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청신경병증이 아닌 성인의 순음청력검사와 청성지속반응검사의 역치값 불일치
노혜일,이혜숙 대한이비인후과학회 2020 대한이비인후과학회지 두경부외과학 Vol.63 No.8
Background and Objectives To evaluate mismatches between pure-tone audiometry (PTA)and auditory steady-state response (ASSR) tests in non-auditory neuropathy adults and investigatebrain lesions that may explain the mismatches, especially in cases where the ASSR thresholdwas worse than the estimated PTA threshold. Subjects and Method PTA, speech audiometry, auditory brainstem response, ASSR, andneuroimaging tests were carried out on individuals selected. Among them, medical records of30 subjects (16 males, 14 females; mean age=54.4±13.2 years) with significant mismatches betweenPTA and estimated ASSR thresholds were analyzed retrospectively. All neuroimagingtests were reviewed to identify any neurologic abnormalities. Results Pathologic brain lesions were found in 19 cases (63.3%) in the study group, all of whichshowed significant mismatch in hearing threshold between PTA and ASSR. Seven case of ischemicbrain lesions (23.3%), five tumorous lesions (16.6%), and four brain vessel anomalies (13.3%)were found. Brain hemorrhage due to trauma were found in two cases (6.6%) as well as one case(3.3%) of unruptured aneurysm. Central auditory pathway disorder was suspected in two cases. The 11 cases showing normal results in the imaging studies included one mental retardation, onebrain concussion, and seven cases (23.3%) with no specific causes. Six tinnitus cases includedtwo subjects showing discrepancies between frequency matching in the tinnitogram. Conclusion In adults with a mismatch between PTA thresholds and estimated ASSR thresholds,especially for those with moderate to profound hearing loss, additional neuroimaging testsand other audiologic tests may reveal other possible causes of hearing loss.
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어음청력검사를 위한 Compact Disks 개발과 새로 제작된 검사어표의 1차 검증 과정
노혜일,장기홍 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.5
Background and ObjectivesZZTo standard test method of Korean speech audiometry, we developed an audio compact disk, the KsoM-07 (Korean Society of Otolaryngolgy, Monosyllabic,2007) word lists and evaluated them for clinical usage. Subjects and MethodZZThe monitored live voice (MLV) of a female talker was digitally recorded with a Beltone audiometer and the GoldWave program. The calibration for each word was done by calculating the root-mean-square (RMS) at the moving time of 300 ms using MATLAB ® (7.0 version, The MathWorks, Inc. Natick, Massachusetts, USA) and the GoldWave (v 5.25 GoldWave Inc. St. John’s, NL, Canada) program. The discrimination score was measured in 20 normal subjects to obtain psychometric function curve of each word and to compare the homogeneity of two lists. The first verification methods for new speech materials were done by comparing the discrimination scores of the flat type and the descending types at 150 sensorineural hearing loss with similar pure tone threshold. ResultsZZ44% of MLV recording was above ±3 dB deviation and had to be recalibrated. Two lists showed equal difficulty or homogeneity in normal subjects. Discrimination scores were statistically different among the groups with respect to hearing level and the slope of audiogram. ConclusionZZKsoM-07 word lists were relatively homogeneous and showed differences between the descending type and the flat type of hearing loss. Therefore, KsoM-07 word lists can be useful in evaluating the impairment found in the descending type of sensorineural hearing loss as well as in serving as a new speech test material for Korean monosyllabic words. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:290-9
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노혜일,이현용,이수형,고기범,김인혜,김래형 대한이비인후과학회 2017 대한이비인후과학회지 두경부외과학 Vol.60 No.1
Background and Objectives To determine appropriate counseling time for the first hearing aids user, we measured the effectiveness of first counseling time limit of 20 minutes for those who need hearing aids and collected predictive parameters during history taking. Subjects and Method We reviewed the medical records of 956 patients (age 66.5±12.1) with hearing impairment who needed hearing aids. We divided patients into two groups, those who had counseling time limited to 20 minutes and others who had no time limitation. Job status, working condition of noise status, social activity and audiological variables were analyzed as probable predicting factors influencing the purchasing of the hearing aid (penetration rate). Results Of the total 956 patients, 48.64% of subjects decided to purchase hearing aids at first counseling. The two groups showed no significant difference (p=0.396): 49.81% of the group without time limitation purchased the hearing aid and 47.04% of those with time limitation purchased the aid. The social status, right side pure tone threshold and right side tinnitus were significant for calculating the explanation power (64.15%) in the hearing aid uptake probability equation. Conclusion The level of social activity, hearing threshold and tinnitus were predictive variables obtained during the counseling. The time limitation of 20 minutes did not affect the rate of decision to purchase hearing aids. These results might help hearing clinics improve efficient time management at hearing aid clinics. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(1):13-8
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노혜일,이동희 대한이비인후과학회 2012 Clinical and Experimental Otorhinolaryngology Vol.5 No.3
Objectives. To investigate the electric-acoustic interactions within the inferior colliculus of guinea pigs and to observe how central masking appears in invasive neural recordings of the inferior colliculus (IC). Methods. A platinum-iridium wire was inserted to scala tympani through cochleostomy with a depth no greater than 1 mm for intracochlear stimulation of electric pulse train. A 5 mm 100 μm, single-shank, thin-film, penetrating recording probe was inserted perpendicularly to the surface of the IC in the coronal plane at an angle of 30-40° off the parasagittal plane with a depth of 2.0-2.5 mm. The peripheral and central masking effects were compared using electric pulse trains to the left ear and acoustic noise to the left ear (ipsilateral) and to the right ear (contralateral). Binaural acoustic stimuli were presented with different time delays and compared with combined electric and acoustic stimuli. The averaged evoked potentials and total spike numbers were measured using thin-film electrodes inserted into the central nucleus of the IC. Results. Ipsilateral noise had more obvious