편측 인공와우 이식자의 보청기 사용

허승덕,김리석,정동근,최아현,고도홍,김현기,Heo, Seung-Deok,Kim, Lee-Suk,Jung, Dong-Keun,Choi, Ah-Hyun,Ko, Do-Heung,Kim, Hyun-Gi 한국음성학회 2005 음성과학 Vol.12 No.4

The cochlear implantation(CI) as an useful tool for aural rehabilitation in bilateral severe to profound hearing impairment. However, CI prefer to usually one ear in spite of bilateral hearing impaired. because of the various characteristics of hearing loss, the hearing conservation for the future possibility, and socioeconomic condition of hearing impaired person and their families. The unilateral CI has limitations such as a directional loss, a difficult speech understanding in noise and a neural plasticity. These limitations will be overcome by hearing aid(HA) which is familiar with hearing impairer. but HA fitting for bimodal-binaural hearing are difficult because the difference output characteristic of HA and CI. This study will be confirm realities of use of HA in unilateral cochlear implantee. For this goal, 25(m:f=10:15) child participated who are used to HA for 1 to 17 months. We had telephone interviews with their mother about use of HA, change of auditory performance and own voice. As the results, hearing threshold levels of unimplanted ear, the use of a appropriate HA, implanted and aided hearing threshold level(HTL) are must be considered for successful biomodal-binaural hearing. Especially, implanted and aided HTL should be very useful parameter for a prediction of HA effect and a criterion of selection for bilateral cochlear implantation.

Speech-in-Noise Perception According to Subtypes of Mild Cognitive Impairment

Soo Jung Lee(이수정),Kyung Won Park(박경원),Lee-Suk Kim(김리석),HyangHee Kim(김향희) 한국언어치료학회 2016 한국언어치료학회 학술발표대회 논문집 Vol.2016 No.12

Purpose: The objectives of the current study are as follows: 1) to compare speech-in-noise perception performance among mild cognitive impairment (MCI) subgroups and a cognitively normal elderly (CNE) group; and 2) to explore cognitive domains specifically related to speech-in-noise perception. Methods: Data were collected on samples of 46 patients with MCI and 39 hearing threshold-matched CNE subjects. Two different patient classifications were used: 1) patients with amnestic MCI (aMCI) (n=21) or patients with non-amnestic MCI (naMCI) (n=25); and 2) patients with frontal-executive dysfunction (FED) (n=16) or patients without FED (n=30). All subjects received audiometric, neuropsychological, and speech-in-noise perception assessments. Speech-in-noise perception was measured via sentence recognition tests with speech-spectrum and multi-talker babble background noise at four SNRs: +5 dB, 0 dB, -2 dB, and -5 dB. Results: First, the MCI with FED group scored lower than both the MCI without FED and the CNE groups under both types of noise when the SNR fell from 0 dB to -5 dB. At SNR + 5 dB, there was no group difference in the presence of speech-spectrum noise, but the MCI with FED group still scored lower than the CNE group in the presence of multi-talker babble noise. Second, there were no differences between the aMCI and naMCI groups in speech perception performance under any noisy conditions. Third, significant positive correlations were found between speech-in-noise perception and frontal-executive function in the MCI patients. Conclusions: Our findings suggest that frontal-executive function strongly relates to speech-in-noise perception. Considering that deficits in speech-in-noise perception are related to increased risk of cognitive decline and dementia, MCI patients with FED who have severely impaired speech perception may have a higher risk of developing dementia. These patients should receive cognitive training focused on frontal-executive function and audiological rehabilitation.

인공와우이식 아동의 학교 수행력: 5세 이전에 수술 받은 아동을 중심으로

허민정 ( Min Jung Heo ),김리석 ( Lee Suk Kim ) 한국특수교육문제연구소 2010 특수교육저널 : 이론과 실천 Vol.11 No.3

