| ObjectiveTo investigate the speech recognition threshold and hearing improvement of patients with unilateral hearing loss fitting with Sophono softband bone conduction device.To provide potential counseling information regarding bone conduction implantation for patients with unilateral hearing loss.MethodsA total of 52 patients with hearing loss were recruited in the First Affiliated Hospital of Zhengzhou University from June 2019 to November 2019,aged at a range of 10 to 69 years,with an average of 38.71±16.32 years.The pure tone audiometry,acoustic immittance measurement,HRCT or MRI of temporal bone were used to assess the patients.1.Inclusion criteria:?Patients with unilateral conductive or mixed hearing loss:the mean bone conductive thresholds?45 dB HL,with an air-bone gap>25 dB;?Patients with bilateral conductive or mixed hearing loss:the mean bone conductive thresholds ?45 dB HL,with an air-bone gap>25 dB;?SSD:air conductive thresholds of normal ear?30 dB HL,air conductive thresholds of the deaf ear?90 dB HL.?Patients understood spoken Mandarin.?Patients had good compliance with tests.2.Group assignments:?unilateral conductive or mixed hearing loss group,aged at a range of 11 to 67 years,with an average of 37.81 ± 14.65 years and the hearing threshold average of 61.19±1.12 dB HL;?single-side deafness(SSD)group,aged at a range of 13 to 69 years,with an average of 41.57±16.08 years;?bilateral conductive or mixed hearing impaired group(control group):aged at a range of 10 to 69 years,with an average of 37.47±18.99 years.and the hearing threshold average of 63.68±3.44 dB HL for better ear.The average interaural difference was 2.60±1.93 dB.3.Audiological evaluation:All the tests were performed in sound field test environment.Each participant was seated in a chair one meter away from the loudspeakers with the ears at the height equal to the loudspeaker array.The loudspeakers were placed at 0°azimuth,90°azimuth and 270°azimuth to the participant.All the three groups were evaluated under the following conditions,before and after wearing the device.?Pure tone threshold average,with loudspeaker 0°azimuth to the patients.The better ears were masked while tested.?Speech recognition threshold(SRT)in quiet,with loudspeaker 0°azimuth,90°azimuth and 270°azimuth to the patients.?SRT in noise,with loudspeaker 0°azimuth to the patients.The SRT conducted with Chinese Open-set Speech Evaluation System of Angel Training.Questionnaires:All patients were asked to fill out questionnaires after testing.4.Statistical analysis:SPSS 21.0 was employed to analyze data.The values are expressed as the means ± standard deviation(SD).Paired-sample t test was used to assess the significance of changes among continuous variables,and independent-sample t test was used to assess the significance of gain value among different patients.Statistical significance was determined at P<0.05.Results1.For the unilateral conductive or mixed hearing loss group,the auditory thresholds of 0.25,0.5,1,2,4 kHz unaided were 54.05±12.91 dB HL,58.10±12.40 dB HL,62.38±10.68 dB HL,58.33 ±10.41 dB HL,59.76±12.50 dB HL respectively.The auditory thresholds of 0.25,0.5,1,2,4 kHz aided were 44.05±10.44 dB HL,41.90±12.60 dB HL,26.43±7.61 dB HL,33.81±10.24 dB HL,48.57±13.24 dB HL respectively.The gain value were 10.00±10.00 dB?16.19±10.71 dB?24.52±9.47 dB?11.19±8.50 dB?37.68±9.63 dB.All frequency showed significant improvement compared to that of unaided(P<0.05).The unaided average SRT in quite of three azimuth(0°,90°,270°)were 31.1±5.86 dB HL?38.89±5.13 dB HL?30.35±5.58 dB HL respectively.The aided average SRT of three azimuth(0°,90°,270°)were 28.56±5.89 dB HL?33.54±4.80 dB HL?27.69±5.59 dB HL respectively.The gain value were 2.55±1.25?5.36±2.33?2.66±1.97 dB respectively,showing significant improvement compared to that of unaided(P<0.05),The average signal-to-noise