使用低增益放大管理功能性听力困难：听觉处理评估病例报告

文献信息

中文摘要

背景： 功能性听力困难在听力阈值低于25 dB HL的平民和军事人员中都很常见，尤其是那些暴露于爆炸或患有轻度创伤性脑损伤（mTBI）的人。尽管听力阈值“正常”，这些人经常报告在嘈杂环境中有显著的听力挑战。低增益助听器（LGHA）已成为管理这些困难的一种有前景的干预措施。
目的： 描述识别LGHA候选者的决策过程并评估结果。
研究设计： 病例报告。
研究样本： 三名服务人员的病例报告：两名男性和一名女性。
数据收集与分析： 呈现三名接受听觉处理评估的病例报告，以说明听力阈值低于25 dB HL且功能性听力困难患者的临床决策和结果，突出LGHA的潜在益处和局限性。
结果： 患者1在标准化问卷结果支持下，功能性听力困难有所改善。患者2最初在使用助听器方面遇到困难，但在设备调整和咨询后获得了显著益处，表现为使用增加和障碍评分改善。患者3的困难主要归因于共病而非听觉系统异常，在任何听力学干预之前被转诊管理这些疾病。
结论： 这些病例强调了个体化评估和治疗策略对优化结果的重要性。LGHA对于听力阈值“正常”但经历显著沟通困难，尤其是在具有挑战性的聆听环境中的人来说，是一种可行的干预措施。这些设备可以提供可测量的益处，如改善的感知言语理解和减少听力障碍，使其成为该人群的宝贵选择。
临床相关性声明： LGHA为听力阈值“正常”但经历功能性听力困难，尤其是在噪声中的患者提供了一种可行且可测量的治疗选择。这些病例报告展示了个体化评估和设备咨询如何能够改善沟通结果，鼓励临床医生将放大作为这一服务不足人群更广泛管理策略的一部分。

英文摘要

BACKGROUND: Functional hearing difficulties are common among both the civilian population and military personnel with hearing thresholds less than 25 dB HL, particularly those exposed to blasts or with mild traumatic brain injuries (mTBIs). These individuals often report significant hearing challenges in noisy environments, despite "normal" audiometric thresholds. Low-gain hearing aids (LGHAs) have emerged as a promising intervention for managing these difficulties.
PURPOSE: Describe the decision-making process for identifying a candidate for LGHAs and evaluate the outcomes.
RESEARCH DESIGN: Case reports.
STUDY SAMPLE: Three case reports of service members: two male and one female.
DATA COLLECTION AND ANALYSIS: Three case reports who underwent auditory processing evaluations are presented to illustrate clinical decision-making and outcomes for patients with hearing thresholds less than 25 dB HL and functional hearing difficulties, highlighting the potential benefits and limitations of LGHAs.
RESULTS: Patient 1 exhibited improvement in functional hearing difficulties supported by standardized questionnaire results. Patient 2 initially struggled with hearing aid use but experienced significant benefit after device adjustments and counseling, as evidenced by increased usage and improved handicap scores. Patient 3, whose difficulties were attributed primarily to comorbid conditions rather than auditory system abnormalities, was referred for management of these conditions before any audiological intervention.
CONCLUSIONS: These cases highlight the importance of individualized assessment and treatment strategies for optimizing outcomes. LGHAs are a feasible intervention for individuals with "normal" hearing thresholds who experience significant communication difficulties, particularly in challenging listening environments. These devices can provide measurable benefits, such as improved perceived speech understanding and reduced hearing handicap, making them a valuable option for this population.
CLINICAL RELEVANCE STATEMENT: LGHAs offer a viable and measurable treatment option for patients with "normal" hearing thresholds who experience functional hearing difficulties, especially in noise. These case reports demonstrate how individualized assessment and device counseling can lead to improved communication outcomes, encouraging clinicians to consider amplification as part of a broader management strategy for this underserved population.