Analysis of the results of hearing screening in physical examination in Beijing / 中华健康管理学杂志

Objective:To investigate the prevalence and characteristics of adult hearing loss.Methods:From March 2018 to November 2019, 8, 439 adult physical examinees were screened for hearing (i.e., 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz pure tone air conduction audiometry), while some were examined for hearing diagnosis (i.e., 250 Hz, 500 Hz, 1, 000 Hz, 2, 000 Hz, 4 000 Hz, and 8 000 Hz pure tone bone air conduction audiometry). Prevalence, location, frequency and type of hearing loss in different age and gender groups were analyzed using SPSS 25.0.Results:The prevalence of hearing loss was 32.2%, which increased with age. The prevalence in males was higher than that of females (40.1% vs. 21.6%). The rate of single frequency damage was higher in male than in female, while the rate of multiple frequency damage was higher in women than in men ( P<0.001). The high frequency (4 000 Hz) damage rate in male was higher than that of females, while the low-middle frequency (500-2 000 Hz) damage rate in females was higher than that of males ( P<0.001). Sensorineural hearing loss accounted for 90.8%, while conductive hearing loss was 3.9%, mixed hearing loss was 5.0%, and others were 0.3%. Conductive hearing loss was mainly concentrated in the younger age group. Conclusion:Physical examination population has a relatively high prevalence of hearing loss. The characteristics of hearing loss differed with age and gender.

An Analysis of Hearing Screening Results from 616 Preschool Children / 听力学及言语疾病杂志

Objective To explore the feasibility and effectiveness of otoacoustic emission (OAE) in hearing screening for preschool children .Methods A total of 616 preschool children aged 3～6 (mean age 4 .6 years old) were included in this study .All the subjects received transiently evoked otoacoustic emission (TEOAE) test by trained personnel .The children who failed the hearing screening received diagnostic examination in the hearing ex-amination center .Results Of 616 children ,66 (10 .71％ ) failed the hearing screening and 16 children received audi-ological assessment .In these 16 children ,8 had otitis media with effusion (5 with mild conductive hearing loss ) ,5 had impacted cerumen ,3 had normal hearing ,and none had sensorineural hearing loss .Conclusion OAE can be used effectively in the hearing screening for preschool children .But how to improve the referral rate of children who failed the hearing screening needs further discussion .

The review of categorization features of tone perception / 临床耳鼻咽喉头颈外科杂志

Categorical perception (CP) is the unique phenomenon that gradually morphed physical feature in a stimulus continuum tends to be perceived as discrete representations. CP has been evidenced in several modalities in the sensor perception. The first study of CP of phonetic perception was performed in 1957. However, the early CP studies focused on segmental features. The first study of CP of pitch contours was performed until 1976. This article will review the results of previous studies focus on the categorical perception applies to the lexical tone perception.

The analysis of correlative factors on mental health of post-linguistic hearing loss adults / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the mental health level of the post-linguistic deafen adult, to analyze factors affecting the mental health level.@*METHOD@#Fifty-two adult patients with severe to extremely severe post-linguistic hearing loss were randomly selected to participate the study. A self-reporting questionnaire drew up by researchers was used to collect sociological data of the participants. The self-rating anxiety scale (SAS), self-rating depression scale (SDS) and personal report of communication apprehension (PRCA-24) were used to measure the mental health degree of 52 post-linguistic hearing loss adults. To analyze related factors affecting the mental health in post-linguistic deafen adult.@*RESULT@#(1) Majority of post-linguistic deafen adult have mental symptoms, including 24 subjects (46.15%) with anxiety feeling, 18 subjects (34.61%) with depression feeling and 45 subjects (86.54%) with communication apprehension. (2) Gander, with/without tinnitus, duration of hearing loss, education background and family support had significant correlation with the mental health level of subjects. Higher incident rate of mental symptoms were found in male (OR = 2.246), with tinnitus (OR = 0.536), short duration (OR = 1.397, 1.530), high education background (OR = 0.323) and poor family support (OR = 1.724).@*CONCLUSION@#The mental health of the post-linguistic deafen adult was worse than that of the normal people, pathological feature and sociological factors were significantly correlated to the psychological evaluation. It is very important to pay attention on mental health and to give effective counseling of hearing loss people.

