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Inteligibilidade de fala em trabalhadores expostos a ruído com protetores auditivos / Speech intelligibility in workers exposed to noise with hearing protectorsRocha, Clayton Henrique 12 May 2017 (has links)
Introdução: O ruído é um dos principais agentes de poluição ambiental, que em intensidades elevadas, poderá causar a perda auditiva induzida por níveis de pressão sonora elevadas (PAINPSE). A PAINPSE é o segundo tipo de perda auditiva neurossensorial mais frequente, e considerada uma das principais doenças ocupacionais. Para evitar os prejuízos da exposição ao ruído ocupacional, legislações determinam o monitoramento e o desenvolvimento de ações para reduzir os efeitos da exposição, sendo o uso de dispositivos de proteção auditiva (DPA) a mais empregada. Contudo é comum que o trabalhador relate dificuldades para se comunicar com o DPA, o que pode induzi-lo ao uso inadequado. Os estudos já realizados apresentam discordâncias sobre os efeitos do DPA para a inteligibilidade da fala, além de serem poucos os que compararam participantes com perdas auditivas com normo-ouvintes. Objetivos: Avaliar a inteligibilidade de fala em trabalhadores expostos a ruído durante o uso de DPA. Métodos: Trata-se de um estudo transversal, aprovado pelo Comitê de Ética em Pesquisa da instituição nº 130/14, com amostra de 36 participantes, todos do sexo masculino e expostos ao ruído. Foram divididos em grupo normo-ouvintes (G1), com 20 participantes e com perda auditiva (G2), com 16 participantes. Todos os participantes realizaram avaliação da inteligibilidade de fala em campo acústico, utilizando listas de monossílabas e sentenças, em situações de uso do DPA no silêncio e no ruído e sem o uso do DPA no ruído. Resultados: Na avaliação da inteligibilidade de fala com DPA utilizando as monossílabas, ambos os grupos apresentaram porcentagens de acertos superiores à 95% na situação de silêncio. Na presença do ruído com o DPA, não foi detectado efeito de interação envolvendo grupo (p>=0,106) e nem efeito de grupo (p=0,182), mas houve efeito de interação entre intensidade de fala e relação sinal/ruído (S/R) (p=0,006). Na avaliação da inteligibilidade de fala no ruído sem o DPA, foi detectado efeito de interação entre uso do DPA e relação S/R (p=0,010) sobre a média das porcentagens de acertos. Na avaliação com listas de sentenças, a porcentagem de acertos com DPA foram superiores a 98% no silêncio; contudo, no ruído houve piora, com efeito de interação entre intensidade de fala e relação S/R (p=0,010) e entre grupo e relação S/R (p=0,039). Na comparação do uso/não uso do DPA, houve efeito de interação entre uso do DPA e as relações S/R (p=0,009) sobre a média das porcentagens de acertos. Conclusões: Para ambos os grupos, houve piora da inteligibilidade de fala com o aumento da intensidade do ruído; contudo, a dificuldade foi maior para o G2. Na comparação das situações com/sem o uso do DPA, o uso dificultou a inteligibilidade de fala, mas não houve diferença significante entre as situações. Por fim, ressalta-se a importância de realizar mais estudos dos efeitos do DPA na comunicação, além de inserir nas avaliações ocupacionais testes que avaliam a fala no ruído, para determinar as dificuldades que podem surgir no ambiente ocupacional, e assim desenvolver medidas que beneficiem os trabalhadores que necessitam se comunicar durante as atividades laborais / Introduction: Noise is one of the main agents of environmental pollution, and at high intensities, it may provoke noise-induced hearing loss (NIHL). NIHL is the second most frequent type of sensorineural hearing loss and it is considered one of the main occupational diseases. In order to avoid the effects of the exposition to occupational noise, legislation determines the monitoring and development of actions to reduce the effects of such exposure and one of the most applied measure is the mandatory use of hearing protection devices (HPD). However, workers often report difficulties to communicate when using the HPD, what may induce them to use it improperly. Previous studies showed divergences between the effects of HPD on speech intelligibility; besides, few studies compared participants with hearing loss to those with normal hearing. Purpose: To assess speech intelligibility of workers exposed to noise during the use of HPD. Methods: This is a cross-sectional study, approved by the Institution\'s Ethics Committee (nº 130/14) and counted on a sample of 36 participants, all males and exposed to noise. They were distributed into a normal hearing group (G1), with 20 participants and hearing loss group (G2), with 16 participants. All participants were submitted to an assessment of speech intelligibility in free field, using monosyllable and sentence lists, when using the HPD in silence and noise situation, and also without the use of HPD in noise. Results: In the assessment of speech intelligibility with HPD using the monosyllables, both groups presented percentages of correct answers above 95%. In the presence of noise with HPD, there was no interaction effect involving group (p>=0.106) or group effect (p=0.182), but there was found