RU2816026C1 - Method for training hearing skills in hearing aid patients with chronic sensorineural hearing loss using computer program - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to otorhinolaryngology and audiology. Disclosed is a method in which a patient selects for listening to audio tracks with non-speech and speech signals, structured by the level of complexity of speech material and frequency spectrum, in random order of reproduction both in silence, and on background of interference in the form of "white noise". After the proposed audio signal, the patient selects a response option using a keyboard or a computer "mouse" on a laptop or computer screen, correct answers are automatically recorded in the program as a percentage and in the form of diagrams. Length of one training session to improve listening skills is 30 minutes, of which 10 minutes is for listening to audio tracks in silence and 20 minutes is for listening to audio tracks on the background of interference in the form of "white noise". Length of the listening training course is ten days, two sessions a week. In addition, before the beginning of the training course of listening skills, on the fifth and tenth day, the patient fills in the questionnaires in the computer program interface – The Speech, Spatial and Qualities of Hearing Scale (SSQ) and The Spatial Hearing Questionnaire (SHQ), result is recorded in points and on a diagram on scales of questionnaires. Final protocol is sent to the audiologist-otorhinolaryngologist via the Internet for analysis. At the end of the training course of listening skills (by 10th day), the audiologist-otorhinolaryngologist performs speech audiometry in the patient in a free sound field in silence and on the background of noise. Result obtained on the fifth day of the training of listening skills is compared with the initial one (before the beginning of the training of listening skills) and the result obtained on the tenth day of training of listening skills. Efficiency of listening skills is assessed, dynamics is considered to be satisfactory and completed, if the number of correct answers when listening to audio tracks is more than 70% in silence and more than 60% against the background of interference in the form of "white noise" and the level of questionnaire scales is more than 50 points on the fifth day of listening skills, and if the number of correct answers when listening to audio tracks is more than 80% in silence and more than 70% against the background of interference in the form of "white noise" and the level of questionnaire scales is more than 70 points on the tenth day of listening training. If at the end of the course of listening skills (by 10th day), the result of correct answers when listening to audio tracks is less than 60% in silence and less than 50 % against the background of interference in the form of "white noise" and the level of questionnaire scales is less than 49 points, dynamics is considered to be unsatisfactory and the patient requires repeated consultation with an audiologist-otorhinolaryngologist.

EFFECT: invention provides improved listening skills in hearing aid patients with chronic sensorineural hearing loss together with assessment of dynamics of performed rehabilitation taking into account spatial, speech and qualitative characteristics of hearing.

1 cl, 9 dwg

Description

The invention relates to medicine, namely to otorhinolaryngology and audiology, and can be used in the treatment of speech perception disorders, improving the spatial and qualitative characteristics of hearing in patients with chronic sensorineural hearing loss after a hearing aid procedure by training listening skills using the computer program “Program for rehabilitation and hearing training “Audio Tracker” [1].

Modern hearing aids, which operate on the principle of sound amplification, do not allow patients to fully adapt to rapidly changing environmental signals, which affects speech perception difficulties. One of the directions in the treatment of patients with chronic sensorineural hearing loss after hearing aids for the first time is the method of auditory training, which helps to increase the efficiency of hearing restoration at the rehabilitation stage. Options for conducting auditory training include the use of computer programs. Repeated repetition of signals ensures the formation of new and correction of previously formed auditory images. The method of auditory training consists of acoustic stimulation by presenting sound signals with different characteristics: speech signals (presented in the form of oral speech), non-speech signals (environmental sounds, nature, music), which can be reproduced in different orders, with different intensities, repeated several times , to make listening more difficult, combine with interference, for example, in the form of “white noise”, simulating the speech spectrum of the voices of a large group of people.

There is a known “Method of auditory-speech rehabilitation and a device for its implementation” [2], in which, using the audiometry procedure, the amplitude-frequency characteristics of the patient’s hearing are assessed and the frequency range of the residual sensorineural sensitivity of hearing is identified, a base of visual images is formed, voiced by the corresponding reference speech signals, a visual image is selected from the database, its image and letter designation are reproduced and simultaneously voiced, while the corresponding reference speech signal, before being sent to the patient, is converted by transferring its spectrum to the frequency range of the patient’s residual neurosensory hearing sensitivity, after which it is supplied to the patient, analyzing the response by comparison signal received from the patient after he reproduced the reference speech signal, the degree of coincidence is visually displayed in the form of a numerical value of the correlation level, by which the correct pronunciation of the patient is judged. The disadvantage of this method is the need for additional equipment in the form of a device containing a microphone, an electronic board and headphones. The inventive method and device are intended for patients only with profound hearing loss - hearing loss of the 3rd, 4th degree and deafness with residual hearing, which limits its use for persons with mild and moderate hearing loss (hearing loss of the 1st and 2nd degree) .

