聲源方向與助聽器使用者語音辨識率之探討

背景：探討助聽器使用者在不同聲源角度與語音辨識率的關聯性。方法：自2021年2月自2021年5月，在三軍總醫院耳鼻喉科聽力室招募16位聽力正常與32位佩戴助聽器之成年人，平均年齡為48歲。聽力正常者做為控制組。以60歲為分組的依據，將受測者分為兩組。受測者頭部與喇叭的相對位置，設定為音源出現的位置，分為0、45與90度角。依聽損的程度，將受試者分為四組。收集變項含性別、年齡、左右耳、聽力損失程度與在0、45與90度角下之語音辨識率。統計分析以套裝統計軟體SPSS 22.0執行，以獨立樣本t檢定、獨立樣本單因子變異數分析、相依樣本單因子變異數分析及多元迴歸分析不同檢定方式，考驗是否會因不同性別、年齡、左右耳、聽損程度及角度有顯著差異。結果：在45和90度角時， 60歲以下的受試者在語音辨識率上皆較60歲（含）以上的受試者為佳。聽力損失程度越輕之受試者在0、45與90度角之語音辨識程度優於聽力損失程度較重之受試者。本研究發現安靜情境中之語音辨識率在特定聲源角度下，會受到年齡、聽損程度的影響。建議未來應招募更多受測者且執行噪音情境，探究不同聲源角度對語音辨識率影響之完整面向。

Background: The aim of the present study made an attempt to investigate the ability of hearing-impaired individuals with different hearing conditions to discriminate spatial auditory-sources at the midline and lateral positions.Method: We enrolled 48 subjects ≥ 20 years (mean = 48.02 ± 19.36 years), including 16 adults with normal hearing and 32 adults wearing hearing aids from the otolaryngologic audio division of Tri-Service General Hospital between May and February, 2021. The participants who with normal hearing were divided into the control group. Participants were also classified into two age groups by WHO definition, Group 1 (20～59 years) and Group 2 (60～79 years). The relative position of the subject's head and the speaker was set as the position where the sound source appear, which was divided into 0°, 45° and 90°. According to the degree of hearing loss, the subjects were divided into four groups. The variables include gender, age, left and right ear, the degree of hearing loss, and the speech discrimination at 0°, 45°, and 90°. An investigation was launched based on the aforementioned factors, and statistical analysis was performed using SPSS 22.0. Various analysis methods such as independent sample t−test, an independent sample analysis of variance, dependent sample analysis of variance, and multiple regression analysis were used to test if each of the aforementioned factors would lead to a significant difference in speech discrimination.Results and Discussion: The speech discrimination score was higher at 45° and 90° when the hearing−impaired subjects were younger than 60 years old. The subjects who were milder degrees of hearing loss show better scores than those severe ones at 0°, 45°, and 90°. Conclusion：This study discovered that speech discrimination in a quiet environment would be affected by age, degree of hearing loss, and angle of the voice source. For future studies, it is recommended that more test subjects can be recruited and noisy environment can be included to have a comprehensive investigation and understanding of the impact of the different voice source angles on speech discrimination.