an interaction effect between speech intensity and signal-to-noise ratio (SNR) (p=0.006). In the assessment of speech intelligibility in noise without HPD, an interaction effect between HPD use and SNR (p=0.010) was detected over the mean percentage of correct answers. In the evaluation with lists of sentences, the percentage of correct answers with HPD were superior to 98% in the silence; however, in noise, there was a decrease on the interaction effect between speech intensity and SNR (p = 0.010) and between group and SNR (p = 0.039). In the comparison with/without use of HPD, there was found an interaction effect between hearing protection use and SNR (p = 0.009) on the mean percentage of correct answers. Conclusions: For both groups, it was noticed that speech intelligibility decrease with the increasing of noise intensity; nevertheless, the difficulty was greater for the group with hearing loss. In the comparison of situations with and without the use of HPD, its use made speech intelligibility more challenging, but no significant difference between the situations was found. Finally, it is important to highlight the importance of further studies regarding the effects of HPD on communication and, besides, inserting speech-in-noise tests in occupational examination in order to determine the difficulties that may arise in the occupational environment and thus, develop measures that benefits the workers who need communicate during their labor activities
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"Processamento auditivo: teste de fala comprimida em português em adultos normo-ouvintes" / Auditory Processing: a portuguese compressed speech test for normal hearing adultsRabelo, Camila Maia 02 September 2004 (has links)
Introdução: o teste de fala comprimida é sensível para avaliar o fechamento, porém não é usado no Brasil, pois não existe no português. Objetivo: elaborar um teste de fala comprimida em português aplicá-lo em jovens normo-ouvintes e verificar qual das listas comprimidas (50, 60 e 70%) é a mais apropriada para integrar a grupo de testes de Processamento Auditivo. Método: foram avaliados 144 indivíduos jovens, de ambos os sexos. Foram aplicados os testes de fala comprimida, comparando os resultados de acordo com a orelha inicial, ordem de apresentação e tipo de teste. Resultados: a média de acertos diminui com o aumento da compressão. Conclusão: as listas com compressão de 60% mostraram-se mais estáveis. / INTRODUCTION: The compressed speech test is good for evaluate closure, however it is not used in Brazil because it doesn't exist in portuguese. AIM: make a compressed speech test in portuguese, apply it in normal hearing adults and verify which of the compressed lists (50, 60, 70%) is the most appropriate to be a part of the auditory processing test set. METHOD: 144 individuals of both genders were evaluated. The compressed speech tests were used and the results were compared in respect of inicial ear, order of presentation and monosyllable and bisyllable. RESULTS: the average of correct responses decrease as the compression increase. CONCLUSION: the 60% compression test list shows to be the more stable of them.
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Taluppfattbarhet med strupmikrofon / Speech intelligibility with throat microphoneWickman, Erik January 2018 (has links)
Contact microphones, especially throat microphones, have been developed to be used in environments with high background noises to improve the speech intelligibility in communication. They pick up vibrations from the surface they are attached to and are therefore less sensitive to sound and noise from the air. Comparison of the speech intelligibility with other types of microphones have previously been done by letting test persons examine the communication devices in question. This study examines the possibility to make use of the STI-method instead and therefore make a comparison faster, more cost-efficient and customizable. The thought is that if the relationship between speech signals and vibrations were known, it could be used to transform the STI test signal to vibrations and then use the STImethod to estimate the speech intelligibility for the chosen contact microphone. This study, containing 22 men and women, evaluated the vibrations at the most suitable locations on the head for contact microphones and compared it with the speech signal of the same test person. Frequency responses were calculated for all locations of the head and a more detailed study showed that the frequency response of the neck may be approximated as a second order lowpass filter with a cut-off frequency of about 300 Hz that attenuates speech signals with higher frequencies. Experiments were also done to measure the STI value of a throat microphone with the known relationship. However, the results pointed out several problems that needs to be addressed before a STI method can be performed successfully. The results from this study may also be used to deeper study the relationships between different vibrations resulting from speech signals and suggestions on how the performance of contact microphones may be improved are given.