effects on the electric response than did contralateral noise. Contralateral noise decreased slightly the response amplitude to the electric pulse train stimuli. Immediately after the onset of acoustic noise, the response pattern changed transiently with shorter response intervals. The effects of contralateral noise were evident at the beginning of the continuous noise. The total spike number decreased when the binaural stimuli reached the IC most simultaneously. Conclusion. These results suggest that central masking is quite different from peripheral masking and occurs within the binaural auditory system, and this study showed that the effect of masking could be observed in the IC recording. These effects are more evident and consistent with the psychophysical data from spike number analyses than with the previously reported gross potential data. Objectives. To investigate the electric-acoustic interactions within the inferior colliculus of guinea pigs and to observe how central masking appears in invasive neural recordings of the inferior colliculus (IC). Methods. A platinum-iridium wire was inserted to scala tympani through cochleostomy with a depth no greater than 1 mm for intracochlear stimulation of electric pulse train. A 5 mm 100 μm, single-shank, thin-film, penetrating recording probe was inserted perpendicularly to the surface of the IC in the coronal plane at an angle of 30-40° off the parasagittal plane with a depth of 2.0-2.5 mm. The peripheral and central masking effects were compared using electric pulse trains to the left ear and acoustic noise to the left ear (ipsilateral) and to the right ear (contralateral). Binaural acoustic stimuli were presented with different time delays and compared with combined electric and acoustic stimuli. The averaged evoked potentials and total spike numbers were measured using thin-film electrodes inserted into the central nucleus of the IC. Results. Ipsilateral noise had more obvious effects on the electric response than did contralateral noise. Contralateral noise decreased slightly the response amplitude to the electric pulse train stimuli. Immediately after the onset of acoustic noise, the response pattern changed transiently with shorter response intervals. The effects of contralateral noise were evident at the beginning of the continuous noise. The total spike number decreased when the binaural stimuli reached the IC most simultaneously. Conclusion. These results suggest that central masking is quite different from peripheral masking and occurs within the binaural auditory system, and this study showed that the effect of masking could be observed in the IC recording. These effects are more evident and consistent with the psychophysical data from spike number analyses than with the previously reported gross potential data.
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노혜일,이동희 대한이비인후과학회 2012 Clinical and Experimental Otorhinolaryngology Vol.5 No.2
Objectives. To investigate acoustic differences between conversational and clear speech of Korean and to evaluate the influence of the gender on the speech clarity using the long-term average speech spectrum (LTASS). Methods. Each subject’s voice was recorded using a sound level meter connected to GoldWave program. Average long-term root mean square (RMS) of one-third octave bands speech spectrum was calculated from 100 to 10,000 Hz after normalizing to 70 dB overall level using the MATLAB program. Twenty ordinary Korean were compared with 20Korean announcers with equal numbers of men and women in each group. Results. Compared with the LTASS of ordinary men, that of ordinary women was lower at low frequencies, but higher at 630, 800, 1,600, 5,000, and 10,000 Hz. Compared with the LTASS of male announcers, that of female announcers was lower at low frequencies. Compared with the LTASS of ordinary men, that of male announcers was significantly lower at 100, 125, 200, and 250 Hz. Compared with the LTASS of ordinary women, that of female announcers was lower at 100, 125, 160, 200, 250, 500, and 10,000 Hz. The LTASS of announcer showed lower levels at 100, 200 Hz and higher at 500, 630, 800, and 1,000 Hz that that of ordinary Koreans. Conclusion. This study showed that the drop-off of the LTASS in the low frequency region might make the ratings of women and announcers more clearly than those of men and ordinary persons respectively. This drop-off in the low frequency might result in less upward spread of masking and clearer speech. This study reduced an error resulting from a wide variability of clear speech strategies and intelligibility gains, because this study recruited professional speakers. We hope that our results demonstrate the difference in acoustic characteristics of the speech of ordinary Korean persons. Objectives. To investigate acoustic differences between conversational and clear speech of Korean and to evaluate the influence of the gender on the speech clarity using the long-term average speech spectrum (LTASS). Methods. Each subject’s voice was recorded using a sound level meter connected to GoldWave program. Average long-term root mean square (RMS) of one-third octave bands speech spectrum was calculated from 100 to 10,000 Hz after normalizing to 70 dB overall level using the MATLAB program. Twenty ordinary Korean were compared with 20Korean announcers with equal numbers of men and women in each group. Results. Compared with the LTASS of ordinary men, that of ordinary women was lower at low frequencies, but higher at 630, 800, 1,600, 5,000, and 10,000 Hz. Compared with the LTASS of male announcers, that of female announcers was lower at low frequencies. Compared with the LTASS of ordinary men, that of male announcers was significantly lower at 100, 125, 200, and 250 Hz. Compared with the LTASS of ordinary women, that of female announcers was lower at 100, 125, 160, 200, 250, 500, and 10,000 Hz. The LTASS of announcer showed lower levels at 100, 200 Hz and higher at 500, 630, 800, and 1,000 Hz that that of ordinary Koreans. Conclusion. This study showed that the drop-off of the LTASS in the low frequency region might make the ratings of women and announcers more clearly than those of men and ordinary persons respectively. This drop-off in the low frequency might result in less upward spread of masking and clearer speech. This study reduced an error resulting from a wide variability of clear speech strategies and intelligibility gains, because this study recruited professional speakers. We hope that our results demonstrate the difference in acoustic characteristics of the speech of ordinary Korean persons.
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