雙耳雙模式輔具配置對人工耳蝸植入兒童在華語音調辨識上的效益

Benefit of Binaural Bimodal Fitting on Tonal Discrimination in Mandarin-speaking Cochlear Implanted Children

謝易倫(I-Lun Hsieh) ； 高純珠(Chun-Chu Kao) ； 劉淑惠(Shu-Hui Liu) ； 李恆惠(Heng-Huei Lee) ； 楊惠美(Hui-Mei Yang) ； 吳俊良(Jiunn-Liang Wu)

《台灣耳鼻喉頭頸外科雜誌》 46卷6期 (2011/12) Pp. 298-303

https://doi.org/10.6286/2011.46.6.298

摘要

BACKGROUND: Binaural advantages using a hearing aid with a cochlear implant (CIHA) in opposite ears have been proved on speech perception and functional performance in everyday life. However, whether such bimodal fitting can improve tonal discrimination which is critical on perception of tonal language (i.e. Mandarin Chinese) is still not clear. In this study, we investigated the effect of low-frequency hearing of opposite ears on tonal discrimination in cochlear implanted children.MATERIAL AND METHODS: Thirty-six native Mandarin-speaking children who received cochlear implant in NCKUH during 1999-2008 were enrolled in this study. The inclusion criteria were 1. Children whose pure tone audiometry are better than 30 dB with cochlear implant, 2. children with spontaneous oral communication. Among these children, nineteen of them used CI only and the other seventeen children used CI and opposite hearing aids. AII the children received the following examinations 1. Mandarin Lexical Neighborhood test (M-LNT) with easy word and hard word, 2. Speech perception in noise (SPIN) with high predictability and low predictability, 3. Tonal discrimination test. All the data were examined in unpaired t-test.RESULTS: Two children failed to complete all the tests, and in the end, 34 children's data were collected. In MLNT, the average score of CI group is 52(+/-21 .82) and 32.44(+/-23.03) in easy word and hard word respectively, and the CIHA group is 61.55(+/-15.18) and 43.11 (+/-2 1.8). No significant difference is found between CI and CIHA. In SPTN, the average score of CI group is 74.28(+/-18.4 1) and 54.28(+/-16.20) in high predictability sentence and low predictability sentence respectively, and the CIHA group is 74(+/-24.60) and 59.6(+/-20.08). No significant difference is found. In tonal discrimination test, the average score of CI group is 70.4(+/-10.74) and the CIHA group is 83.13(+/-5.61). The difference is statistically significant with P value less than 0.001.CONCLUSIONS: In our study, Madarin-speaking children with residual low frequency who used hearing aids in opposite ear have better performance in tonal discrimination. Biaural bimodal fitting for cochlear is suggested in native Madarin-speaking children with residual low frequency hearing for better speech perception and study. (J Taiwan Otolaryngol Head Neck Surg 2011; 46:298-303)

關鍵字

雙模式輔具配置 ； 對側低頻殘存聽力 ； 音調辨識 ； 人工耳蝸

並列摘要

BACKGROUND: Binaural advantages using a hearing aid with a cochlear implant (CIHA) in opposite ears have been proved on speech perception and functional performance in everyday life. However, whether such bimodal fitting can improve tonal discrimination which is critical on perception of tonal language (i.e. Mandarin Chinese) is still not clear. In this study, we investigated the effect of low-frequency hearing of opposite ears on tonal discrimination in cochlear implanted children.MATERIAL AND METHODS: Thirty-six native Mandarin-speaking children who received cochlear implant in NCKUH during 1999-2008 were enrolled in this study. The inclusion criteria were 1. Children whose pure tone audiometry are better than 30 dB with cochlear implant, 2. children with spontaneous oral communication. Among these children, nineteen of them used CI only and the other seventeen children used CI and opposite hearing aids. AII the children received the following examinations 1. Mandarin Lexical Neighborhood test (M-LNT) with easy word and hard word, 2. Speech perception in noise (SPIN) with high predictability and low predictability, 3. Tonal discrimination test. All the data were examined in unpaired t-test.RESULTS: Two children failed to complete all the tests, and in the end, 34 children's data were collected. In MLNT, the average score of CI group is 52(+/-21 .82) and 32.44(+/-23.03) in easy word and hard word respectively, and the CIHA group is 61.55(+/-15.18) and 43.11 (+/-2 1.8). No significant difference is found between CI and CIHA. In SPTN, the average score of CI group is 74.28(+/-18.4 1) and 54.28(+/-16.20) in high predictability sentence and low predictability sentence respectively, and the CIHA group is 74(+/-24.60) and 59.6(+/-20.08). No significant difference is found. In tonal discrimination test, the average score of CI group is 70.4(+/-10.74) and the CIHA group is 83.13(+/-5.61). The difference is statistically significant with P value less than 0.001.CONCLUSIONS: In our study, Madarin-speaking children with residual low frequency who used hearing aids in opposite ear have better performance in tonal discrimination. Biaural bimodal fitting for cochlear is suggested in native Madarin-speaking children with residual low frequency hearing for better speech perception and study. (J Taiwan Otolaryngol Head Neck Surg 2011; 46:298-303)

並列關鍵字

bimodal fitting ； contralateral residual low frequency hearing ； tone discrimination ； cochlear implant