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Formas geometricas e qualidade acustica de salas de aula : estudo de caso em Campinas-SP / Geometric shapes and classroom acoustical quality : case study at Campinas-SPAmorim, Adriana Eloa Bento 22 August 2007 (has links)
Orientador: Stelamaris Rolla Bertoli / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil, Arquitetura e Urbanismo / Made available in DSpace on 2018-08-09T02:39:04Z (GMT). No. of bitstreams: 1
Amorim_AdrianaEloaBento_M.pdf: 15352732 bytes, checksum: 327b5fe0a18f76c48649f2007c4f4dba (MD5)
Previous issue date: 2007 / Resumo: Estudos sobre a acústica de salas de aula estão cada vez mais comuns no meio acadêmico e científico, devido à sua influência nas questões do ensino-aprendizagem. Os ambientes escolares exigem qualidade acústica que deve ser prevista já na concepção do projeto. A inadequação acústica de escolas e salas de aula é apontada em diversas pesquisas que utilizam variadas metodologias, geralmente através da aplicação de testes de acertos e erros de vocábulos, e também da análise de parâmetros de avaliação como medidas dos níveis de pressão sonora e do tempo de reverberação. Na rede estadual de ensino público em São Paulo, as salas de aula são projetadas a partir de diretrizes pré-estabelecidas que visam a padronização dos projetos de escolas. Portanto, este trabalho tem como objetivos identificar as formas geométricas mais comuns de salas de aula propostas para a rede pública estadual de ensino em Campinas-SP, apresentar o comportamento dos parâmetros acústicos quanto à inteligibilidade da fala e apontar as formas mais favoráveis à qualidade acústica de salas de aula. Para a definição da amostra realizou-se um levantamento cadastral das escolas e o levantamento arquitetônico das salas. Desse levantamento, identificou-se o número de configurações geométricas mais comuns de salas. Foram analisadas as salas dentro da uma mesma configuração padrão, totalizando dezessete salas de aula. Para a medição acústica foi utilizada a técnica da resposta impulsiva da sala e os parâmetros acústicos foram obtidos através do programa de avaliação acústica de salas, o DIRAC®, da empresa Brüel & Kjaer. Os parâmetros derivados da resposta impulsiva analisados neste trabalho foram: o Tempo de Reverberação (TR), o Tempo de Decaimento Inicial (EDT), a Definição (D50), o Índice de Transmissão da Fala (STI) e a Porcentagem de Perda na Articulação de Consoantes (%ALCons), em função da freqüência na faixa de bandas de 1/1 de oitava. Também foi medido e analisado o Nível de Pressão Sonora ou ruído de fundo ambiental equivalente (LAeq) interno e externo à sala, obtido com o medidor de pressão sonora. A análise complementar da forma para cada sala foi feita pela proporcionalidade das dimensões, segundo a escala do Diagrama de Bolt. As formas geométricas em planta mais comuns de salas são as quadradas (7x7m) e retangulares (6x8m). Dentro de cada configuração as salas apresentaram diferentes desempenhos acústicos. Pelo fato de existir uma grande variedade de fatores e parâmetros que interferem na acústica da sala, foi possível identificar algumas tendências de comportamento acústico por configuração geométrica / Abstract: Studies about classroom acoustics are developed each time more into the scientific and academic society, due to its influence in the teach-learning. The school¿s environments demand acoustical quality that must be foreseen already during the design planning. Some situations of acoustic not adjusted on classrooms are shown in research that using several methods, generally with application of word¿s rightness and error tests as well as of the analysis and evaluation of parameters as the sound pressure levels and reverberation time. In the State of Sao Paulo the classrooms of public education buildings are projected in accordance with same lines of direction that aim at the school design standardization. Therefore, this work has as objective to identify what geometric shapes are more common on classroom¿s design found in public schools at Campinas-SP, to present the acoustic parameters behavior how much to the speech intelligibility of classrooms and to point the shapes that are most favorable to the acoustical quality for classrooms. It was made classroom¿s cadastral survey for sample definition and after was made architectural survey hers. This procedure allows identifying the number of the rooms more common geometric configurations. The classrooms which have the same configuration standard were selected and analyzed, totalizing seventeen classrooms. The acoustical measurements were made using the impulse response technique of the room and the acoustical parameters were obtained of the room acoustics evaluation software, the DIRAC®, by Brüel & Kjaer. The parameters were derived from the impulse response were analyzed in this work: Reverberation Time (RT), Early Decay Time (EDT), Definition (D50), Speech Transmission Index (STI) and Percentage Articulation Loss of Consonants (%ALCons), for each 1/1 octave frequency band. Also it was analyzed the internal and external background noise or ambiental Equivalent Sound Pressure Level (LAeq), which were measured with sound pressure level meter. Complementary analysis of the form for each room was made by the proportionality of the dimensions, according to Bolt¿s Diagram scale. Among the more common geometric shapes in plant of rooms had found were: the square shaped (7x7m) and rectangular (6x8m). Inside each configuration of classroom had presented different acoustical performances. For the fact to exist a great variety of factors and parameters intervening on classroom acoustics, it was possible to identify some acoustical behaviors trends for geometric configuration / Mestrado / Arquitetura e Construção / Mestre em Engenharia Civil