본 연구의 목적은 만 5세 이전에 인공와우이식을 받은 아동들의 일반학교 통합 후 학교 수행력을 건청 아동과 비교하여 알아보고, 학교 수행력과 관련된 변인을 알아보고자 하는 것이다. 이를 위해 담임 교사에게 인공와우이식 아동 1명과 건청 아동 1명의 학교 수행력을 설문지를 통해 평가하게 하였다. 그 결과, 인공와우이식 아동은 저학년보다 고학년에서 수행력이 더 낮은 것으로 평가되었다. 건청 아동과의 비교 결과, 저학년에서는 의사소통능력에서 차이를 보였고, 고학년에서는 학교 수행력의 네 하위영역 전체에서 건청 아동에 비해 유의하게 낮은 수행력을 보였다. 관련 변인을 살펴보면, 의사소통능력은 수술 연령, 청각적 수행력, 언어능력, 재활참여정도와 상관관계가 있었고, 사회-정서 적응은 청각적 수행력, 언어능력, 재활 참여정도와 상관관계가 있었으며, 학업성취는 청각적 수행력, 언어능력과 관련이 있었다. This study aims to investigate the school performance of children who received cochlear implantation under age of five and have been integrated into regular elementary schools compared to that of normal hearing children, and to examine the factors associated with the school performance of these children. Classroom teachers completed the questionnaires comprised of 26 items regarding communication skill, psycho-social adjustment, academic achievement, and general integration adjustment for 37 children with cochlear implants and 37 normal hearing children attending the same classrooms. As a result, the school performance of higher grade students with cochlear implants was significantly lower than that of lower grade students with cochlear implants. In the lower grade, students with cochlear implants showed significantly lower communication abilities than normal hearing children. On the other hand, in the higher grade, students with cochlear implants showed significantly lower performance on four aspects of school performance. In terms of related factors to school performance, communication abilities were correlated with age at implantation, auditory performance, language ability, and habilitation, and social-emotional adjustment was related with three variables except age at implantation. Academic achievement was related with auditory performance and language ability.

인공와우이식 아동의 전기 자극 역치와 역동범위의 변화

김수진(Soo Jin Kim),김리석(Lee Suk Kim),이규식(Kyu Shik Rhee) 한국언어청각임상학회 1999 Communication Sciences and Disorders Vol.4 No.-

인공와우의 매핑은 소아 인공와우 프로그램에서 필수적인 부분으로 아동이 인공와우로부터 받는 도움의 정도를 평가함에 있어 중요한 역할을 담당한다. 본 연구는 Nucleus 다채널 인공와우 시스템을 이식 받은 아동 15명의 전기 자극 역치와 역동범위를 측정하여 그 변화를 분석하였다. 대상아동의 연령범위는 최소 2세 9개월에서 최대 10세 11개월이었으며, 각 전극의 전기 자극 역치와 최대 쾌청치는 첫 자극으로부터 3, 6,12, 18, 24, 36개월째에 측정하였다. 대상아동 15명 중 13명의 전기 자극 역치에서, 그리고 14명의 역동범위에서 통계적으로 유의미한 변화를 보였으며 3개월에서 12개월 사이에 비교적 많은 변화를 나타냈다. 이와 같은 결과는 인공와우이식 아동이 일상생활에서 인공와우로부터 최대한의 도움을 받기 위해서는 특히 이 기간에 더 많은 회기의 매핑이 필요함을 의미한다. Mapping of cochlear implant s is an essential part of the paediatric program. It is necessary to assess children over time to determine the long - term benefit s. T he purpose of this study was to measure changes in electrical thresholds, dynamic range of children with cochlear implant s. Fifteen children with prelingual onset s of deafness were implanted with the Nucleus multichannel cochlear prosthesis. T hey ranged in age from 2 year s 9 months to 10 year s 11 months. Electrical thresholds and comfortable levels for each electrode used in the children were measured at 3, 6, 12, 18, 24, and 36 months after initial stimulation. T hirteen of the 15 children had statistically significant changes over time in their electrical thresholds and 14 of the 15 children, in dynamic range. The changes occurred between 3 months and 12 months considerably . The result of this study underlines the necessity for more frequent programming sessions for 12 months from the fir st stimulation to optimize hearing in everyday life.

인공와우 이식 아동의 어휘 발달

김수진(Soo-Jin Kim),김리석(Lee-Suk Kim),이규식(Kyu-Shik Rhee) 한국언어치료학회 1999 言語治療硏究 Vol.8 No.2

보청기와 인공와우 기기에 대한 대학생들의 인식 및 태도: 보청기 효과와 인공와우 효과

허민정 ( Min Jung Heo ),김리석 ( Lee Suk Kim ),안성우 ( Seong Woo Ahn ),부성현 ( Sung Hyun Boo ) 한국특수교육문제연구소 2008 특수교육저널 : 이론과 실천 Vol.9 No.3

