单侧听力损失：现实世界中的聆听能力、社会参与及应对挑战的适应策略。

文献信息

中文摘要

背景： 单侧听力损失（UHL）与噪声中言语困难、空间听觉受损及社会参与减少相关，但常规听力学评估可能无法捕捉这些现实世界中的后果。本研究使用生态学导向的测试组合来刻画UHL的多维功能影响，并探讨可获取的行为学和自我报告测量是否能解释噪声中言语理解力的个体差异。方法：15名患有中度至重度感音神经性UHL的成人和16名听力正常的成人完成了评估听力残疾和社会参与的标准问卷、安静和噪声下的听觉反应时任务、国家声学实验室动态对话测试、头部朝向追踪以及任务后自我报告。使用混合效应模型和独立样本t检验评估组间差异。一项探索性回归分析了UHL组内的噪声中言语表现。结果：UHL参与者报告了更大的听力困难和社交参与限制，并表现出轻度较差的噪声中言语理解力，尽管在年龄调整后，UHL与NH在噪声中言语理解力方面的差异不再具有统计学显著性。噪声下的反应时显著长于安静下，但听力组间无显著差异。UHL组还表现出显著更明显的朝向听力较差侧的头部朝向以及更大的参与者内头部朝向变异性。一个结合噪声下反应时和三个任务后自我报告条目的探索性模型显示出强的表观样本内拟合（调整R2 = 0.71）。然而，对完整模型选择程序进行内部交叉验证后，预测性能显著降低（RCV2 = 0.19）。结论：UHL与日常交流中互补的知觉、行为和自我报告维度的差异相关。多模态功能评估可能提供超出常规听力计的信息，尽管该探索性模型需要在更大、年龄匹配的独立队列中验证。

英文摘要

Background: Unilateral hearing loss (UHL) is associated with speech-in-noise difficulties, impaired spatial hearing, and reduced social participation, yet conventional audiological assessments may not capture these real-world consequences. This study characterised the multidimensional functional impact of UHL using an ecologically oriented test battery and explored whether accessible behavioural and self-reported measures accounted for individual differences in speech-in-noise comprehension. Methods: Fifteen adults with moderate to profound sensorineural UHL and sixteen adults with normal hearing completed standardised questionnaires assessing hearing disability and social participation, an auditory reaction-time task in quiet and noise, the National Acoustic Laboratories Dynamic Conversations Test, head-orientation tracking, and post-task self-reports. Group differences were assessed using mixed-effects models and independent-samples t-tests. An exploratory regression examined speech-in-noise performance within the UHL group. Results: Participants with UHL reported greater hearing difficulties and social participation restrictions, and showed modestly poorer speech-in-noise comprehension although the UHL-NH difference in speech-in-noise comprehension was no longer statistically significant after adjustment for age. Reaction times were significantly longer in noise than in quiet but did not differ significantly between hearing groups. The UHL group also showed a significantly more pronounced head orientation towards the poorer-hearing side and greater within-participant head-orientation variability. An exploratory model combining reaction time in noise with three post-task self-report items showed strong apparent in-sample fit (adjusted R2 = 0.71). However, internal cross-validation of the complete model-selection procedure yielded substantially lower predictive performance (RCV2 = 0.19). Conclusions: UHL is associated with differences across complementary perceptual, behavioural, and self-reported dimensions of everyday communication. Multimodal functional assessment may provide information beyond conventional audiometry, although the exploratory model requires validation in larger, age-matched independent cohorts.