[[alternative]]The study of perceived communication ability in cochlear implant recipients by using acceptable noise level (ANL)

[[abstract]]本研究目的為： 1) 比較人工電子耳植入者與正常聽力者之ANL是否具顯著差異。 2) 探討人工電子耳植入者其ANL數值與噪音背景辨識語音測驗 (speech perception in noise test, SPIN) 分數之相關性。 3) 探討人工電子耳植入者其ANL數值與人工電子耳效益量表分數之相關性。 4) 探討人工電子耳植入者其人工電子耳效益量表分數與SPIN分數之相關性。 本研究受試者分為實驗組與對照組。實驗組為核式24型人工電子耳植入者，對照組為正常聽力者，各為15名，年齡範圍10歲至16歲。將ANL測驗施測於實驗組及對照組，使用t檢定分析兩組其ANL是否具顯著差異。而SPIN測驗與人工電子耳效益量表只施測於實驗組，並使用簡單迴歸分析ANL、SPIN及人工電子耳效益量表兩兩間是否具顯著相關性。 研究結果顯示：1) 人工電子耳植入者之ANL平均值為4.933 dB，正常聽力者之ANL平均值為0.667 dB。兩組之ANL具顯著差異 (p 0.05)。 3) 人工電子耳植入者其人工電子耳效益量表第一部分平均值為79.381%，第二部分平均值為29.481%。人工電子耳植入者其ANL數值與人工電子耳效益量表無顯著相關性 (p > 0.05)。 4) 人工電子耳植入者其人工電子耳效益量表第一部分及第二部分與SPIN分數無顯著相關性 (p > 0.05)。 本研究結論顯示：1) 正常聽力者與人工電子耳植入者ANL數值具顯著差異，可能因人工電子耳植入者多屬習語前失聰者，中樞聽覺系統發展之型態不同，且人工電子耳使用電流刺激方式，影響中樞聽覺系統之神經發展模式。2) ANL數值與SPIN分數無顯著相關，因此，兩者測驗反映在中樞聽覺系統中，訊息處理方式可能並不相同，若評估人工電子耳植入者在噪音中語音接收能力之工具，可使用客觀性之噪音背景辨識語音測驗及ANL。 3) 人工電子耳植入者其ANL數值與人工電子耳效益量表無顯著相關，可能原因在人工電子耳植入者年齡較小，缺乏某些聽覺經驗，影響人工電子耳效益問卷填寫。4) 人工電子耳植入者其SPIN分數與人工電子耳效益量表無顯著相關，可能原因在於聽覺經驗較缺乏，而影響人工電子耳效益問卷填答。[[abstract]]Aim of study: The purposes of this study are to determine : 1) whether the Mandarin - ANLs are different between cochlear implant (CI) recipients and normal - hearing (NH) listeners. 2) whether the Mandarin - ANLs are relative to the Mandarin- speech perception in noise(SPIN) test performance in CI recipients. 3) whether the Mandarin - ANLs and the subjective outcome measure in CI recipients are related. 4) whether the subjective outcome measure is relative to the Mandarin - SPIN performance in CI recipients.Material & methods: Fifteen CI recipients and fifteen NH listeners were evaluated by the Mandarin - ANL test. In addition, all fifteen CI recipients were evaluated with the Mandarin - SPIN test and assessed with the cochlear implants benefit inventory. The Mandarin - ANLs of CI recipients were compared to those of NH listeners. Meanwhile, the study compared the Mandarin-ANLs, the Mandarin-SPIN scores and the cochlear implants benefit inventory scores of CI recipients in pairs. Results: 1) The mean Mandarin – ANLs of NH listeners were 4.933 dB. The mean Mandarin – ANLs of CI recipients were 0.667 dB. The mean Mandarin – ANLs of CI recipients were significantly larger than NH listeners (p< 0.05). 2) The mean Mandarin – SPIN Global, SPIN HP, and SPIN LP scores were individually 36.267, 39.733,and 32.800 in CI recipients. The Mandarin – ANLs were not significantly correlated with the Mandarin – SPIN scores. 3) The mean cochlear implants benefit inventory scores (part Ⅰ) of CI recipients were79.381%, and the cochlear implants benefit inventory scores (part Ⅱ) were 29.481%. The Mandarin – ANLs were not significantly correlated with the cochlear implants benefit inventory scores. 4) The cochlear implants benefit inventory scores were not significantly correlated with the Mandarin – SPIN scores.Conclusions: 1) The Mandarin – ANLs of CI recipients were significantly larger than NH listeners. The results of the study suggested that the prelinguistic hearing loss may have a different pattern of central auditory system development. The different pattern of neuromaturation of the central auditory nervous system in CI recipients may affect the ANLs. 2) The Mandarin – ANLs were not significantly correlated with the Mandarin –SPIN scores. The Mandarin –SPIN test and the Mandarin –ANL test may be reflecting different aspects of listening in noise. The result of this study suggested that the Mandarin –ANL test can be used as a tool to evaluate the processing in noise with CI recipients. 3) The Mandarin –ANLs were not significantly correlated with the cochlear implants benefit inventory scores. The results of the study suggested that the CI recipients of this study were younger, and their auditory experiences were not enough. Consequently, the cochlear implants benefit inventory scores were affected. 4) The Mandarin –SPIN scores were not significantly correlated with the cochlear implants benefit inventory scores. The auditory experiences of the CI recipients were not enough. Consequently, the cochlear implants benefit inventory scores were affected