본 연구는 보청기와 인공와우 기기에 대한 대학생들의 인식 및 태도를 알아보고, 보청기와 인공와우 기기에 대한 태도와 관련된 변인을 알아보고자 하는 것이다. 이를 위해 114명의 대학생에게 보청기와 인공와우 기기를 착용한 조건과 착용하지 않은 조건에 대해 형용사형 척도를 작성하게 하였고, 보청기와 인공와우 기기에 대한 태도 설문 조사를 시행하였다. 연구결과를 살펴보면 보청기와 인공와우 기기 모두 착용하지 않은 조건보다 착용한 조건에 대해외모, 성격, 성취에서 더 부정적인 평가를 받았다. 성별로 비교한 결과 여성 보다는 남성에대한 평가가 더 부정적이었다. 또한, 보청기보다 인공와우 기기에 대해 사회적 낙인, 개인적견해, 지식에서 더 부정적인 태도가 나타났다. 관련된 변인을 분석한 결과 성별과 안경 혹은콘텍트렌즈 착용 유무가 인공와우 기기 착용자에 대한 사회적 낙인과 상관관계가 있는 것으로 나타났다. 이는 한국의 대학생에서도 보청기나 인공와우 기기에 대한 ‘보청기 효과’와 ‘인공와우 효과’가 있음을 보여주는 결과이며, 보청기보다 더 외형적으로 드러나는 인공와우 기기에 대해 더 부정적인 태도를 가짐을 보여주는 결과라고 할 수 있다. This study aims to investigate the perception and attitude of university students about hearing aid and cochlear implant, and to examine the variables related to their attitudes towards hearing aid and cochlear implant. The subjects were 114 university students, who were asked to see the pictures on wearing conditions and non-wearing conditions of hearing aid and cochlear implant and complete the adjective format scale . Also, they saw the pictures of hearing aid wearer and cochlear implant wearer, and completed the questionnaires about attitude for hearing aid and cochlear implant. Results show that university students show more negative perception about wearing conditions than non-wearing conditions on appearance, personality, and achievement for both hearing aid and cochlear implant. Attitude for cochlear implant was more negative than that for hearing aid on social stigma, viewpoint, and knowledge. As a result of analyzing related factors for attitude about hearing aid and cochlear implant, sex and wearing glasses or contact lenses were related to the social stigma for cochlear implant users. These results show that there exist ‘hearing aid effect’ and ‘cochlear implant effect’ in Korean university students, and their attitudes are more negative for cochlear implant than for hearing aid.

정상 성인에서 청성유발 피부전위

허승덕,정동근,서덕준,김광년,김기련,강명구,김리석,Heo, Seung-Deok,Jung, Dong-Keun,Suh, Duk-Joon,Kim, Gwang-Nyeon,Kim, Gi-Ryon,Kang, Myung-Koo,Kim, Lee-Suk 한국음성학회 2005 음성과학 Vol.12 No.2

Electrodermal activity(EDA) is a bio-electric signal which occurs at the skin surface during the sweating. EDA reflects the activity of the sympathetic axis of the autonomic nervous system. EDA is associated with the eccrine sweat gland at the palmar and plamar surface. This study was aimed to characterize the relationship between EDA and auditory stimulus intensities. Acoustic stimulus used in this study were 500 Hz, 1 kHz, 2 kHz of narrow band noise, which were representative of speech frequencies in audible range. Stimulus intensity between 90 and 30 dB in 10 dB within dynamic range. After deriving the minimum stimulus intensity(threshold of skin potential) which elicited skin potential, and then the latency and amplitude were derived from waveform of skin potential, each latency and amplitude were compared to stimulus intensity. The waveform of skin potential were recorded stably, and the threshold of skin potential appeared nearly the hearing threshold level of the participant. The latency was decreased and the amplitude was increased according to the increase of the stimulus intensity. These results suggest that auditory evoked skin potential can be applicable to auditory assessment and audiological diagnosis tool.

