雙模式聆聽使用者與雙側人工耳蝸植入者在安靜及噪音環境之聲調辨識

目前許多研究皆已證實雙側聆聽的諸多優勢，而重度至極重度聽力損失患者可選擇雙模式聆聽或雙側人工耳蝸植入；然目前尚無上述兩種聆聽模式聲調辨識表現的相關研究。因此，本研究以國語作為聲調辨識測試工具，旨在探討安靜、訊噪比+5 dB和訊噪比+15 dB下雙模式聆聽及雙側人工耳蝸的聲調辨識表現。本研究共納入30名受試者，雙模式聆聽使用者及雙側人工耳蝸植入者各15位。首先測試裸耳、配戴聽覺輔具之聲場效益等；接著分別在三種不同環境下進行聲調辨識測試；統計方法使用無母數分析法的曼-惠特尼考驗分析兩組在不同環境下的聲調辨識表現。結果顯示雙側人工耳蝸植入者表現在安靜（p = .021）、訊噪比+15 dB（p = .005）和+5 dB（p < .001）皆顯著優於雙模式聆聽使用者，且隨著訊噪比越小表現顯著更佳。兩種配戴模式下正確率最高聲調皆為4聲，雙模式聆聽使用者易將2聲混淆為3聲，訊噪比+5 dB下更有忽略訊號之狀況；雙側人工耳蝸植入者同樣在2聲及3聲之間易混淆。研究證實在不同環境下的聲調辨識能力，雙模式聆聽使用者皆較雙側人工耳蝸植入者差；且雙側人工耳蝸對聲調辨識的1聲幫助最大、3聲幫助最小。

Studies have demonstrated the benefits of binaural hearing, and for patients with severe to profound hearing loss, listening options include bimodal hearing or bilateral cochlear implants. However, limited research that compares tone recognition between these two binaural hearing modes. This study aims to investigate the tone recognition of bimodal hearing users and bilateral cochlear implant recipients in quiet, SNR+5 dB, and SNR+15 dB environments, using Mandarin as the test material.This study included 30 participants, comprising 15 bimodal hearing users and 15 bilateral cochlear implant recipients. After testing unaided hearing thresholds and aided sound field thresholds, tone recognition tests were conducted across the three specified listening environments. The findings revealed that the bilateral cochlear implant recipients significantly outperformed bimodal hearing users in quiet conditions (p=.021), SNR+15 dB (p=.005), and SNR+5 dB (p<.001). Additionally, tone 4 had the highest accuracy among all tones in both aided modes. Bimodal hearing users frequently confused tone 2 with tone 3. Bilateral cochlear implant recipients also showed difficulty distinguishing between tone 2 and tone 3.The study demonstrates that tone recognition across various environments was consistently worse for bimodal hearing users compared to bilateral cochlear implant recipients. Among the tones, tone 1 benefited the most from bilateral cochlear implants, while tone 3 showed the least improvement.