14), wave A (0,19–0,25), wave C (0,08–0,13), wave D (0,11–0,17), wave E (0,17–0,42), wave F (0,14–0,33) and wave O (0,11–0,31) and left ear - wave V (0,09–0,13), wave A (0,08–0,23), wave C (0,08–0,14), wave D (0,10–0,15), wave E (0,20–0,26), wave F (0,16–0,22) and wave O (0,12–0,20). For the values of complex VA (slope: μv/ms and area μv x ms) the follow values obtained were: right ear – slope (0,32–0,42) and area (0,29–0,38) and left ear – slope (0,30–0,39) and area (0,27–0,35).     

人工耳蜗植入儿童汉语声母发音错误规律探究

目的：探讨人工耳蜗植入儿童常见汉语声母错误发音规律。方法选用听力障碍儿童听觉、语言能力评估标准及方法中有关语音清晰度测试的卡片对30例3～5岁语前聋人工耳蜗植入儿童进行测试,记录分析其声母发音错误率、错误类型,从发音部位及方法进一步分析错误率的发生规律。结果30例人工耳蜗植入儿童的言语清晰度约为73．93％±12．76％;发音错误率较高的声母分别为／s／、z／、／sh／、／g／、／ch／、／j／、／k／、／l／、／c／、／zh／、／f／、／p／;错误类型多为替代;按发音部位分类,舌尖前音、舌根音错误率较高,而双唇音、舌尖中音错误率最低;按发音方法分类,鼻音、边音和不送气塞音错误率最低,其余错误率均较高。结论人工耳蜗植入儿童常见汉语声母发音错误为对舌尖前音和舌根音等较难掌握的音,在语言康复训练中应有针对性地训练。