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"Processamento auditivo: teste de fala comprimida em português em adultos normo-ouvintes" / Auditory Processing: a portuguese compressed speech test for normal hearing adultsCamila Maia Rabelo 02 September 2004 (has links)
Introdução: o teste de fala comprimida é sensível para avaliar o fechamento, porém não é usado no Brasil, pois não existe no português. Objetivo: elaborar um teste de fala comprimida em português aplicá-lo em jovens normo-ouvintes e verificar qual das listas comprimidas (50, 60 e 70%) é a mais apropriada para integrar a grupo de testes de Processamento Auditivo. Método: foram avaliados 144 indivíduos jovens, de ambos os sexos. Foram aplicados os testes de fala comprimida, comparando os resultados de acordo com a orelha inicial, ordem de apresentação e tipo de teste. Resultados: a média de acertos diminui com o aumento da compressão. Conclusão: as listas com compressão de 60% mostraram-se mais estáveis. / INTRODUCTION: The compressed speech test is good for evaluate closure, however it is not used in Brazil because it doesn't exist in portuguese. AIM: make a compressed speech test in portuguese, apply it in normal hearing adults and verify which of the compressed lists (50, 60, 70%) is the most appropriate to be a part of the auditory processing test set. METHOD: 144 individuals of both genders were evaluated. The compressed speech tests were used and the results were compared in respect of inicial ear, order of presentation and monosyllable and bisyllable. RESULTS: the average of correct responses decrease as the compression increase. CONCLUSION: the 60% compression test list shows to be the more stable of them.
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Algorithmes de réduction du bruit en vue d'une amélioration de l'intelligibilité de la parole : cas de la prothèse cochléaire / Reduction algorithms for speech intelligibility improvement dedicated to a bilateral cochlear implantKallel, Fathi 13 December 2011 (has links)
La prothèse cochléaire est un appareillage destiné à la réhabilitation des surdités profondes et totales dont un appareillage conventionnel est inefficace. Elle assure la stimulation directe des neurones cochléaires à travers un faisceau d’électrodes. Différents travaux de recherches ont été établis afin d'évaluer l'intelligibilité de la parole chez les sujets bilatéralement implantés en environnements silencieux et bruité. Les résultats ont montré une bonne intelligibilité de la parole en milieu silencieux. Toutefois, les capacités de perception de la parole chez les patients implantés se dégradent en environnement bruité. Nous avons de ce fait proposé trois approches de traitement du signal en vue d'une amélioration de l'intelligibilité de la parole dans le cas de l'implant cochléaire bilatéral: la stimulation bilatérale décalée, l'algorithme de la soustraction spectrale bi-voie et l'algorithme de la soustraction interspectrale. Des améliorations de l'intelligibilité de la parole entre 4% et 10% ont été notées dans le cas de la stimulation bilatérale décalée par rapport à la stimulation bilatérale symétrique. L'approche basée sur l'algorithme de la soustraction spectrale bi-voie présentait des améliorations variables entre 10% et 17%. De meilleures performances ont été obtenues lorsque l'approche basée sur l'algorithme de la soustraction interspectrale est considérée où les améliorations étaient entre 15% et 27% / Cochlear prostheses are intended for persons suffering from deep or total deafness where conventional prostheses proved ineffective. In quiet listening conditions, most bilateral cochlear implant (BCI) users can now achieve even more than 80% word recognition scores regardless the used device. However, under more challenging listening conditions, BCI recipients perform poorly, compared to normal-hearing listeners. In this work, we proposed three speech processing approaches for speech intelligibility improvement. The first is based on shifted bilateral cochlear implant stimulation; the second is based on dual-channel spectral subtraction algorithm and finally the cross power spectral subtraction algorithm was considered. Experimental results showed a speech intelligibility improvement between 4% and 10% when the shifted bilateral cochlear implant stimulation is considered. Performance amelioration was observed when the dual-channel spectral subtraction based speech enhancement algorithm was considered and the improvement was between 10% and 17%. The better performance was obtained when noisy speech signals were processed using cross power spectral subtraction algorithm and the improvement was between 15% and 27%
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Inteligibilidade de fala em trabalhadores expostos a ruído com protetores auditivos / Speech intelligibility in workers exposed to noise with hearing protectorsClayton Henrique Rocha 12 May 2017 (has links)