There is a well-known “Method of auditory-speech rehabilitation and its assessment in patients with cochlear implants” [3], in which the ability to invariantly and noise-resistant speech recognition is trained by submitting audio speech signals, the number of correct answers and the patient’s reaction time are determined, comparing with previously obtained data. The disadvantage of this method is the limited technical capabilities: the choice of conditions for sending signals and the direction of training, the need for a specialized installation, including a personal computer with a sound card, a remote control with indicator lights for entering answers, which limits use at home. This method is used only in patients with pre-installed cochlear implants no earlier than the fifth day after the cochlear implant processor is first turned on.

The closest to the claimed method and adopted as a prototype is the “Complex for the development of basic auditory perception skills in people with hearing impairments” [4], in which combined and multidirectional training of basic hearing skills is carried out by coordinated presentation of audio and video signals to the patient using a functional complex , the results of the lessons are automatically registered and the results obtained are compared with a given value based on the percentage of correct auditory identifications. The disadvantage of the complex is the conditions for sending signals through a fixed choice of the pause value between signals, which can affect the results of perception if there is insufficient time between signals; there is no assessment of the dynamics of spatial, speech and qualitative characteristics of hearing. The complex is designed for patients with pre-installed cochlear implants.

The purpose of the invention is to create a method for training listening skills in hearing replacement patients with chronic sensorineural hearing loss using the computer program “Program for rehabilitation and hearing training “Audio Tracker””.

The technical result of the method is the rehabilitation and improvement of listening skills in hearing-aided patients with chronic sensorineural hearing loss, together with an assessment of the dynamics of the rehabilitation performed, taking into account the spatial, speech and qualitative characteristics of hearing.

This result is achieved by the fact that in the method of training listening skills in hearing aided patients with chronic sensorineural hearing loss using the computer program “Program for rehabilitation and hearing training “Audio Tracker””, when supplying speech signals, audio tracks are used, structured according to the level of complexity of the speech material (numbers , monosyllabic words, polysyllabic words) and frequency spectrum (male voice, female voice, children's voice), train the ability to recognize non-speech and speech signals both in silence and against the background of interference in the form of “white noise”, correct answers are recorded automatically as a percentage and in the form of diagrams, additionally, before the start of the course of auditory training, the patient fills out questionnaires in the computer program interface on the 5th and 10th day of listening skills training - The Speech, Spatial and Qualities of Hearing Scale , SSQ) and the Spatial Hearing Questionnaire (SHQ), the result is recorded in points and on a chart according to the scales of the questionnaires, the final protocol is sent to an audiologist-otolaryngologist via Internet connection for analysis, the result received on the 5th day listening skills training is compared with the initial (before the start of listening skills training) and the result obtained on the 10th day of listening skills training, the dynamics are considered satisfactory and completed if the number of correct answers when listening to audio tracks is above 70% in silence and above 60% in the background interference in the form of “white noise” and the level of questionnaire scales more than 50 points on the 5th day of listening skills training, and if the number of correct answers when listening to audio tracks is above 80% in silence and above 70% against the background of interference in the form of “white noise” and the level of the questionnaire scales was more than 70 points on the 10th day of listening skills training. If at the end of the course of auditory training (by the 10th day of listening skills training) the result of correct answers when listening to audio tracks is less than 60% in silence and less than 50% against the background of interference in the form of “white noise” and the level of the questionnaire scales is less than 49 points, the dynamics are considered unsatisfactory and the patient requires repeated consultation with an audiologist-otorhinolaryngologist.

The essence of the method is illustrated by drawings , where in Fig. 1 shows a screenshot of the patient’s personal data screen; in fig. Figure 2 shows a screenshot of the results of pure tone threshold audiometry; in fig. Figure 3 shows a screenshot of the screen of The Speech, Spatial and Qualities of Hearing Scale (SSQ); in fig. Figure 4 shows a screenshot of the Spatial Hearing Questionnaire (SHQ); in fig. Figure 5 shows a screenshot of the listening skills training mode screen; in fig. 6 shows a screenshot of the response screen for correct and incorrect responses to the audio track beep; in fig. Figure 7 shows a screenshot of the screen recording the results of the patient’s correct responses to the presented sound signal of the audio track in silence and against the background of interference in the form of “white noise”; in fig. Figure 8 shows a screenshot of the screen for recording the results of the Spatial Hearing Questionnaire scales in the form of a diagram; in fig. Figure 9 shows an example of the final protocol.

