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  • Title: [Comparison of horizontal plane auditory spatial discrimination abilities and testing methods in patients with symmetrical sensorineural hearing loss].
    Author: Wei L, Li JY, Wang X, He XL, Nie S, Fu X, Li H, Liu JX, Zhao XL, Zhao ZH, Wang NY, Zhang J.
    Journal: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2024 Sep 07; 59(9):922-927. PubMed ID: 39289960.
    Abstract:
    Objective: To evaluate auditory spatial discrimination capabilities in patients with mild to moderately severe symmetrical sensorineural hearing loss (SNHL) and to compare the impact of different psychophysical testing methods on Minimum Audible Angle (MAA) and test duration. Methods: A total of 105 symmetrical SNHL patients aged from 18 to 60 years old were enrolled from April to July 2023, including 56 males and 49 females. They were divided into three groups based on PTA: mild, moderate, and moderately severe hearing loss, with 35 individuals in each group. Additionally, a control group of 35 individuals with normal hearing was tested, including 18 males and 17 females. Participants underwent four distinct psychophysical discrimination tests: the block up-down, 1-up/1-down, 1-up/2-down, and 1-up/3-down procedures. We recorded the MAA and test duration for each. We employed repeated measures of ANOVA to compare the MAA and test duration across different methods and groups, and Pearson's correlation to assess the relationship between MAA and degree of hearing loss. Results: MAA of sound localization in patients with symmetrical SNHL was significantly positively correlated with the degree of hearing loss (r=0.59, P<0.01). Significant deterioration in MAA was observed as hearing loss progressed to the moderate level (PTA≥35 dBHL, P<0.01). The testing methods significantly influenced MAA and testing duration (F=24.02, P<0.01; F=75.56, P<0.01) and the 1-up/1-down method was the quickest, averaging only (0.69±0.32) mins. Conclusions: The horizontal plane auditory spatial discrimination abilities in patients with symmetrical SNHL is impaired progressively with increasing hearing loss, notably beyond moderate hearing loss levels. Different psychophysical methods influence both MAA and test duration, the quicker 1-up/1-down method is recommended for assessing MAA in symmetrical SNHL patients. 目的： 评估轻至中重度对称性感音神经性听力损失（sensorineural hearing loss，SNHL）患者在水平方位的角度辨别能力，同时探讨不同心理物理测量方法对测试结果及测试时间的影响。 方法： 2023年4—7月期间共纳入105例年龄18~60周岁的对称性SNHL患者，其中男性56例、女性49例，根据平均纯音听阈（pure-tone average，PTA）分为轻度听力损失组（20 dBHL≤PTA<35 dBHL）、中度听力损失组（35 dBHL≤PTA<50 dBHL）、中重度听力损失组（50 dBHL≤PTA<65 dBHL），每组35例；另外选取35名年龄18~60周岁的听力正常者作为对照组，其中男性18例、女性17例。所有受试者均完成4种不同的心理物理测量法的角度辨别测试，包括区块法、1降1升法、2降1升法和3降1升法，分别记录其角度辨别阈，即最小可听角（minimum audible angle，MAA）及测试用时。采用重复测量方差分析比较不同测试方法、不同组别的MAA及测试用时，Pearson相关性分析检验MAA与听力损失的关系。 结果： 对称性SNHL患者的MAA随着听力损失程度加重而增大，二者存在正相关关系（r=0.59，P<0.01）。当听力损失达到中度（PTA≥35 dBHL）时，与正常听力对照组相比，MAA组间差异具有统计学意义（P<0.01）。四种心理物理测量法对MAA及测试用时均有显著影响（F=24.02，P<0.01；F=75.56，P<0.01），其中1降1升法测试用时最短（0.69±0.32）min。 结论： 对称性SNHL患者的水平方位角度辨别能力随听力损失程度加重而下降，当听力损失达到中度时其角度辨别能力较正常人明显受损。不同心理物理测量法会对MAA测试结果及测试用时产生影响，推荐使用1降1升法测试对称性SNHL患者的水平方位角度辨别阈。.
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