Introdução: O ruído é um dos principais agentes de poluição ambiental, que em intensidades elevadas, poderá causar a perda auditiva induzida por níveis de pressão sonora elevadas (PAINPSE). A PAINPSE é o segundo tipo de perda auditiva neurossensorial mais frequente, e considerada uma das principais doenças ocupacionais. Para evitar os prejuízos da exposição ao ruído ocupacional, legislações determinam o monitoramento e o desenvolvimento de ações para reduzir os efeitos da exposição, sendo o uso de dispositivos de proteção auditiva (DPA) a mais empregada. Contudo é comum que o trabalhador relate dificuldades para se comunicar com o DPA, o que pode induzi-lo ao uso inadequado. Os estudos já realizados apresentam discordâncias sobre os efeitos do DPA para a inteligibilidade da fala, além de serem poucos os que compararam participantes com perdas auditivas com normo-ouvintes. Objetivos: Avaliar a inteligibilidade de fala em trabalhadores expostos a ruído durante o uso de DPA. Métodos: Trata-se de um estudo transversal, aprovado pelo Comitê de Ética em Pesquisa da instituição nº 130/14, com amostra de 36 participantes, todos do sexo masculino e expostos ao ruído. Foram divididos em grupo normo-ouvintes (G1), com 20 participantes e com perda auditiva (G2), com 16 participantes. Todos os participantes realizaram avaliação da inteligibilidade de fala em campo acústico, utilizando listas de monossílabas e sentenças, em situações de uso do DPA no silêncio e no ruído e sem o uso do DPA no ruído. Resultados: Na avaliação da inteligibilidade de fala com DPA utilizando as monossílabas, ambos os grupos apresentaram porcentagens de acertos superiores à 95% na situação de silêncio. Na presença do ruído com o DPA, não foi detectado efeito de interação envolvendo grupo (p>=0,106) e nem efeito de grupo (p=0,182), mas houve efeito de interação entre intensidade de fala e relação sinal/ruído (S/R) (p=0,006). Na avaliação da inteligibilidade de fala no ruído sem o DPA, foi detectado efeito de interação entre uso do DPA e relação S/R (p=0,010) sobre a média das porcentagens de acertos. Na avaliação com listas de sentenças, a porcentagem de acertos com DPA foram superiores a 98% no silêncio; contudo, no ruído houve piora, com efeito de interação entre intensidade de fala e relação S/R (p=0,010) e entre grupo e relação S/R (p=0,039). Na comparação do uso/não uso do DPA, houve efeito de interação entre uso do DPA e as relações S/R (p=0,009) sobre a média das porcentagens de acertos. Conclusões: Para ambos os grupos, houve piora da inteligibilidade de fala com o aumento da intensidade do ruído; contudo, a dificuldade foi maior para o G2. Na comparação das situações com/sem o uso do DPA, o uso dificultou a inteligibilidade de fala, mas não houve diferença significante entre as situações. Por fim, ressalta-se a importância de realizar mais estudos dos efeitos do DPA na comunicação, além de inserir nas avaliações ocupacionais testes que avaliam a fala no ruído, para determinar as dificuldades que podem surgir no ambiente ocupacional, e assim desenvolver medidas que beneficiem os trabalhadores que necessitam se comunicar durante as atividades laborais / Introduction: Noise is one of the main agents of environmental pollution, and at high intensities, it may provoke noise-induced hearing loss (NIHL). NIHL is the second most frequent type of sensorineural hearing loss and it is considered one of the main occupational diseases. In order to avoid the effects of the exposition to occupational noise, legislation determines the monitoring and development of actions to reduce the effects of such exposure and one of the most applied measure is the mandatory use of hearing protection devices (HPD). However, workers often report difficulties to communicate when using the HPD, what may induce them to use it improperly. Previous studies showed divergences between the effects of HPD on speech intelligibility; besides, few studies compared participants with hearing loss to those with normal hearing. Purpose: To assess speech intelligibility of workers exposed to noise during the use of HPD. Methods: This is a cross-sectional study, approved by the Institution\'s Ethics Committee (nº 130/14) and counted on a sample of 36 participants, all males and exposed to noise. They were distributed into a normal hearing group (G1), with 20 participants and hearing loss group (G2), with 16 participants. All participants were submitted to an assessment of speech intelligibility in free field, using monosyllable and sentence lists, when using the HPD in silence and noise situation, and also without the use of HPD in noise. Results: In the assessment of speech intelligibility with HPD using the monosyllables, both groups presented percentages of correct answers above 95%. In the presence of noise with HPD, there was no interaction effect involving group (p>=0.106) or group effect (p=0.182), but there was found an interaction effect between speech intensity and signal-to-noise ratio (SNR) (p=0.006). In the assessment of speech intelligibility in noise without HPD, an interaction effect between HPD use and SNR (p=0.010) was detected over the mean percentage of correct answers. In the evaluation with lists of sentences, the percentage of correct answers with HPD were superior to 98% in the silence; however, in noise, there was a decrease on the interaction effect between speech intensity and SNR (p = 0.010) and between group and SNR (p = 0.039). In the comparison with/without use of HPD, there was found an interaction effect between hearing protection use and SNR (p = 0.009) on the mean percentage of correct answers. Conclusions: For both groups, it was noticed that speech intelligibility decrease with the increasing of noise intensity; nevertheless, the difficulty was greater for the group with hearing loss. In the comparison of situations with and without the use of HPD, its use made speech intelligibility more challenging, but no significant difference between the situations was found. Finally, it is important to highlight the importance of further studies regarding the effects of HPD on communication and, besides, inserting speech-in-noise tests in occupational examination in order to determine the difficulties that may arise in the occupational environment and thus, develop measures that benefits the workers who need communicate during their labor activities