The Characteristics of Spontaneous Otoacoustic Emissions in Full -term Newborns / 听力学及言语疾病杂志

Objective To analyze the characteristics of spontaneous otoacoustic emission in full-term newbo‐rns .Methods The Capella OAE equipment (Madsen ,Denmark) was used to test Spontaneous Otoacoustic Emission (SOAE) in 147 cases (236ears) who have passed the newborn hearing screening with TEOAE(Transient Evoked Otoacoustic Emissions) .Results The SOAE incidence was 56 .77% (male 41 .51% ,female 69 .23% ;left ear 49 .14% ,right ear 64 .17% ) .It was significantly higher in females (P<0 .05) and in right ear (P<0 .05) .The av‐erage amplitude was 11 .78 ± 8 .36 dB SPL( 11 .73 ± 8 .25 dB in male ,11 .81 ± 8 .43 dB SPL in female;11 .97 ± 8 .56 dB SPL in the left ear ,11 .65 ± 8 .22 dB SPL in the right ear) .There were significant differences in genders(P<0 .01) .The frequency of SOAE focused on 3 .2~ 3 .7 kHz(2 .9~3 .4 kHz in males ,3 .4~3 .9 kHz in females ;3 .2~3 .7 kHz in the left ears ,3 .2~3 .6 kHz in the right ears) .There were significant differences in genders(P<0 .01) .The average peak of SOAE was 3 .70 ± 2 .75(3 .86 ± 2 .87 in males ,3 .62 ± 2 .70 in females;3 .70 ± 3 .02 in the left ears ,3 .70 ± 2 .55 in the right ears) .There were no significant differences in genders and laterality .Conclusion The characteristics of SOAE in full-term newborns include higher incidences ,multiple peaks and high frequency distribution .

The effect of improving the physical and mental health on different rehabilitation programs for post-linguistic cochlear implantees / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the physical and mental health status of post-linguistic cochlear implantees, and then to explore the effectiveness on of different rehabilitation programs.@*METHOD@#Mandarin hearing in noise test (MHINT), personal report of communication apprehension (PRCA-24) and Nijmegen cochlear implant questionnaire (NCIQ) were used to measure the hearing ability, mental health degree and the health related life quality in 36 post-linguistic cochlear implant users, respectively. The improvement of subjects' physical and mental health levels was compared with among different rehabilitation programs, including family training program, auditory habilitation program and psychological intervention program.@*RESULT@#(1) Family training program only can improve the subject's hearing ability (P < 0.05), but failed to ease the communication apprehension; ((2) Auditory habilitation program can both significantly improve the subjects' hearing ability (P < 0.01) and ease the fear of talking face to face (P < 0.01); (3) Psychological intervention program can significantly increase the auditory abilities (P < 0.01), reduce the communication apprehension (P < 0.01) and improve the quality of life.@*CONCLUSION@#Post-linguistic cochlear implantees had obvious mental symptoms. It was very important to design an effective rehabilitation program to improvement the living quality of hearing loss people.

The review of newborn hearing screening program in neonatal intensive care unit / 临床耳鼻咽喉头颈外科杂志

The incidence of hearing impairment in neonatal intensive care unit (NICU) was much higher than that of well-baby nursery. The incidence of the former was 2%-4%, whereas that of the latter was 0.1%-0.3%. Furthermore, the incidence of auditory neuropathy spectrum disorder, progressive and delayed hearing loss was also higher than those of other infants. Therefore, the newborn hearing screening program in NICU has become an important part of pediatric audiology. In this paper, we reviewed the previous studies and suggested the special procedure of hearing screening and following-up which based on the physiological and pathological characteristics of NICU in order to detect hearing impaired as early as possible.