The claimed method has the following advantages compared to known inventions : the method provides training in listening skills, structured by the level of complexity of speech material (numbers, monosyllabic words, polysyllabic words) and frequency spectrum (male voice, female voice, children's voice); the method allows you to train listening skills in silence and against the background of interference in the form of “white noise”; the method involves recording the result in the form of correct responses to the presented sound signal of the audio track as a percentage (before the start of listening skills training, on the 5th and 10th day of listening skills training), additionally displayed in the diagram; the method involves recording the results of questionnaires - The Speech, Spatial and Qualities of Hearing Scale (SSQ) and the Spatial Hearing Questionnaire (SHQ) in points on scales with graphical display on the diagram; the method involves a comparative assessment of the initial results (before the start of listening skills training) with the results obtained on the 5th and 10th day of listening skills training by an audiologist-otolaryngologist; The method helps to increase adaptation to the hearing aid in patients with chronic sensorineural hearing loss receiving hearing aids for the first time.

The method is implemented as follows . First, the patient undergoes pure tone threshold audiometry, a hearing aid is selected according to the degree of hearing loss by an audiologist-otolaryngologist, and speech audiometry is performed in a free sound field in silence and against a background of noise.

To train listening skills, use a personal computer or laptop (Windows, Linux operating system; processor from 4 GHz, RAM of at least 4 GB, internal hard drive of at least 100 GB) with a sound card and speakers (total sound power of at least 38 W, frequency range from 20 Hz to 20 KHz, impedance of at least 4 ohms), keyboard of a personal computer or laptop or computer mouse, computer program “Program for rehabilitation and hearing training “Audio Tracker”” [1].

In the working interface of the computer program “Program for rehabilitation and hearing training “Audio Tracker””, the patient’s personal data (full name, age, gender), data on the presence of a hearing aid, complaints, concomitant diseases and medications taken are entered (Fig. 1).

Next, a template for a pure tone threshold audiometry form, previously performed by an audiologist-otorhinolaryngologist, is filled out according to the given sample (Fig. 2).

Before listening skills training begins, The Speech, Spatial and Qualities of Hearing Scale (SSQ) (Fig. 3) and The Spatial Hearing Questionnaire (SHQ) (Fig. 4) are completed.

The patient selects to listen to audio tracks with non-speech and speech signals, structured by the level of complexity of speech material (numbers, monosyllabic words, polysyllabic words) and frequency spectrum (male voice, female voice, children's voice), in random playback order. After the proposed sound signal (speech or non-speech signal), the patient is offered three answer options on the laptop or computer screen, one of which must be selected using the keyboard or computer mouse (Fig. 5).

If the answer is correct, the word “Correct” is displayed in green letters in the program interface; if the answer is incorrect, the word “Wrong” is displayed in red letters (Fig. 6). At the patient's request, audio tracks can be played repeatedly by pressing the button with a green triangle on the interface window if he does not understand the audio signal.

Listening to audio tracks is carried out sequentially in silence and against the background of interference in the form of “white noise”. The result is recorded in the program and automatically saved as a percentage of correct answers (Fig. 7).

The duration of one training session to improve listening skills is 30 minutes, of which 10 minutes are for listening to audio tracks in silence and 20 minutes for listening to audio tracks against the background of interference in the form of “white noise”. The duration of the listening skills training course is ten days, two lessons per week.

On the 5th and 10th day of listening skills training, The Speech, Spatial and Qualities of Hearing Scale (SSQ) and The Spatial Hearing Questionnaire (SHQ) are filled out again, and the results are recorded. in scores and on a chart based on questionnaire scales (Fig. 8), the final protocol (Fig. 9) is sent for analysis to an audiologist-otolaryngologist via Internet connection.

At the end of the course of listening skills training (by the 10th day), the audiologist-otorhinolaryngologist performs speech audiometry on the patient in a free sound field in silence and against a background of noise.

The result obtained on the 5th day of listening skills training is compared with the initial one (before the start of listening skills training) and the result obtained on the 10th day of listening skills training; the dynamics are considered satisfactory if the number of correct answers when listening to audio tracks is above 70% in silence and above 60% against the background of interference in the form of “white noise” and the level of the questionnaire scales is more than 50 points on the 5th day of listening skills training, and if the number of correct answers when listening to audio tracks is above 80% in silence and above 70% against the background of interference in the form of “white noise” and the level of questionnaire scales was more than 70 points on the 10th day of listening skills training.

If, at the end of the listening skills training course (by the 10th day), the result of correct answers when listening to audio tracks is less than 60% in silence and less than 50% against the background of interference in the form of “white noise” and the level of the questionnaire scales is less than 49 points, the dynamics are considered unsatisfactory.