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Evaluation of Selected Speech Parameters after Prosthesis Supply in Patients with Maxillary or Mandibular DefectsMüller, Rainer, Höhlein, Andreas, Wolf, Annette, Markwardt, Jutta, Schulz, Matthias C., Range, Ursula, Reitemeier, Bernd 05 August 2020 (has links)
Background: Ablative surgery of oropharyngeal tumors frequently leads to defects in the speech organs, resulting in impairment of speech up to the point of unintelligibility. The aim of the present study was the assessment of selected parameters of speech with and without resection prostheses. Patients and Methods: The speech sounds of 22 patients suffering from maxillary and mandibular defects were recorded using a digital audio tape (DAT) recorder with and without resection prostheses. Evaluation of the resonance and the production of the sounds /s/, /sch/, and /ch/ was performed by 2 experienced speech therapists. Additionally, the patients completed a non-standardized questionnaire containing a linguistic self-assessment. Results: After prosthesis supply, the number of patients with rhinophonia aperta decreased from 7 to 2 while the number of patients with intelligible speech increased from 2 to 20. Correct production of the sounds /s/, /sch/, and /ch/ increased from 2 to 13 patients. A significant improvement of the evaluated parameters could be observed only in patients with maxillary defects. The linguistic self-assessment showed a higher satisfaction in patients with maxillary defects. Conclusion: In patients with maxillary defects due to ablative tumor surgery, an increase in speech performance and intelligibility is possible by supplying resection prostheses.
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Spécificités de l'implant électro-acoustique : indications, interface bioélectrique et stratégie de codage / Specificities of electric-acoustic stimulation : indications, bioelectrical interface and coding strategySeldran, Fabien 19 December 2011 (has links)
Le clinicien se trouve parfois confronté à des sujets qui présentent une surdité supérieure à 90 dB HL au-delà de 1 kHz avec une audition résiduelle dans les fréquences graves. Pour réhabiliter les hautes fréquences, il existe aujourd’hui différentes technologies : amplification conventionnelle, compression fréquentielle, implant cochléaire et depuis une dizaine d’année la stimulation électro-acoustique EAS qui consiste à stimuler acoustiquement les sons graves et électriquement les sons aigus via un implant cochléaire. La première partie de cette thèse a consisté à identifier les facteurs qui influencent les capacités des patients sourds partiels à traiter l’information basse fréquence de la parole. Nous avons utilisé un test d’audiométrie vocale filtrée passe-bas. Nos résultats indiquent que les scores d’intelligibilité de la parole sont positivement corrélés avec la durée de la surdité. Ceci signifie qu’avec le temps, ces sujets malentendants apprennent à comprendre avec cette audition type filtre passe-bas, à tel point que certains ont des performances supra-normales pour l’utilisation des basses fréquences. Nos résultats montrent également une corrélation négative entre l’âge d’apparition de la surdité et les scores l’intelligibilité. Ce test pourra aider le clinicien à mieux cibler l’appareillage le plus adapté à chaque profil de patient. La seconde partie de cette thèse, consacrée à l’EAS, a consisté à évaluer par des simulations chez le normo-entendant, diverses stratégies de codage du son par l’implant EAS. Actuellement, la stratégie utilisée pour l’EAS est calquée sur celle de l’implant cochléaire et nos résultats suggèrent que cette stratégie peut être optimisée. / Clinicians may face patients who have a deafness superior to 90 dB HL above 1 kHz with good lowfrequency residual hearing. Today, several technologies are available to provide high frequencies: conventional amplification, frequency compression, cochlear implant since about 10 years Electric-Acoustic Stimulation EAS which consists in stimulating acoustically low frequencies while stimulating electrically high frequency sounds via a cochlear implant. The firt part of this dissertation consisted in identifying the factors which may influence abilities of partially deaf subjects to process low-frequency speech information. We used a low-pass filtered speech test. Our results show that speech intelligibility scores are positively correlated to the duration of deafness. This means that these hearing-impaired subjects learn to understand with this lowpass-like hearing, in such a way that some of them exhibit supranormal abilities for the processing of low-frequency sounds. Our results also show a negative correlation between the age at onset of deafness and speech intelligibility scores. This test may help the clinician to better evaluate which device would be best for every patient’s profile. The second part of this dissertation, about EAS, consisted in evaluating through simulations in normal hearing listeners, several coding strategies by the EAS implant. Now the strategy used for EAS duplicates the strategy used by cochlear implants and our results suggest that this strategy could be optimized.