순음청력검사를 이용한 사청 예측

허승덕(Seung-Deok Heo),황찬호(Chan-Ho Hwang),장윤석(Youn-Seok Jang),김리석(Lee-Suk Kim),정동근(Dong-Keun Jung) 한국언어치료학회 2004 言語治療硏究 Vol.13 No.3

Pseudohypacusis(malingering deafness) are exaggerate a hearing loss when secondary personal gains or other issues are involved from having a hearing loss. In most commonly encountered in adult. With improvement of socioeconomical background, an interest in health and activation of hearing conservation program, people more frequently meet with chance of audiological assessment. This situation change naturally, increasingly evoked motivation of pseudohypacusis. and also increase in case of after trauma for the purpose of financial compensation. It could judge pseudohypacusis by various conventional audiological assessment that were discrepancy between hearing threshold level of pure tone and speech audiometry or repeated pure tone audiometry. Objective audiological procedure are also useful tool for detection of pseudohypacusis. In this study, it is considered about only case of unilateral pseudohypacusis of subject with tinnitus and bilateral hearing loss that is worse in left ear than in right ear after traffic accident. Air conduction(AC) hearing threshold level(HTL) of ascending and descending method of pure tone audiometry were comparatively consistency at all test frequencies. But We predicted pseudohypacusis because discrepancy of masked AC and bone conduction(BC) HTL were shown. Finally, We certified pseudohypacusis through speech audiometry and auditory brainstem response.

인공와우이식 아동의 일반학교 통합 후 학교 수행력

허민정(Min Jung Heo),정성욱(Sung Wook Jeong),안성우(Seong Woo Ahn),부성현(Sung Hyun Boo),김리석(Lee Suk Kim) 한국언어치료학회 2007 言語治療硏究 Vol.16 No.3

The aims of this study were to investigate the school performance of children with cochlear implants who have been integrated into regular schools from the perspective of the classroom teacher and to examine the factors associated with the school performance.   Forty eight prelingually deaf children who were integrated into regular classrooms were included in this study. Classroom teachers completed the questionnaire comprised of 19 items regarding communication skill, psycho-social adjustment, and academic achievement of children with cochlear implants in regular classrooms. To identify the factors associated with the school performance of these children, stepwise multiple regression analysis was performed using age at implantation, duration of implant use, preoperative hearing thresholds, speech perception ability, and language ability as independent variables.   The average ratings on communication skill and psycho-social adjustment were 3.61 (SD=0.66) and 3.69 (SD=0.67), respectively. Academic achievement was evaluated as being somewhat poor. Better communication skill and better academic achievement were associated with better language ability. Better psycho-social adjustment was associated with better speech perception ability. Most of children with cochlear implants in mainstream classrooms were evaluated as being well adjusted in aspects of communication skill and psycho-social adjustment, whereas substantial percentage of them were perceived as performing at below average level by teachers. Language and speech perception abilities were important factors for school performance in children with cochlear implants.

청성뇌간유발반응 재현성을 이용한 사청 감별

허승덕(Seung-Deok Heo),박정홍(Jung-Hong Park),장윤석(Yoon-Seok Jang),최아현(Ah-Hyun Choi),김리석(Lee-Suk Kim),강명구(Myung-Koo Kang) 한국언어치료학회 2007 言語治療硏究 Vol.16 No.3

Background & Objectives: Auditory brainstem response(ABR) is measured hearing function using averaging technique. Subjects relaxation is important for collection of stable potentials. If the subject senses a tension or makes a body motion by intention during the test, the results would show poor reproducibility. The aim of this study to evaluate whether the reproducibility of ABR wave V measured by averaging technique detects pseduohyoacusis.   Participants & Methods: The 13-subject(19-ear) were participated, as a experimental group. All subjects had mismatch between ascending and descending responded threshold in pure tone audiometry(PTA) and had unwanted activity during ABR test. Participants to the measurement of PTA and ABR were classified into control group(n=9; 13 ears). For the analysis of reproducibility, ABR was recorded in each of 100, 300, 500, 700, 900, 1,024(3-time) of average in same intensity of click. The average of responded threshold level at frequencies of 1, 2, 3 kHz(high 3 PTAs) on ascending/descending PTA and ABR threshold was compared in experimental group. Between both groups, the changes of latency and amplitude of ABR wave Ⅴ were compared. Results & Conclusion: In experimental group, the gap between high 3 PTAs in the acending and descending method and ABR thresholds was 34.2±13.6㏈ and 53±18.4㏈, respectively. The gap of maximum and minimum of latency and amplitude was observed from 0.32 to 7.4(3.2±1.76)㎳, from 0.2 to 2.47(0.815±0.563)㎶ in experimental group, from 0.08 to 0.4(0.22±0.086)㎳, from 0 to 0.26(0.142±0.064)㎶ in control group. There was a significant difference between both groups(latency; p=0.000, amplituce; p=0.004). Our results show that it is useful tool for differentiation of malingering deafness.