The effects on psychological health of patients with hearing loss / 临床耳鼻咽喉头颈外科杂志

Previous studies have shown that hearing loss people are more likely to have not only abnormal speech communication, but also psychological problems especially emotional disorders, cognitive impairments and personality defects. Therefore, it is necessary to provide psychological support to patients during they accept medical therapy.

Development of Mandarin tonal identification in noise test materials / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The aim of this study was to develop comprehensive test material for Mandarin tone identification in noise (M-TINT) based on the linguistic characteristics in Chinese.</p><p><b>METHODS</b>In keeping with both the reliability and efficiency in clinical practice, a primary list consisted of 320 words(80 syllables in four tones each) was designed according to the following principles: shortness of the lists, word familiarity and with a meaning in all four tones. The digital sound file was recorded by a male speaker and a female speaker (both of them are radio broadcaster).</p><p><b>RESULTS</b>The tonal identification material database, which included 288 items (72 loudness-balanced syllables in all 4 Mandarin tones) was established by digital filler and balanced for equal loudness. The complete material was recorded in two CDs in a male version and a female version. The speaker-specific masking noises were generated by filtering Gaussian white noise to the speaker's long-term average speech spectrum (LTASS) and by scaling the masking noises to the same RMS amplitudes, as those of the speech, in order to acquire the effective sound masking. The speaker-specific masking noises could be able or disable during the word presentation. The sound pressure level could be selected concerning on the test setting.</p><p><b>CONCLUSIONS</b>The mandarin tonal identification materials were designed by both the tonal acoustic properties and the psychophysics characteristic of adults. It is an useful speech test in clinical work and research, and can potentially be used as the basic list for other tonal language identification test in the future.</p>

Effects of temporal fine structure stimulation on Mandarin identification in cochlear implant users / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To assess the contribution of the temporal fine structure cues on speech recognition, especially tone perception of cochlear implant users whose native language is Mandarin Chinese.</p><p><b>METHODS</b>Twelve Mandarin speaking users of the MED-EL COMBI 40+ cochlear implants with the standard COMBI 40+ electrode array participated in the study. The subjects were followed up and studied using the longitudinal method for six weeks to compare the difference in speech identification results between fine structure processing (FSP) and continuous interleaved sampler (CIS). The test battery comprised two objective speech tests, including tone identification in quiet as well as a sentence recognition task in quiet and noise.</p><p><b>RESULTS</b>The scores of acute speech test: after replacing FSP strategy, the acute tone test results were similar to that of daily used CIS strategy(male version t = 0.791, P = 0.446;female version t = 0.679, P = 0.511), but the scores of MHINT were decreased significantly (t = -4.365, P = 0.001). The scores of long-lasting speech test were as follows the scores of tone identification test were sharply increased after subjects used the new coding strategy for six weeks continuously(male version t = 3.023, P = 0.018;female version t = 3.883, P = 0.003) and the MHIN results were similar to that of daily used CIS strategy(t = 1.475, P = 0.173).</p><p><b>CONCLUSION</b>The extraction of temporal fine structure cues supplemented in speech processing strategy of cochlear implant benefits the improvements in tone perception and the understanding of speech in cochlear implant recipients, which can further promotes their quality of life.</p>

Lexical tone perception and quality of life in nurotron cochlear implant users / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the lexical tone perception and quality of life of Nurotron cochlear implant users.@*METHOD@#Forty-nine adult cochlear implant users participated in this study. Mandarin tone identification test developed by Beijing Institute of Otolaryngology was used to evaluate the tone perception. Nijmegen cochlear im plantation questionnaire (NCIQ) was administered to quantify the quality of life.@*RESULT@#(1) The average scores of tone perception in quiet was 67.26%. The tone perception rates under quiet condition for all cochlear implant recipients were higher than the opportunity level. (2) The average scores of tone perception under noisy condition was 51.92%. Exc ept for two recipients, the tone perception rates under noise condition for the rest recipients were better than chance. (3) The confusion patterns of tone recognition showed that Tone 3 was the easiest tone to perceive. (4) The postimplant scores for the total , basic sound perception, advanced sound perception, speech pro duction, self-esteem, activity and social interactions of NCIQ were 55.4, 72.4, 54.0, 63.4, 50.7, 47.3 and 44.7, respectively.@*CONCLUSION@#The Nurotron cochlear implant users had the ability for lexical tone perception and had an improvement in quality of life after cochlear implantation.

