Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems
Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems
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DOI：
10.1097/01.aud.0000134552.22205.ee
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发表时间：
2004-08-01
期刊：
影响因子：
3.7
通讯作者：
Wackym, PA
中科院分区：
文献类型：
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作者：
Firszt, JB;Holden, LK;Wackym, PA
目的：本研究的目的是对Clarion、Med-El和Nucleus人工耳蜗植入系统的成年接受者进行大规模调查，以（1）确定在三个强度水平下呈现的单词和句子刺激的平均得分和表现范围（70、60和50 dB SPL）;（2）通过获得所有测试条件下的重测测量值，提供每个受试者分数的变异性信息;以及（3）进一步评估较低语音呈现级别的潜在使用（即，60和/或50 dB SPL）在人工耳蜗植入候选人assessment.Design：78个成年人工耳蜗植入受体，26与三个人工耳蜗植入系统，参加了这项研究。为了确保收集的数据反映使用三种植入系统（Clarion HiFocus I或11、Aled-El Combi 40+、Nucleus 24 M或24 R）的最新技术的成人接受者的性能范围，确定了辅音-核-辅音（CNC）单音节词评分的复合范围和分布。选择使用每种器械的受试者，以密切代表CNC性能的范围和分布。在测试过程中，受试者在三个呈现水平（70，60和50 dB SPL）下进行噪音听力测试（HINT）句子测试和CNC单词测试。还以60 dB SPL和+8 dB的信噪比（SNR）管理HINT句子。颤音被用来确定从250到4000赫兹的声场阈值水平。测试重测措施，获得每个语音识别测试，以及为颤音音声场thresholds.Results：Cobalar植入收件人使用的号角，Med-El，或Nucleus设备平均表现同样，以及在60与70分贝声压级相比，当听单词和句子。此外，对于相同的刺激，受试者在50 dB SPL的较软水平下具有实质性的开集语音感知性能;然而，受试者在噪声中收听更大强度的信号（60 dB SPL + 8 SNR）时理解语音的能力比在安静时收听以软呈现水平（50 dB SPL）呈现的信号时差。一个显着的相关性被发现之间的声场阈值和语音识别分数低于70分贝SPL的介绍水平。结果表明，人工耳蜗植入用户的这些介绍水平和刺激的重测信度高。平均声场阈值为24和29分贝HL之间的频率为250至4000赫兹，跨会议的结果基本上是相同的。结论：语音感知措施与人工耳蜗植入候选人和收件人应反映个人在自然沟通的情况下遇到的听力挑战。这些数据为推荐新的候选标准提供了基础，这些标准基于以60和/或50 dB SPL呈现的语音识别测试，这些强度水平反映了真实的听力，而不是70 dB SPL。
Objective: The purpose of this study was to conduct a large-scale investigation with adult recipients of the Clarion, Med-El, and Nucleus cochlear implant systems to (1) determine average scores and ranges of performance for word and sentence stimuli presented at three intensity levels (70, 60, and 50 dB SPL); (2) provide information on the variability of scores for each subject by obtaining test-retest measures for all test conditions; and (3) further evaluate the potential use of lower speech presentation levels (i.e., 60 and/or 50 dB SPL) in cochlear implant candidacy assessment.Design: Seventy-eight adult cochlear implant recipients, 26 with each of the three cochlear implant systems, participated in the study. To ensure that the data collected reflect the range of performance of adult recipients using recent technology for the three implant systems (Clarion HiFocus I or 11, Aled-El Combi 40+, Nucleus 24M or 24R), a composite range and distribution of consonant-nucleus-consonant (CNC) monosyllabic word scores was determined. Subjects using each device were selected to closely represent this range and distribution of CNC performance. During test sessions, subjects were administered the Hearing in Noise Test (HINT) sentence test and the CNC word test at three presentation levels (70, 60, and 50 dB SPL). HINT sentences also were administered at 60 dB SPL with a signal-to-noise ratio (SNR) of +8 dB. Warble tones were used to determine sound-field threshold levels from 250 to 4000 Hz. Test-retest measures were obtained for each of the speech recognition tests as well as for warble-tone sound-field thresholds.Results: Cochlear implant recipients using the Clarion, Med-El, or Nucleus devices performed on average equally as well at 60 compared with 70 dB SPL when listening for words and sentences. Additionally, subjects had substantial open-set speech perception performance at the softer level of 50 dB SPL for the same stimuli; however, subjects' ability to understand speech was poorer when listening in noise to signals of greater intensity (60 dB SPL + 8 SNR) than when listening to signals presented at a soft presentation level (50 dB SPL) in quiet. A significant correlation was found between sound-field thresholds and speech recognition scores for presentation levels below 70 dB SPL. The results demonstrated a high test-retest reliability with cochlear implant users for these presentation levels and stimuli. Average sound-field thresholds were between 24 and 29 dB HL for frequencies of 250 to 4000 Hz, and results across sessions were essentially the same.Conclusions: Speech perception measures used with cochlear implant candidates and recipients should reflect the listening challenges that individuals encounter in natural communication situations. These data provide the basis for recommending new candidacy criteria based on speech recognition tests presented at 60 and/or 50 dB SPL, intensity levels that reflect real-life listening, rather than 70 dB SPL.