The Journal of the Acoustical Society of Korea (한국음향학회지)

The Acoustical Society of Korea (한국음향학회)
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A study on the clinical usefulness and improvement of hearing in noise test in evaluating central auditory processing

중추 청각 처리 기능 평가에서 hearing in noise test의 임상적 유용성과 개선점 고찰

  • Han, Soo-Hee (Department of Otolaryngology-Head and Neck Surgery, Konkuk University School of Medicine)
  • Received : 2021.11.15
  • Accepted : 2022.01.10
  • Published : 2022.01.31
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Abstract

Speech recognition in noise situation is an important skill for effective communication. Hearing In Noise Test (HINT) has been suggested as a clinical tool to evaluate these aspects. However, this tool has not been used widely in domestic clinics. In this study, psychophysical aspects of HINT and burdens in clinical application were analyzed to improve the applicability of the tool. The difficulty in understanding speech in the elderly population is due to hearing loss based on aging of peripheral and central auditory pathways. As typical clinical cases, HINT scores for young and elderly listeners (20s vs 70s) were compared. Four conditions of HINT test were Quiet (Q), Noise Front (NF), Noise Right (NR), and Noise Left (NL). Quantitative scores showed that the elderly listener required more Signal to Noris Ratio (SNR) values than the younger counterpart in noisy situations. Although both showed Binaural Masking Level Difference (BMLD) effect, the strength was smaller in the elder. However, the age-matched normalized data were not established in detail for clinical application. Confirmed usefulness of HINT and the related improvement in clinical measuring procedure were suggested.

소음상황에서의 어음 이해 능력은 효과적인 의사소통을 위한 중요한 기술이다. 이러한 능력을 평가하는 방법으로 Hearing In Noise Test(HINT) 도구가 제안되어 사용되고 있다. 하지만 국내에서 이 유용한 도구가 초기의 기대와 달리 임상에서 적극적으로 활용되지 못하고 있다. 연령이 높아질수록 정상 청력을 가지고 있을지라도 양이에서 들어오는 신호들을 처리하는데 어려움을 겪게 되고, 특히 배경 소음이 있는 상황에서 듣기는 더욱 어려워진다. 하지만, 어음이해에 상당한 문제점을 갖고 있는 노인 인구들을 임상적으로 평가하는 도구들이 많지 않다. 본 연구에서는 이러한 검사법이 근거하고 있는 기전에 있는 인지적 특성과 임상에서의 문제점을 분 석하여 개선점을 제안하고자 한다. 기본 임상 사례로 정상 청력을 가진 20대와 70대의 대표적 HINT점수를 비교하고, 소음이 어떤 조건에서 제시되는가에 따른 문장 인지 특징을 조명하였다. 대상자의 HINT score는 Quiet(Q), Noise Front(NF), Noise Right(NR), Noise Left(NF)조건에서 분석되었다. 여러 임상적 관점에서 유용한 점은 배경 소음이 있을 때 노인의 경우 청년보다 더 많은 신호대잡음비를 필요함을 나타내는 정량적 변수를 보여주고, 양이차폐감소차이(Binaural Masking Level Difference, BMLD)효과도 보여주고 있다는 점이다. 효과적 임상적 적용에는 세부 연령대별 비교 가능한 표준 자료가 극히 부족한 실정이다. 이러한 유용성 확인과 함께 임상 관련 개선점을 제시하였다.

Keywords

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