Analysis of reliability of the Chinese version of satisfaction with amplification in daily life / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the reliability of the Chinese version of Satisfaction with Amplification in Daily Life (SADL).@*METHOD@#The cross-cultural adaption measures were used to translate the SADL into Chinese version. Thirty hearing aid users no younger than 18 years old were included. Test-retest analysis was administrated to the patients without significant changes in health and social status with an interval of two weeks between test and retest.@*RESULT@#Test-retest reliability of the SADL was proved to be satisfactory. All subscales and global score had coefficients that exceeded 0.70 (P < 0.01). Except for "personal image", the score of other subscales and global score in this study are higher than the U. S. interim norms described by Cox and Alexander (1999) (P < 0.01).@*CONCLUSION@#This study completed the translation and test-retest analysis of Chinese version of SADL. We need further discussion about validation of Chinese version of SADL in order to meet basic psychometric criteria of a standard outcome measurement.

A study on the normal values of musical sounds in cochlear implants test battery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To establish music reference values for normal-hearing (NH) person in China, in order to give convenience in clinical application.@*METHOD@#The NH participant group included 39 subjects, of which 21 females and 18 males. Musical Sounds in Cochlear Implants test battery was used to assess the music perception ability for normal-hearing participants.@*RESULT@#The median pitch difference NH participants could discriminate for string was 2.5 semitones and 0.5 for flute. The average scores of rhythm discrimination, melody discrimination, chord discrimination, instrument identification and instrument number detection test were 86.1% (SD = 11.2), 76.5% (SD = 11.1), 75.6% (SD = 11.4), 89.9% (SD = 13.0) and 74.1% (SD = 20.7), respectively.@*CONCLUSION@#The MuSIC test could be a test for music perception ability for China users and in further study the material that more suited for our culture should be added into it.

Emotional response to music by postlingually-deafened adult cochlear implant users / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the emotional response to music by postlingually-deafened adult cochlear implant users.@*METHOD@#Munich music questionnaire (MUMU) was used to match the music experience and the motivation of use of music between 12 normal-hearing and 12 cochlear implant subjects. Emotion rating test in Musical Sounds in Cochlear Implants (MuSIC) test battery was used to assess the emotion perception ability for both normal-hearing and cochlear implant subjects. A total of 15 pieces of music phases were used. Responses were given by selecting the rating scales from 1 to 10. "1" represents "very sad" feeling, and "10" represents "very happy feeling.@*RESULT@#In comparison with normal-hearing subjects, 12 cochlear implant subjects made less active use of music for emotional purpose. The emotion ratings for cochlear implant subjects were similar to normal-hearing subjects, but with large variability.@*CONCLUSION@#Post-lingually deafened cochlear implant subjects on average performed similarly in emotion rating tasks relative to normal-hearing subjects, but their active use of music for emotional purpose was obviously less than normal-hearing subjects.

The effects of hearing level on auditory performance in infants with hearing aids / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The purpose of this study is to investigate the effects of hearing level on auditory performance in infants with hearing aids and provide a clinical database for their hearing and speech habilitation.@*METHOD@#A total of 32 infants with prelingual hearing loss participated in this study, ranging in age at hearing aid fitting from 3 to 34 months with a mean of 16 months. According to their hearing level, they were divided into three groups. Infants in group A were with moderate hearing loss (41-60 dB HL). Infants in group B were with severe hearing loss (61-80 dB HL). Infants in group C were with profound hearing loss (>81 dB HL). The infant-toddler meaningful auditory integration scale (IT-MAIS) was used to evaluate their auditory performance. The evaluation was performed before hearing aid fitting and 1, 3, 6, 9, 12 months after fitting.@*RESULT@#The mean scores of auditory performance showed significant improvements with time of hearing aid use for the three groups of infants (P 0.05). However, significant differences were observed between group A and C at 3, 6, 9, 12 months after fitting (P < 0.05). Significant differences were also shown between group B and C at 1, 3, 6, 9, 12 months after fitting (P < 0.05).@*CONCLUSION@#Auditory performance of infants with prelingual hearing loss developed significantly with the use of hearing aids within the first year after fitting. The degree of hearing loss in infants had significant influence on the development of auditory performance.

