时域精细结构信息对汉语人工耳蜗使用者言语识别的影响

摘要

Objective 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.Methods 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.Results 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 scroes 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).Conclusion 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.%目的 探讨增加时域精细结构(temporal fine structure)信息的人工耳蜗编码策略对汉语普通话人工耳蜗使用者言语识别能力的影响.方法 对12名母语为汉语普通话的Med-EL C40+人工耳蜗使用者进行为期6周的跟踪性研究,比较从连续间隔采样编码策略(continuous interleaved sampler,CIs)改为精细结构编码策略(fine structure processing,FSP)后,人工耳蜗使用者噪声下汉语普通话声调识别测试(Tone Identification in Noise Test)和汉语普通话版噪声下言语测试(Mandarin Hearing in Noise Test)成绩的变化趋势.结果 人工耳蜗使用者由CIS编码策略改为FSP编码策略后,其即刻声调测试成绩与日常使用CIS编码策略所得成绩相当,差异无统计学意义(男声版t=0.791,P=0.446;女声版t=0.679,P=0.511);但是普通话噪声下言语测试呈现明显下降趋势,平均下降16.8％,差异具有统计学意义(t=-4.365,P=0.001).持续使用FSP编码策略6周后,受试者声调识别成绩较更换前有显著提高,差异具有统计学意义(男声版平均提高11.6％,t=3.023,P=0.018;女声版平均提高10.9％,t=3.883,P=0.003);普通话噪声下言语测试成绩与更换前日常使用CIS编码策略所得成绩接近,差异无统计学意义(t=1.475,P=0.173).结论 在人工耳蜗言语提取方案中增加对时域细微结构线索的提取,有利于改善耳蜗植入者对声调的感知能力和对言语整体性的理解,进而有助于提高人工耳蜗植入者的生活质量.