微聽損治療策略：耳鼻喉科醫師及聽語人員專業意見調查

背景：微聽損包含輕度聽力損失、高頻聽損及單側聽損，過去研究指出約有5.4%之學齡兒童有微聽損。這群患者在不良的聽覺環境中之語言理解力較差，易有語言結構問題、疲勞、行為及社交困難、課業及職涯發展障礙。早期發現及治療，可讓聽損兒童發展出較佳之語言理解及社交技巧，但微聽損未我國達身心障礙或失能的標準，目前政策對此一族群之輔具及醫療尚無補助。方法：本研究為關於兒童微聽損治療策略之觀察性研究，於台灣耳鼻喉頭頸外科年會及台灣聽力語言學會定點發放紙本問卷及擺放電子問卷連結，隨意邀請不特定與會者回答。問卷記錄受試者之執業經驗、地點、院所之規模及對於三種兒童微聽損之治療決策差異。結果：本次回收228份有效問卷，共計174位耳鼻喉科醫師、30位聽力師、21位語言治療師及3位聽語教職人員之問卷納入統計分析，發現不同的訓練背景、執業院所會導致微聽損治療決策差異，但治療決策不受執業年資及地點等因子之影響。結論：臨床上除評估患者之聽覺能力外，亦應將語言的發展評估視為是否治療介入之重要參考依據。本研究希望可促進臨床耳鼻喉科醫師與聽力師、語言治療師、聽語療育基金會等建立團隊合作模式，營造更好的聽覺健康環境。

關鍵字

微聽損；輕度聽損；高頻聽損；單側聽損；助聽器

並列摘要

Background: Minimal hearing loss includes mild hearing loss, high frequency hearing loss, and unilateral hearing loss. Minimal hearing loss negatively affects children's language development, resulting in a cascading effect on their communication, psychosocial and academic abilities, and lateral occupational success. Early diagnosis and intervention can improve language and psychosocial outcomes of the affected patients. However, this group of patients do not meet the disability criteria in Taiwan and do not receive allowance for assistive device or treatment. Methods: We conducted this descriptive epidemiology study by randomly issuing questionnaires at the Taiwan Otolaryngological Society meeting and the annual meeting of the Speech-Language-Hearing Association in Taiwan. All participants completed a questionnaire including questions about demographic information of participants and suggestions for treatment strategies regarding minimal hearing loss. The result was delinked by coding in the database and underwent further statistical analysis. Results: A total of 228 valid questionnaires, answered by 174 otolaryngologists, 30 audiologists, 21 speech therapists, and three school staff members who are experts in the field of audiology and speech-language pathology, were analyzed. We found that the decisions regarding treatment were significantly influenced by training and institutional backgrounds but not by the duration or location of practice of the study participants. Conclusion: In addition to evaluating patients' hearing ability, language development assessment should also be considered during the management of minimal hearing loss. The aim of our study was to promote the establishment of teamwork between clinicians, audiologists, and speech therapist.

並列關鍵字

Minimal hearing loss ； Mild hearing loss ； High frequency hearing loss ； Unilateral hearing loss ； Hearing aid

參考文獻

Benchetrit, L., Ronner, E. A., Anne, S., & Cohen, M. S. (2021). Cochlear implantation in children with single-sided deafness: A systematic review and meta-analysis. JAMA Otolaryngology-Head & Neck Surgery, 147, 58-69. doi:10.1001/jamaoto.2020.3852

Bess, F. H., Davis, H., Camarata, S., & Hornsby, B. W. Y. (2020). Listening-related fatigue in children with unilateral hearing loss. Language, Speech, and Hearing Services in Schools, 51, 84-97. doi:10.1044/2019_lshss-ochl-19-0017

Bess, F. H., Dodd-Murphy, J., & Parker, R. A. (1998). Children with minimal sensorineural hearing loss: Prevalence, educational performance, and functional status. Ear and Hearing, 19, 339-354. doi:10.1097/00003446-199810000-00001

Bess, F. H., & Hornsby, B. W. (2014). Commentary: Listening can be exhausting-Fatigue in children and adults with hearing loss. Ear and Hearing, 35, 592-599. doi:10.1097/aud.0000000000000099

Chen, P.-Y., Lin, Y.-H., Liu, T.-C., Lin, Y.-H., Tseng, L.-H., Yang, T.-H., ... Hsu, C.-J. (2020). Prediction model for audiological outcomes in patients with GJB2 mutations. Ear and Hearing, 41, 143-149. doi:10.1097/aud.0000000000000742

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