Effect of age at cochlear implantation on auditory performance at the early stage after surgery in infants / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the auditory performance of infants with cochlear implants at the early stage after surgery, summarize the development of auditory ability, investigate the effect of age at cochlear implantation on auditory performance within the first year after surgery and provide a reference for their habilitation program.@*METHOD@#A total of 272 infants with prelingually profound hearing loss participated in this study, ranging in age at cochlear implantation from 18 to 36 months. The mean age was 21 months with a standard deviation of 7 months. Infants with cochlear implants were divided into three groups according to their age at implantation. Infants in group A were implanted under 18 months of age. Infants in group B were implanted between 18 and 24 months of age. Infants in group C were implanted between 25 and 36 months of age. Categories of auditory performance (CAP) was used to evaluate the auditory performance, which rates auditory abilities in eight categories for a scale of 0 to 7.@*RESULT@#The mean scores of CAP for all infants at each interval were significantly different after implantation. Significant differences were observed in mean scores of CAP among these three groups in 1 and 3 months after switch-on. However there were no significant differences in pre-operation, 6, 9 and 12 months after switch-on.@*CONCLUSION@#There is a significant improvement in auditory performance of infants with prelingually profound hearing loss within the first year after cochlear implantation. The age at cochlear implantation has no critical influence on the development of auditory capabilities at the early stage after surgery. CAP is a practical tool which can be used in clinic in China.

The contribution of different cochlear insertion region to Mandarin speech perception in users of cochlear implant / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the effect of cochlear electrode coverage and different insertion region on speech recognition, especially tone perception of cochlear implant users whose native language is Mandarin Chinese.@*METHOD@#Setting seven test conditions by fitting software. All conditions were created by switching on/off respective channels in order to simulate different insertion position. Then Mandarin CI users received 4 Speech tests, including Vowel Identification test, Consonant Identification test, Tone Identification test-male speaker, Mandarin HINT test (SRS) in quiet and noise.@*RESULT@#To all test conditions: the average score of vowel identification was significantly different, from 56% to 91% (Rank sum test, P 0.05). However the more channels activated, the higher scores obtained, from 68% to 81%.@*CONCLUSION@#This study shows that there is a correlation between insertion depth and speech recognition. Because all parts of the basement membrane can help CI users to improve their speech recognition ability, it is very important to enhance verbal communication ability and social interaction ability of CI users by increasing insertion depth and actively stimulating the top region of cochlear.

Assessment of cochlear implant performance with Mandarin Hearing In Noise Test / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the abilities speech perception of post-lingual cochlear implant patients by Mandarin Hearing In Noise Test(MHINT), get the performance-intensity function (P-I function).@*METHOD@#The material was MHINT adults' version, including 12 lists, 20 sentences per list. Twenty-two cochlear implant patients were the subjects, age from 14 to 56. Three adaptive rules were used during the test. Firstly Rule 3 would be done. If subject could finish the test, then Rule 2 and Rule 1 would be used. Got the Reception threshold of sentences and speech recognition score of subjects, then got performance-intensity function (PI function).@*RESULT@#Among those 22 subjects, 5 of them could be tested in all three rules, 3 could be tested in Rule 2 and Rule 3, 7 of them could be tested with Rule 3, and 7 of the CI users could not be tested even with Rule 3. All of the PI functions for CI users are shifted 10 dB or more above the normal PI functions. Most CI users thought that MHINT was hard for them.@*CONCLUSION@#When use new adaptive scoring rules for MHINT, most CI users could be tested with the modified HINT scoring rules, although three subjects could not be tested. Compared with normal hearing subjects, all CI users required positive S/N ratios to perform the HINT measures.

