The objective of the present study was to evaluate to what degree the function of the central auditory pathways influences the intelligibility of the speech in the patients suffering from the sensorineural loss of hearing (SNLH). The study included a total of 20 patients at the age varying from 31 to 80 years presenting with moderate to moderately severe symmetrical SNLN. All the patients were permanent hearing aid users. They underwent the standard audiological examination including pure-tone threshold and suprathreshold audimetries together with impedancemetry, the evaluation of the functional ability of the central auditory pathways with special reference to temporal resolution and differential frequency sensitivity, binaural integration, and the ability to distinguish a sound stimulus against the background noise. It has been found that the impaired intelligibility of the speech and the decreased efficiency of the hearing aids in the patients presenting with SNLH were attributable to the central auditory pathway disorders detected in 50% of the participants in the study. The strong correlation between the results of detection of the stimulus under conditions of tonal signal interference, the binaural integration test, and intelligibility of the speech in the users of hearing aids was documented.

The authors define the term presbycusis and discuss the prevalence of hearing loss in elderly people, its etiology, and methods of diagnostics (anamnesis, evaluation of the peripheral and central parts of the hearing system). The authors emphasize that central auditory processing disorder (CAPD) significantly impairs speech perception in elderly people and makes difficult the rehabilitation of patients with presbycusis. The possibility of improving speech intelligibility by using auditory training is considered. Improved functioning of the central auditory pathways in hearing aid (HA) users with moderate to moderately severe chronic sensorineural hearing loss (SNHL) and symptoms of CAPD was shown after the auditory training with the use of two approaches ("bottom-up" and "top-down"). The algorithm of the auditory training was designed based on distinction between nonverbal and verbal stimuli of varying complexity, as well as tasks to improve memory (e.g., memorizing poetry). The benefits of the auditory training in the rehabilitation of HA users with low speech intelligibility were demonstrated. Improvement of speech intelligibility in elderly patients with SNHL proves that plasticity of the auditory regions of the brain remains possible throughout the life. Options of the presbycusis prophylaxis are summarized.Different authors sometimes interpret this term differently. Some researchers meant (imply under this term) age-related hearing disorders caused by involutional changes only in the cochlea, and others meant that changes involve all parts of the auditory system [1,2]. Presbycusis is considered to be one of the forms of progressive SNHL, which is associated with age-related involutional changes of different parts of the hearing system and is presented by symmetric pure tone audiogram with flat loss toward high-frequency range (less steep than 20 dB/oct) [3]. Numerous studies are dedicated to anatomical and functional risk factors of the presbycusis [4][5][6][7][8][9]. The significance of the presbycusis problem is determined by its social importance, lack of data about its etiology, and need for clinical practice to accurately determine an impaired area of auditory system and to identify the presbycusis genesis. PrevalencePresbycusis is a rather common disorder. According to the World Health Organization (WHO), more than 5% of global population (about 328 millions of adults) suffers from any degree of hearing loss, while among people older than 65 years of age, the prevalence of hearing loss exceeds 30% [10].Its prevalence increases every year that may be due to the general trend of increased life duration-much more adults reach aged (from 60 to 74 years old according to the WHO classification) and senile (75 years old and more) periods. The world population is rapidly aging. At the period between 2000 and 2050, the proportion of the world's population over 60 years will double from about 11 to 22%. The absolute number of people aged 60 years and over is expected to increase from 605 million to 2 billion ov...

1 лаборатория слуха и речи (зав. -д.м.н. м.Ю. бобошко) Первого санкт-Петербургского государственного медицинского университета им. акад. и.П. Павлова» минздрава россии, санкт-Петербург, россия, 197022; 2 Группа медицинской физики и высокотехнологичный кластер по улучшению слуха (руководитель -проф. б. Кольмейер) в университете Карла фон оссиецки ольденбурга, ольденбург, Германия, 26129Матриксный тест, предполагающий использование в качестве речевого материала семантически непредсказуемых фраз из 5 слов на фоне шума, разработан и апробирован для многих языков. Цель исследования -апробация русской версии матриксного фразового теста (RuMatrix Test) Принятые сокращения: дБ нПС -децибел относительно нормального порога слышимости дБ УЗД -децибел относительно исходного уровня звуко-вого давления RuMatrix -Russian matrix sentence test -русский матрикс-ный фразовый тест SNR -Signal-to-Noise Ratio -отношение сигнал/шум SRT -Speech reception threshold -порог речевой разборчи-вости SRT 5 -отношение сигнал/шум, при котором достигается уровень 50% речевой разборчивости ОРигинаЛьные статьи

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Assessment of the condition of auditory analyzer central part functioning has been performed using of psychoacoustic tests that characterize human auditory system resolution, frequency differential response, binaural interaction and the ability to detect sound signal against the noise background. 20 patients with chronic bilateral symmetric sensorineural hearing loss at the age of 31 through 80 years old and 10 patients at the age of 20 through 25 years with normal hearing have been examined. Low informative value of the measurement of frequency difference thresholds and high importance of the gap detection test in diagnosing of central auditory disorders in patients with hearing loss have been noted. The studies on detection of a sound signal against the noise background made it possible to suggest a new test for assessment of central parts of auditory analyzer – the measurement of the useful signal threshold shift under the conditions of simultaneous presentation of tonal interference. Significantly greater signal threshold shifts against the noise background have been revealed in the patients with sensorineural hearing loss accompanied by impaired binaural interaction than in the patients with peripheral hearing loss and normal hearing.