Factors Affecting Bimodal Benefit in Pediatric Mandarin-Speaking Chinese Cochlear Implant Users
Factors Affecting Bimodal Benefit in Pediatric Mandarin-Speaking Chinese Cochlear Implant Users
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影响中国普通话儿童人工耳蜗使用者双峰获益的因素
DOI：
10.1097/aud.0000000000000712
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发表时间：
2019-11-01
期刊：
影响因子：
3.7
通讯作者：
Fu，Qian-Jie
中科院分区：
文献类型：
--
作者：
Liu，Yang-Wenyi;Tao，Duo-Duo;Fu，Qian-Jie
目标：虽然基频 (F0) 线索对于词汇语气感知和多说话者隔离都很重要，但人工耳蜗 (CI) 用户对 F0 线索的感知较差。通过对侧耳朵的助听器增加低频听觉可能会改善 CI 用户的 F0 感知。对于说英语的 CI 用户来说，对侧声学听力已被证明可以改善噪声中和竞争谈话者对目标语音的感知。对于普通话等声调语言，F0 信息具有词汇意义。考虑到来自多个说话者和词汇声调的竞争性 F0 信息，对侧声学听力可能特别有利于讲普通话的 CI 用户对竞争语音的感知。 设计：在 11 名讲普通话的中国儿童 CI 用户中评估了双峰效益（CI+助听器 - 仅 CI）。在实验 1 中，使用改进的协调响应测量测试来自适应测量语音识别阈值 (SRT)；受试者被要求从每个类别的 10 个选项中正确识别 2 个关键词。 SRT 是在存在稳态噪声 (SSN) 或具有相同 (M+ M) 或不同语音性别 (M+ F) 的竞争语音的情况下，通过仅 CI 或双模态聆听来测量的。将非 CI 耳朵的无辅助阈值和人口因素与言语表现进行比较。在实验 2 中，在 SSN 中自适应测量 SRT 来识别 5 个关键字，这是比实验 1 中的 2 个关键字识别任务更困难的听力任务。结果：在实验 1 中，在仅 CI 和双模态听力条件下，SSN 的 SRT 显着低于竞争语音。 SSN 和 M+ F 的纯 CI 听力和双模式听力之间没有显着差异 (p> 0.05)；对于 M+ M，仅 CI 的 SRT 显着低于双模态聆听 (p< 0.05)，表明存在双模态干扰。受试者能够利用声音性别差异进行双模态聆听 (p< 0.05)，但不能利用声音性别差异进行纯 CI 聆听 (p> 0.05)。非 CI 耳朵的无辅助阈值与 M+ M 的双峰 SRT 呈正相关（p < 0.006），但与 SSN 或 M+ F 则不然。在任何人口统计变量和 SRT 之间未观察到显着相关性（在所有情况下，p > 0.05）。在实验 2 中，两个关键字的 SRT 显着低于五个关键字的 SRT（p < 0.05）。仅在 5 个关键字条件下观察到显着的双峰益处 (p< 0.05)。结论：单独使用 CI 时，受试者受到竞争性语音的干扰比 SSN 更大，并且无法使用语音性别差异来区分说话者。对于协调响应测量任务，当竞争的说话者具有相同的语音性别时，受试者没有体验到双模态益处，甚至没有双模态干扰。在五个关键字条件下观察到 SSN 中的双模态益处，但在两个关键字条件下观察不到，这表明随着听力任务难度的增加，双模态听力可能会更有益。目前的数据表明，双峰益处可能取决于掩蔽器的类型和/或听力任务的难度。
Objectives:While fundamental frequency (F0) cues are important to both lexical tone perception and multitalker segregation, F0 cues are poorly perceived by cochlear implant (CI) users. Adding low-frequency acoustic hearing via a hearing aid in the contralateral ear may improve CI users’ F0 perception. For English-speaking CI users, contralateral acoustic hearing has been shown to improve perception of target speech in noise and in competing talkers. For tonal languages such as Mandarin Chinese, F0 information is lexically meaningful. Given competing F0 information from multiple talkers and lexical tones, contralateral acoustic hearing may be especially beneficial for Mandarin-speaking CI users’ perception of competing speech.Design:Bimodal benefit (CI+ hearing aid–CI-only) was evaluated in 11 pediatric Mandarin-speaking Chinese CI users. In experiment 1, speech recognition thresholds (SRTs) were adaptively measured using a modified coordinated response measure test; subjects were required to correctly identify 2 keywords from among 10 choices in each category. SRTs were measured with CI-only or bimodal listening in the presence of steady state noise (SSN) or competing speech with the same (M+ M) or different voice gender (M+ F). Unaided thresholds in the non-CI ear and demographic factors were compared with speech performance. In experiment 2, SRTs were adaptively measured in SSN for recognition of 5 keywords, a more difficult listening task than the 2-keyword recognition task in experiment 1.Results:In experiment 1, SRTs were significantly lower for SSN than for competing speech in both the CI-only and bimodal listening conditions. There was no significant difference between CI-only and bimodal listening for SSN and M+ F (p> 0.05); SRTs were significantly lower for CI-only than for bimodal listening for M+ M (p< 0.05), suggesting bimodal interference. Subjects were able to make use of voice gender differences for bimodal listening (p< 0.05) but not for CI-only listening (p> 0.05). Unaided thresholds in the non-CI ear were positively correlated with bimodal SRTs for M+ M (p< 0.006) but not for SSN or M+ F. No significant correlations were observed between any demographic variables and SRTs (p> 0.05 in all cases). In experiment 2, SRTs were significantly lower with two than with five keywords (p< 0.05). A significant bimodal benefit was observed only for the 5-keyword condition (p< 0.05).Conclusions:With the CI alone, subjects experienced greater interference with competing speech than with SSN and were unable to use voice gender difference to segregate talkers. For the coordinated response measure task, subjects experienced no bimodal benefit and even bimodal interference when competing talkers were the same voice gender. A bimodal benefit in SSN was observed for the five-keyword condition but not for the two-keyword condition, suggesting that bimodal listening may be more beneficial as the difficulty of the listening task increased. The present data suggest that bimodal benefit may depend on the type of masker and/or the difficulty of the listening task.