A Study of the Intervention of Children with Bilateral Severe Hearing Loss in Countryside of China / 听力学及言语疾病杂志

Objective To investigate the effects of the intervention,rehabilitation and speech development of children with severe hearing loss in some rural areas.Methods 61 children,including 35 males and 26 females,were diagnosed as severe hearing loss with ABR and 40 Hz-AERP from June 2004 to July 2008.All the children failed hearing screening or visited the hospital as outpatients.The ages ranged from 2 to 72 months with the average age of 17.59 months.During telephone follow-up,the questionnaire was used to gather the data regarding the usage of hearing aids,hearing and speech rehabilitation,speech development,and communication abilities.Results 33 (54.10%) children were fitted with hearing aids,and 2 (3.28%) received cochlear implants,while 26(42.62 %) neither had hearing aids nor cochlear implants.10 cases with hearing aids also had speech training,whereas 23 children with hearing aids did not receive the training.2 cases with cochlear implants and 2 cases with hearing aids were found to have good speech development and communication ability,while 31 cases with hearing aids had delayed speech development.26 cases without any devices had to rely on sign language for their commumication.Conclusion Children in rural area with severe hearing loss experience greater speech and communication difficulties because many of them have no access to intervention and speech training.The results suggest that it would be very important to increase public awareness and educate parents to have their children wear hearing aids and receive speech training.

Study on multi-area universal newborn hearing screening in countryside of China / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the feasibility of universal newborn hearing screening in countryside in order to provide reliable evidence in launching this program all over the countryside of China. Method:Subjects were 12 638 infants who were born in 9 counties from Jan 2004 to Dec 2005. TEOAE was used for the fast hearing screening. Infants were screened on the 2-7 days after the birth. The re-screening was conducted in 4-6 weeks if failed in the initial screening,and follow-up were provided continually if they also failed in the re-screening. Result; Ten thouand eight hundred and forty-five of 12 638(85. 8%) were screened including 9 963(91. 9%) normal newborns and 882(8. 1%) newborns with high-risk. Seven thouand four hundred and fifty (68. 7%) newborns passed the initial screening, and 3 395 (31. 3%) people failed. One thouand seven hundred and ninty-three (14. 2%) infants were refused to be screened.Only 2 536 (74. 7%) were re-screened on time, and 859(25. 3%) did not receive re-screening. One hundred and twenty were failed in the re-screening or first screening, and 79 (65. 8%)of them received diagnostic assessment. Among the infants received diagnostic assessment, 6(7.6%)ca-ses were found to have profound hearing loss in both ears, 9(11. 4%)cases were found to be severe hearing loss(7 in both ears and 2 in single ear) , 11(13. 9%)cases were found to be moderate hearing loss (5 in both ear and 6 in single ear), 26 (32. 9%) were found to have slight hearing loss (11 in both ear and 15 in single ears), and 27 (34.2%) were normal. Fifty-two infants were diagnosed as hearing loss with a prevalence of congenital hearing loss(in binaural and monaural) of 0. 5%(52/10845)and a prevalence of bilateral hearing loss of 0. 3%(29/10845). A prevalence of congenital hearing loss was 0. 2% (22/9 963) in well infants and 3. 4% (30/882) in high risk infants. Among the 13 cases of children with severe and profound hearing loss in both ears children, 8(61. 5%)cases were fitted with hearing aids and 1 (7. 7%) case was implanted with cochlear implants. Conclusion:It is necessary and feasible to conduct hearing screening program in the rural area. However, the suitable model to perform the program in the countryside needs to be set up as soon as possible in order to get more poor infants to participate into the hearing screening program for free and increase the screening rate.