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Говорни капацитет особа са израштајима на гласницама / Govorni kapacitet osoba sa izraštajima na glasnicama / Capacity speech of people with tumors of the vocal foldsVeselinović Mila 29 June 2017 (has links)
<p>Говор представља врло сложену људску делатност. За његову успешну реализацију потребно је ускладити правилну артикулацију, исправан акустички сигнал, несметану перцепцију и одговарајућу когнитивну спознају. Као најзначајнији модалитет реализације језика у процесу комуникације у великој мери зависи од квалитетагласа који је његов неодвојиви део. Патолошке карактеристике гласа и говора особа са бенигним и малигним израштајима на гласницама перципирају се као различите варијације висине, интензитета и квалитета говорног гласа. Циљеви истраживања: Утврдити говорни капацитет особа са малигним, бенигним и псеудотуморима, на гласницама пре и после оперативног лечења, разлику између њиховог говорног капацитета и утврдити како оперативно лечење утиче на разумљивост и временске одреднице говора. Истраживање је спроведено током 2016. и 2017. годинена Клиници за болести ува, грла и носа Клиничког центра Војводине. Узорак је чинило 67 испитаника подељених у 2 групе према врсти израштаја на оне који су имали бенигне и псеудотуморе и испитанике са малигним туморима на гласницама старости од 23 до 74 године (AS 55,43 године; SD 11,95 година). Методе примењене у истраживању: Општи упитник, Тестови за искључивање из узорка (Мини-Ментал тест - Mini mental State Examination, Упитник о анксиозности-GAD-7 Anxiety, Тријажни артикулациони тест), Индекс говорног хендикепа -Speech Handicap Index,Акустичка анализа гласа, Максимално фонацијско време вокала /а/, Анализа временске организације говора, Разумљивост говора, Анализа мелодије реченице. Према нашим резултатима, пре операције у обе групе испитаника говорни капацитет је био готово уједначен са малом разликом јер су ипак нешто бољи говорни капацитет имале особе са малигним израштајима на гласницама али без статистичке значајности у поређеним групама. После оперативног лечења бенигних и псеудотумора на гласницама дошло је до статистички значајног побољшања говорног капацитета (p=0,005). После операције постојалаје статистички значајна разлика између говорног капацитета испитиваних група, при чему су бољи говорни капацитет имали испитаници групе I – са бенигним и псеудотуморима (t=-3,807, p<0,001). Разумљивост говора је код испитаника са малигним туморима гласнице била статистички значајно повезана са вредностима говорног капацитета пре операције (p=0,008). У погледу временске организације говора, код испитаника са малигним туморима на гласницама после операције дошло је до статистички значајног погоршања (p=0,025). У истраживању није добијен изоловани ефекат времена или врсте израштаја на говорни капацитет, али постоји њихов удружени ефекат (f = 10,079, p = 0,002). Препорука је да се сви пацијенти после оперативног лечења израштаја на гласницама укључе у поступак рехабилитације гласа и говора.</p> / <p>Govor predstavlja vrlo složenu ljudsku delatnost. Za njegovu uspešnu realizaciju potrebno je uskladiti pravilnu artikulaciju, ispravan akustički signal, nesmetanu percepciju i odgovarajuću kognitivnu spoznaju. Kao najznačajniji modalitet realizacije jezika u procesu komunikacije u velikoj meri zavisi od kvalitetaglasa koji je njegov neodvojivi deo. Patološke karakteristike glasa i govora osoba sa benignim i malignim izraštajima na glasnicama percipiraju se kao različite varijacije visine, intenziteta i kvaliteta govornog glasa. Ciljevi istraživanja: Utvrditi govorni kapacitet osoba sa malignim, benignim i pseudotumorima, na glasnicama pre i posle operativnog lečenja, razliku između njihovog govornog kapaciteta i utvrditi kako operativno lečenje utiče na razumljivost i vremenske odrednice govora. Istraživanje je sprovedeno tokom 2016. i 2017. godinena Klinici za bolesti uva, grla i nosa Kliničkog centra Vojvodine. Uzorak je činilo 67 ispitanika podeljenih u 2 grupe prema vrsti izraštaja na one koji su imali benigne i pseudotumore i ispitanike sa malignim tumorima na glasnicama starosti od 23 do 74 godine (AS 55,43 godine; SD 11,95 godina). Metode primenjene u istraživanju: Opšti upitnik, Testovi za isključivanje iz uzorka (Mini-Mental test - Mini mental State Examination, Upitnik o anksioznosti-GAD-7 Anxiety, Trijažni artikulacioni test), Indeks