不同助听设备下低频退化音乐音质感知的比较

文献信息

中文摘要

目的： 比较不同助听设备使用者对低频退化音乐音质的感知。
方法： 招募52名成人进行横断面观察性研究，包括11名听力正常（NH）听者、8名双侧助听器使用者（HAHA）、17名双模式使用者（CIHA）和16名双侧人工耳蜗使用者（CICI）。参与者使用CI-多刺激隐藏参考与锚定测试评估3秒长音乐片段（15组）的音质。受试者对隐藏参考（“最佳”）、三个低频频截止分别为200、400和800 Hz的高通滤波（HPF）版本以及一个锚定（退化最严重版本）进行评分和排序。采用ART ANOVA及事后比较识别各组间对每种刺激版本平均感知音质评分的差异。
结果： 队列和低频退化程度对音质感知均有显著影响及交互作用（p < 0.001）。在200和400 Hz HPF条件下，HAHA使用者对音质的评分高于CIHA和CICI使用者（p < 0.001），而CIHA和CICI表现相似。在800 Hz HPF条件下未见差异，提示当低频退化严重时，三个听力受损组受到的影响相似。此外，与NH相比，HAHA、CIHA和CICI均难以识别参考并正确排序刺激。
结论： HAHA使用者对低频声音退化（≤ 400 Hz）的敏感性优于CI使用者。这些发现阐明了低频感知限制是导致CI介导音乐音质下降的一个 contributing 因素，并为植入候选者术前咨询其术后音乐聆听体验提供了证据。

英文摘要

OBJECTIVES: To compare low-frequency-degraded musical sound quality perception between users of different hearing-assistive devices.
METHODS: Fifty-two adults including 11 normal-hearing (NH) listeners, eight bilateral hearing aid users (HAHA), 17 bimodal users (CIHA), and 16 bilateral cochlear implant users (CICI) were recruited for a cross-sectional observational study. Participants assessed the sound quality of 3-s-long musical segments (15 sets) using the CI-Multiple Stimulus with Hidden Reference and Anchor test. Subjects rated and ranked a hidden Reference ("best"); three high-pass filtered (HPF) versions with low-frequency cutoffs at 200, 400, and 800 Hz; and an anchor (most degraded version). ART ANOVA with post hoc comparisons was conducted to identify between-group differences in average perceived sound quality ratings for each stimulus version.
RESULTS: Both cohort and degree of low-frequency degradation had significant effects and interaction on sound quality perception (p < 0.001). HAHA users rated sound quality higher than both CIHA and CICI users for the 200 and 400 Hz HPF conditions (p < 0.001), while CIHA and CICI performed similarly. No difference was seen at 800 Hz HPF, suggesting all three hearing-impaired groups were similarly affected when low-frequency degradation was severe. Additionally, HAHA, CIHA, and CICI all had difficulty identifying the Reference and correctly ordering stimuli compared to NH.
CONCLUSION: HAHA users exhibit superior sensitivity to low-frequency sound degradation (≤ 400 Hz) than CI users. These findings elucidate low-frequency perception limitations as a contributing factor to diminished CI-mediated musical sound quality and provide evidence for preoperative counseling of implant candidates regarding their postoperative music-listening experience.