ratio(SNR)of patients with unilateral conductive or mixed hearing loss was-3.48±1.67 dB.The gain value was 1.94±0.85 dB,showing significant improvement compared to that of unaided(P<0.05).2.In SSD group:The unaided average SRT in quite of three azimuth(0°,90°,270°)were 31.56±1.51 dB HL?42.03±3.30 dB HL?29.52±1.44 dB HL respectively.The aided average SRT of three azimuth(0°,90°,270°)were 30.22±1.42 dB HL?37.26±2.77 dB HL?28.81±1.26 dB HL respectively.The gain value were 1.34±1.08 dB?4.78±1.18 dB?0.7 1±1.80 dB respectively,showing significant improvement compared to that of unaided at 0°azimuth and 90°azimuth(P<0.05).The SRT in patients with SSD had no statistically significant difference in 270°azimuth compared to that of unaided(P>0.05).Comparing the data from unilateral conductive or mixed)hearing loss with that from SSD,SRT in unilateral conductive or mixed hearing loss group was superior to SSD(P<0.05).3.To compare the hearing threshold improvement in unilateral conductive or mixed hearing loss with that in bilateral conductive or mixed hearing loss.The unaided and aided hearing threshold in the two groups were tested.The auditory thresholds of 0.25,0.5,1,2,4 kHz unaided were 61.76±7.69 dB HL?64.12±4.76 dB HL?64.12±4.76 dB HL?59.41±3.91 dB HL?59.12±6.18 dB HL respectively.The auditory thresholds of 0.25,0.5,1,2,4 kHz aided were 52.94±7.72 dB HL?42.35±7.31 dB HL?21.47±4.60 dB HL?28.53±5.23 dB HL?49.12±8.52 dB HL respectively.The gain value were 8.82±8.76 dB?21.76±7.49 dB,42.65±5.62 dB?30.88±6.18 dB?10.00±9.35 dB respectively.All frequencies showed significant improvement compared to that of unaided(P<0.05).The PTA in patients with unilateral and bilateral conductive or mixed hearing loss had no statistically significant difference(P>0.05).For patients with bilateral conductive or mixed hearing loss,the aided gain of SRT in quiet of three azimuth(0°,90°,270°)were 23.55±1.27 dB?25.83 ± 1.09 dB?22.54±1.17 dB,showing significant improvement compared to that of unaided(P<0.05).The average SNR in patients with bilateral conductive or mixed hearing loss was 11.04±1.52 dB with a gain of 13.72 ± 2.25 dB,showing significant improvement compared to that of unaided(P<0.05).4.Questionnaire survey results:The research investigated all the patients'satisfaction about the Sophono softband 8 cases(22.86%)felt no significantly improvement with the device on some patients with unilateral hearing loss.It showed significant improvement compared to that of unaided for 27 cases(77.14%).Among 27 cases,12 cases(44.44%)disliked the appearance of this device.The patients with bilateral conductive or mixed hearing loss were more satisfied with the Sophono softband and showed preference to bone conductive implantation.Among the patients with bilateral conductive or mixed hearing loss,4 cases(23.53%)disliked the appearance of this device.Conclusion1.The Sophono softband can improve SRT and hearing threshold of the patients with unilateral hearing loss.Sophono Softband provided superior improvement in the patients with unilateral conductive or mixed hearing loss comparing to that in the patients with SSD.Device preference and subjective assessment from questionnaires showed slightly but not significantly improvement with the device on some patients with unilateral hearing loss.Therefore,bone conduction implantation for unilateral hearing loss should be performed only after a thoughtful evaluation and trial of available treatment options.2.Although,owing to the hearing ear was masked,it seems there was no difference in aided PTA between the patients with unilateral and bilateral conductive or mixed hearing loss.The patients with bilateral conductive or mixed hearing loss were more satisfied with the Sophono softband and showed preference to bone conductive implantation. |
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