govornog hendikepa -Speech Handicap Index,Akustička analiza glasa, Maksimalno fonacijsko vreme vokala /a/, Analiza vremenske organizacije govora, Razumljivost govora, Analiza melodije rečenice. Prema našim rezultatima, pre operacije u obe grupe ispitanika govorni kapacitet je bio gotovo ujednačen sa malom razlikom jer su ipak nešto bolji govorni kapacitet imale osobe sa malignim izraštajima na glasnicama ali bez statističke značajnosti u poređenim grupama. Posle operativnog lečenja benignih i pseudotumora na glasnicama došlo je do statistički značajnog poboljšanja govornog kapaciteta (p=0,005). Posle operacije postojalaje statistički značajna razlika između govornog kapaciteta ispitivanih grupa, pri čemu su bolji govorni kapacitet imali ispitanici grupe I – sa benignim i pseudotumorima (t=-3,807, p<0,001). Razumljivost govora je kod ispitanika sa malignim tumorima glasnice bila statistički značajno povezana sa vrednostima govornog kapaciteta pre operacije (p=0,008). U pogledu vremenske organizacije govora, kod ispitanika sa malignim tumorima na glasnicama posle operacije došlo je do statistički značajnog pogoršanja (p=0,025). U istraživanju nije dobijen izolovani efekat vremena ili vrste izraštaja na govorni kapacitet, ali postoji njihov udruženi efekat (f = 10,079, p = 0,002). Preporuka je da se svi pacijenti posle operativnog lečenja izraštaja na glasnicama uključe u postupak rehabilitacije glasa i govora.</p> / <p>Speech represents a very complicated human ability. For its successful realization, it’s necessary to coordinate proper articulation, correct acoustical signal, unobstructed perception and adequate cognitive recognition. The most significant modality of language realization in the process of communication greatly depends on vocal quality, which is its inseparable element. Pathological vocal and speech characteristics in people with benign and malign growths on the vocal cords are perceived as different variations of pitch, intensity and quality of the speaking voice. Aims of the research: Determining the vocal capacity of people with malign, benign tumors and pseudo-tumors on the vocal cords, before and after surgical treatment, determining the difference between their vocal capacity and how surgical treatment affects comprehensibility and time determinants of speech. The research was conducted during 2016 and 2017 on the Otorhinolaryngology clinic of Vojvodina Clinical Centre. The sample consisted of 67 participants divided into 2 groups based on the type of growth present, into participants with benign and pseudo tumors and participants with malign tumors of the vocal chords, aged 23 – 74 (M=55,43; SD=11,95). Methods used in the research: General Questionnaire, Tests for exclusion from the sample (Mini mental State Examination), Anxiety Questionnaire – GAD-7 Anxiety, Triage Articulatory Test, Speech Handicap Index, Acoustic Vocal Analysis, Maximum phonation time vowel /a/, Time organization of speech analysis, Speech comprehensibility, Sentence melody analysis. According to the results of the research, before surgical treatment, the vocal capacity of both participant groups was nearly equable with a small difference of a somewhat higher vocal capacity in participants with malign growths on the vocal cords, but with no statistical significance between the compared groups. After surgical treatment of benign and pseudo tumors on the vocal cords, a statistically significant improvement of vocal capacity was observed (p=0,005). Post surgically, a statistically significant difference between the vocal capacity of tested groups was observed, with a higher vocal capacity present in the first group of participants with benign and pseudo tumors (t=-3,807, p<0,001). Speech comprehensibility in participants with malign tumors of the vocal cords was significantly correlated with the values of speech capacity prior to the surgical treatment (p=0,008). In regards to time organization of speech, there was a statistically significant deterioration in patients with malign vocal cord tumors (p=0,025). The research showed no isolated effect of time or type of growth on speech capacity, but a combined effect was observed (f=10,079, p=0,002). The recommendation is that all patients are included in the procedure of speech and vocal rehabilitation after surgical treatment.</p>
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