長期未接受介入的單側聽力損失成人佩戴不同輔具之效益評估：個案報告

The Outcome Evaluation of Different Hearing Devices in A Long-Term Untreated Unilateral Hearing Loss Adult-Case Study

10.6143/JSLHAT.202306_(48).0003

柳佩辰(Pei-Chen Liu)；游季璟(Chi-Ching Yu)；張凱淳(Kai-Chun Chang)；林郡儀(Chun-Yi Lin)；張慧珊(Hui-Shan Chang)

單側聽力損失 ； 聲源定位 ； 噪音下言語辨識 ； 問卷 ； 聽覺輔具 ； Unilateral hearing loss ； Sound localization ； Speech recognition in noise ； Questionnaires ； Assistive listening device

台灣聽力語言學會雜誌

48期（2023 / 06 / 01）

43 - 58

繁體中文;英文

全面新生兒聽力篩檢普及前，單側聽力損失者通常在年齡較晚才被發現，且發現後專業人員也不會積極建議佩戴聽覺輔具，因此社會中有許多長期未經輔具介入的成人單側聽損者。單側聽損會導致聲源辨識、噪音環境下聆聽困難以及聽覺剝奪等問題。本研究之目的是藉由一名單側傳導性聽損個案，佩戴氣導、骨導及對側跨傳式等三款不同的助聽器，分別進行聲源定位測驗、噪音下言語辨識及主觀問卷評量之助聽效益。研究結果顯示，以骨導助聽器效果最佳，氣導助聽器次之，對側跨傳式助聽器第三。本文認為長期未介入的單側傳導性聽損者，即使可能存在因長期聽覺剝奪而產生聽覺中樞側化性改變的情況下，仍有可能從骨導或氣導式的助聽器獲得益處。

Before the universal newborn hearing screening program launched, children with unilateral hearing loss were often identified at an older age. Hearing devices and any kind of intervention were also not recommended. Thus, there are a lot of long-term untreated unilateral hearing loss adults in society. Unilateral hearing loss can cause problems like: difficulty in localizing sound sources, difficulty in listening to noise, and hearing deprivation on the hearing loss side. The purpose of this study was to evaluate the outcomes of three hearing devices: air conduction hearing aid, bone-anchored hearing aid (BAHA) with soft-band, and contralateral routing of signals (CROS) on a conductive unilateral hearing loss adult. The ability of sound localization, monosyllabic word recognition in noise, spondee words recognition in noise, and subjective questionnaires were assessed and compared. The result of this study showed that BAHA provided the best outcomes in overall test conditions, while followed by air conduction hearing aid and then CROS. In conclusion, although the lateralization of the central auditory pathway may be changed by long-term hearing deprivation, a long-term untreated conductive unilateral hearing loss adult can still benefit from an air conduction or bone conduction hearing device.