The method allows to increase the efficiency of rehabilitation of patients with chronic sensorineural hearing loss after the first hearing aid procedure.

A method for training listening skills in hearing replacement patients with chronic sensorineural hearing loss using the computer program “Program for rehabilitation and hearing training “Audio Tracker”” was developed at the Samara State Medical University of the Ministry of Health of Russia at the Department of Otorhinolaryngology named after Academician of the Russian Academy of Sciences I.B. Soldatova. The method was tested in 49 patients aged 21 to 86 years who received hearing aids for the first time with a positive result.

The claimed method of rehabilitation is applied to adult patients from 18 years of age inclusive, who require specialized medical care and comprehensive rehabilitation after first-time hearing aid due to chronic sensorineural hearing loss. Using the proposed method, classes to improve listening skills can be carried out by the patient either independently or under the guidance of an audiologist-otorhinolaryngologist. The method is applicable in clinical practice as an additional environmental adaptation during rehabilitation for first-time hearing aid patients with chronic sensorineural hearing loss.

The method is illustrated with clinical examples.

Clinical example No. 1.

Patient P., 75 years old, noted a decrease in hearing after suffering a coronavirus infection in December 2022, was examined by an audiologist-otorhinolaryngologist, as a result, bilateral chronic sensorineural hearing loss of the second degree was diagnosed, hearing replacement was performed on both ears with air conduction devices, with speech audiometry in a free sound field, the number of correctly parsed words in silence was 70%, against a background of noise - 60%.

Subjectively, the patient noted that she heard various sounds and speech, but unintelligibly, especially against the background of surrounding noise. The patient received a training course to improve listening skills using the proposed method. Classes were held for 30 minutes twice a week.

On the 1st day of listening skills training, the number of correct answers when listening to audio tracks in silence was 60%, against the background of interference in the form of “white noise” - 50%, on the Spatial Hearing Questionnaire scale “perception of a male voice” 50 points, “perception of a female voice” 55 points, “perception of a child's voice” 40 points, “perception of music” 45 points, “localization of a sound source” 65 points, “perception of a target signal and noise” 55 points and “perception of a spatially separated target signal and noise” 60 points.

On the 5th day of listening skills training, the number of correct answers when listening to audio tracks in silence was 70%, against the background of interference in the form of “white noise” - 60%, the Spatial Hearing Questionnaire scale “perception of a male voice” was 60 points, “perception of a female voice” 65 points, “perception of a child's voice” 60 points, “perception of music” 60 points, “localization of a sound source” 65 points, “perception of a target signal and noise” 60 points and “perception of a spatially separated target signal and noise” 60 points.

On the 10th day of listening skills training, the number of correct answers when listening to audio tracks in silence was 80%, against the background of interference in the form of “white noise” - 70%, the Spatial Hearing Questionnaire scale “perception of a male voice” was 75 points, “perception of a female voice” 75 points, “perception of a child's voice” 70 points, “perception of music” 80 points, “localization of a sound source” 70 points, “perception of a target signal and noise” 70 points and “perception of a spatially separated target signal and noise” 70 points. During speech audiometry in a free sound field, the number of correctly parsed words in silence was 90%, and against a background of noise - 80%.

Analysis of the final protocol by an audiologist-otorhinolaryngologist, taking into account the designated effectiveness criteria, showed a satisfactory result of the dynamics and improvement in listening skills, so a decision was made to complete the rehabilitation.

Clinical example No. 2.

Patient G., 32 years old, noticed a persistent decrease in hearing after an episode of a sharp increase in blood pressure, consulted an audiologist-otolaryngologist, as a result, bilateral chronic sensorineural hearing loss of the second degree was diagnosed, hearing replacement was performed in both ears with air conduction devices, with speech audiometry in a free sound field, the number of correctly parsed words in silence was 60%, against a background of noise - 50%.

Subjectively, the patient noted the difficulty of talking on the phone, the difficulty of focusing on the main interlocutor in a group of talking people. The patient underwent a rehabilitation course using the proposed method.

On the 1st day of listening skills training, the number of correct answers when listening to audio tracks in silence was 60%, against the background of interference in the form of “white noise” - 50%, on the Spatial Hearing Questionnaire scale “perception of a male voice” 40 points, “perception of a female voice” 40 points, “perception of a child's voice” 40 points, “perception of music” 45 points, “localization of a sound source” 45 points, “perception of a target signal and noise” 40 points and “perception of a spatially separated target signal and noise” 45 points.

On the 5th day of listening skills training, the number of correct answers when listening to audio tracks in silence was 60%, against the background of interference in the form of “white noise” - 50%, the Spatial Hearing Questionnaire scale “perception of a male voice” was 45 points, “perception of a female voice” 40 points, “perception of a child's voice” 45 points, “perception of music” 45 points, “localization of a sound source” 45 points, “perception of a target signal and noise” 45 points and “perception of a spatially separated target signal and noise” 45 points.

On the 10th day of listening skills training, the number of correct answers when listening to audio tracks in silence was 60%, against the background of interference in the form of “white noise” - 50%, the Spatial Hearing Questionnaire scale “perception of a male voice” was 45 points, “perception of a female voice” 45 points, “perception of a child's voice” 45 points, “perception of music” 45 points, “localization of a sound source” 45 points, “perception of a target signal and noise” 40 points and “perception of a spatially separated target signal and noise” 45 points. During speech audiometry in a free sound field, the number of correctly parsed words in silence was 60%, and against a background of noise - 50%. Analysis of the final protocol by an audiologist-otorhinolaryngologist showed unsatisfactory dynamics in the form of the number of correct answers in silence and against the background of interference in the form of “white noise” and a consistently low level of scales of the Spatial Hearing Questionnaire; a decision was made to re-consult with an audiologist-otorhinolaryngologist for calibration hearing aids.

Information sources.

1. Vladimirova T.Yu., Martynova A.B. Computer program “Program for rehabilitation and hearing training “Audio Tracker”” (Certificate of state registration of the computer program No. 2023616840 dated 04/03/2023).

2. Kochergin A.V., Kochergin A.A., Koligaev O.A., Koligaev S.O. A method of auditory-speech rehabilitation and a device for its implementation (RU 2 525366 C1 published on August 10, 2014).

3. Koroleva I.V., Lyublinskaya V.V., Ogorodnikova E.A., Pak S.P., Stolyarova E.I., Pudov V.I. A method of auditory-speech rehabilitation and its assessment in patients with cochlear implants (RU 2209057, published July 23, 2003).

4. Ogorodnikova E.A., Koroleva I.V., Lyublinskaya V.V., Rybakov M.V., Yanov Yu.K. A complex for the development of basic auditory perception skills in people with hearing impairments (RU 82419 U1, published on April 27, 2009).

Claims (12)

A method for training listening skills in hearing aided patients with chronic sensorineural hearing loss using a computer program, characterized in that to train listening skills, use a personal computer or laptop with a sound card and speakers, a keyboard or computer mouse, and the computer program “Program for rehabilitation and hearing training “Audio Tracker”; choose to listen to audio tracks with non-speech and speech signals, structured according to the level of complexity of the speech material: numbers, monosyllabic words, polysyllabic words and frequency spectrum: male voice, female voice, children's voice, in random playback order both in silence and against a background of noise in the form of “white noise”; after the proposed sound signal, using the keyboard or computer “mouse” on the laptop or computer screen, select an answer option, the correct answers are automatically recorded in the program in percentages and in the form of diagrams; the duration of one training session to improve listening skills is 30 minutes, of which 10 minutes are for listening to audio tracks in silence and 20 minutes for listening to audio tracks against the background of interference in the form of “white noise”; The duration of the listening skills training course is ten days, two lessons per week; additionally, before starting the listening skills training course, on the fifth and tenth day, questionnaires are filled out in the computer program interface - the Scale of Speech, Spatial and Qualitative Hearing Characteristics and the Spatial Hearing Questionnaire, the result is recorded in points and on a chart according to the scales of the questionnaires; the final protocol is sent to an audiologist-otorhinolaryngologist via Internet connection for analysis; the result obtained on the fifth day of listening skills training is compared with the initial result obtained before the start of listening skills training and with the result obtained on the tenth day of listening skills training; evaluate the effectiveness of listening skills, while the dynamics are considered satisfactory and complete the training course if the number of correct answers when listening to audio tracks is above 70% in silence and above 60% against the background of interference in the form of “white noise” and the level of the questionnaire scales is more than 50 points on the fifth day listening skills training, and if the number of correct answers when listening to audio tracks is above 80% in silence and above 70% against the background of interference in the form of “white noise” and the level of questionnaire scales is more than 70 points on the tenth day of listening skills training; If, at the end of the course of listening skills training, the result of correct answers when listening to audio tracks is less than 60% in silence and less than 50% against the background of interference in the form of “white noise” and the level of the questionnaire scales is less than 49 points, the dynamics are considered unsatisfactory and the patient requires repeated consultation with an audiologist - otorhinolaryngologist.