1. Aaronson, N. L.,Hartmann, W. M.(2014).Testing, correcting, and extending the Woodworth model for interaural time difference.The Journal of the Acoustical Society of America,135,817-823.
2. American Speech-Language-Hearing Association. (2022). Audiology information series: Unilateral hearing loss. Retrieved July 21, 2022, from https://www.asha.org/siteassets/ais/ais-unilateral-hearing-loss.pdf
3. Augustine, A. M.,Chrysolyte, S. B.,Thenmozhi, K.,Rupa, V.(2013).Assessment of auditory and psychosocial handicap associated with unilateral hearing loss among Indian patients.Indian Journal of Otolaryngology and Head and Neck Surgery: Official Publication of the Association of Otolaryngologists of India,65,120-125.
4. Avan, P.,Giraudet, F.,Büki, B.(2015).Importance of binaural hearing.Audiology & Neuro-otology,20(Suppl. 1),3-6.
5. Bess, F. H.,Tharpe, A. M.(1986).An introduction to unilateral sensorineural hearing loss in children.Ear and Hearing,7,3-13.
6. Bess, F. H.,Tharpe, A. M.,Gibler, A. M.(1986).Auditory performance of children with unilateral sensorineural hearing loss.Ear and Hearing,7,20-26.
7. Bilecen, D.,Seifritz, E.,Radü, E.W.,Schmid, N.,Wetzel, S.,Probst, R.,Scheffler, K.(2000).Cortical reorganization after acute unilateral hearing loss traced by fMRI.Neurology,54,765-767.
8. Bishop, C. E.,Hamadain, E.,Galster, J. A.,Johnson, M. F.,Spankovich, C.,Windmill, I.(2017).Outcomes of hearing aid use by individuals with unilateral sensorineural hearing loss (USNHL).Journal of the American Academy of Audiology,28,941-949.
9. Cañete, O. M.,Purdy, S. C.,Brown, C. R. S.,Neeff, M.,Thorne, P. R.(2019).Impact of unilateral hearing loss on behavioral and evoked potential measures of auditory function in adults.Journal of the American Academy of Audiology,30,564-578.
10. Choi, J. E.,Ma, S. M.,Park, H.,Cho, Y. S.,Hong, S. H.,Moon, I. J.(2019).A comparison between wireless CROS/BiCROS and soft-band BAHA for patients with unilateral hearing loss.PLoS One,14,e0212503.
11. Cooper, H. R.,Burrell, S. P.,Powell, R. H.,Proops, D.W.,Bickerton, J. A.(1996).The Birmingham bone anchored hearing aid programme: referrals, selection, rehabilitation, philosophy and adult results.The Journal of Laryngology and Otology. Supplement,21,13-20.
12. Cox, R. M.,Alexander, G. C.,Beyer, C. M.(2003).Norms for the international outcome inventory for hearing aids.Journal of the American Academy of Audiology,14,403-413.
13. Dawes, P.,Munro, K. J.,Kalluri, S.,Edwards, B.(2014).Acclimatization to hearing aids.Ear and Hearing,35,203-212.
14. Educational Audiology Association. (2017). School-based audiology advocacy series: Minimal, mild, and unilateral hearing loss/single-sided deafness. Retrieved June 21, 2022, from https://www.edaud.org/advocacy/17-advocacy-08-17.pdf
15. Eklöf, M.,Asp, F.,Berninger, E.(2020).Sound localization latency in normal hearing and simulated unilateral hearing loss.Hear Researching,395,108011.
16. English, K.,Church, G.(1999).Unilateral hearing loss in children: An update for the 1990s.Language, Speech, and Hearing Services in Schools,30,26-31.
17. Everberg, G.(1960).Etiology of unilateral total deafness studied in a series of children and young adults.The Annals of Otology, Rhinology, and Laryngology,69,711-730.
18. Golub, J. S.,Lin, F. R.,Lustig, L. R.,Lalwani, A. K.(2018).Prevalence of adult unilateral hearing loss and hearing aid use in the United States.Laryngoscope,128,1681-1686.
19. Häusler, R.,Colburn, S.,Marr, E.(1983).Sound localization in subjects with impaired hearing. Spatial-discrimination and interaural-discrimination tests.Acta Oto-laryngologica. Supplementum,400,1-62.
20. Holstrum, W. J.,Biernath, K.,McKay, S.,Ross, D. S.(2009).Mild and unilateral hearing loss implications for early intervention.Infants & Young Children,22,177-187.
21. Humes, L. E.,Allen, S. K.,Bess, F. H.(1980).Horizontal sound localization skills of unilaterally hearing-impaired children.Audiology: Official Organ of the International Society of Audiology,19,508-518.
22. Kim, G.,Ju, H. M.,Lee, S. H.,Kim, H. S.,Kwon, J. A.,Seo, Y. J.(2017).Efficacy of bone-anchored hearing aids in single-sided deafness: A systematic review.Otology & Neurotology,38,473-483.
23. Kochkin, S.,Luxford, W.,Northern, J. L.,Mason, P.,Tharpe, A. M.(2007).MarkeTrak VII: Are 1 million dependents with hearing loss in America being left behind?.Hearing Review,14(10)
24. Kong, T. H.,Lee, J.,Kwak, C.,Han, W.,Gwon, O. H.,Seo, Y. J.(2021).Audiological benefits and performance improvements of Baha® attract implantation in patients with unilateral hearing loss.Cochlear Implants International,22,270-282.
25. Mylanus, E. A.,van der Pouw, K.C.,Snik, A. F.,Cremers, C. W.(1998).Intraindividual comparison of the bone-anchored hearing aid and air-conduction hearing aids.Archives of Otolaryngology-Head & Neck Surgery,124,271-276.
26. Peter, N.,Kleinjung, T.,Probst, R.,Hemsley, C.,Veraguth, D.,Huber, A.,Caversaccio, M.,Kompis, M.,Mantokoudis, G.,Senn, P.,Wimmer, W.(2019).Cochlear implants in single-sided deafness-clinical results of a Swiss multicentre study.Swiss Medical Weekly,149,w20171.
27. Priwin, C.,Jönsson, R.,Hultcrantz, M.,Granström, G.(2007).BAHA in children and adolescents with unilateral or bilateral conductive hearing loss: A study of outcome.International Journal of Pediatric Otorhinolaryngology,71,135-145.
28. Priwin, C.,Jönsson, R.,Magnusson, L.,Hultcrantz, M.,Granström, G.(2007).Audiological evaluation and self-assessed hearing problems in subjects with single-sided congenital external ear malformations and associated conductive hearing loss.International Journal of Audiology,46,162-171.
29. Rothpletz, A. M.,Wightman, F. L.,Kistler, D. J.(2012).Informational masking and spatial hearing in listeners with and without unilateral hearing loss.Journal of speech, language, and hearing research,55,511-531.
30. Tarkkanen, J.,Aho, J.(1966).Unilateral deafness in children.Acta Oto-laryngologica,61,270-278.
31. Vanderauwera, J.,Hellemans, E.,Verhaert, N.(2020).Research insights on neural effects of auditory deprivation and restoration in unilateral hearing loss: A systematic review.Journal of Clinical Medicine,9,812.
32. Viehweg, R.,Campbell, R. A.(1960).Localization difficulty in monaurally impaired listeners.The Annals of Otology, Rhinology, and Laryngology,69,622-634.
33. Welsh, L. W.,Welsh, J. J.,Rosen, L. F.,Dragonette J. E.(2004).Functional impairments due to unilateral deafness.The Annals of Otology, Rhinology, and Laryngology,113,987-993.
34. 中央通訊社（2022）。職務再設計增服務對象納單側聽損者。取自https://www.cna.com.tw/news/ahel/202204120211.aspx
35. 勞動部（2021）。110 年第1 季（1 至3 月）大事紀。取自https://www.mol.gov.tw/media/ch2hemuu/110年第1季至第4季-奉核.pdf?mediaDL=true