인공와우 이식자에서 자극 잡파를 이용한 고장 평가

허승덕,김상렬,안중기,정동근,강명구,Heo, Seung-Deok,Kim, Sang-Ryeol,Ahn, Joong-Ki,Jung, Dong-Keun,Kang, Myung-Koo 한국음성학회 2007 음성과학 Vol.14 No.2

The aim of this study is to analyze the correlation between current intensity and amplitude of stimulus artifact on the cochlear implantee, and to find out basic information to check the device failure. Subjects were a prelingual child and 3 postlingual adults with more than severe hearing losses. The charge-balanced biphasic pulses were presented at stimulus rates of 11 pulses per second, each pulse width of $25{\mu}s$ with monopolar mode(MP1+2). Current intensities were delivered at 27.5, 33.7, 41.3, 50.5, 61.9, $75.8{\mu}A$. Stimulus artifacts were recorded by evoked potential system. This procedure was performed just before the initial stimulation, and then, the amplitude of stimulus artifacts were compared with each current intensity. The amplitude of stimulus artifacts was increased significantly according to the current intensity (p<0.01). The results suggest that the change of the amplitude of stimulus artifact can be used as a good cue to check the device failure in the cochlear implantee.

편측 인공와우 이식자의 보청기 사용

허승덕,김리석,정동근,최아현,고도홍,김현기,Heo, Seung-Deok,Kim, Lee-Suk,Jung, Dong-Keun,Choi, Ah-Hyun,Ko, Do-Heung,Kim, Hyun-Gi 한국음성학회 2005 음성과학 Vol.12 No.4

The cochlear implantation(CI) as an useful tool for aural rehabilitation in bilateral severe to profound hearing impairment. However, CI prefer to usually one ear in spite of bilateral hearing impaired. because of the various characteristics of hearing loss, the hearing conservation for the future possibility, and socioeconomic condition of hearing impaired person and their families. The unilateral CI has limitations such as a directional loss, a difficult speech understanding in noise and a neural plasticity. These limitations will be overcome by hearing aid(HA) which is familiar with hearing impairer. but HA fitting for bimodal-binaural hearing are difficult because the difference output characteristic of HA and CI. This study will be confirm realities of use of HA in unilateral cochlear implantee. For this goal, 25(m:f=10:15) child participated who are used to HA for 1 to 17 months. We had telephone interviews with their mother about use of HA, change of auditory performance and own voice. As the results, hearing threshold levels of unimplanted ear, the use of a appropriate HA, implanted and aided hearing threshold level(HTL) are must be considered for successful biomodal-binaural hearing. Especially, implanted and aided HTL should be very useful parameter for a prediction of HA effect and a criterion of selection for bilateral cochlear implantation.

정상 성인에서 청성유발 피부전위

허승덕,정동근,서덕준,김광년,김기련,강명구,김리석,Heo, Seung-Deok,Jung, Dong-Keun,Suh, Duk-Joon,Kim, Gwang-Nyeon,Kim, Gi-Ryon,Kang, Myung-Koo,Kim, Lee-Suk 한국음성학회 2005 음성과학 Vol.12 No.2

Electrodermal activity(EDA) is a bio-electric signal which occurs at the skin surface during the sweating. EDA reflects the activity of the sympathetic axis of the autonomic nervous system. EDA is associated with the eccrine sweat gland at the palmar and plamar surface. This study was aimed to characterize the relationship between EDA and auditory stimulus intensities. Acoustic stimulus used in this study were 500 Hz, 1 kHz, 2 kHz of narrow band noise, which were representative of speech frequencies in audible range. Stimulus intensity between 90 and 30 dB in 10 dB within dynamic range. After deriving the minimum stimulus intensity(threshold of skin potential) which elicited skin potential, and then the latency and amplitude were derived from waveform of skin potential, each latency and amplitude were compared to stimulus intensity. The waveform of skin potential were recorded stably, and the threshold of skin potential appeared nearly the hearing threshold level of the participant. The latency was decreased and the amplitude was increased according to the increase of the stimulus intensity. These results suggest that auditory evoked skin potential can be applicable to auditory assessment and audiological diagnosis tool.

Influence of Real Ear Resonance on Male Voice Formant Frequency

허승덕(Seung Deok Heo),강희라(Hui Ra Kang),고도흥(Do Heung Ko) 한국언어청각임상학회 2017 Communication Sciences and Disorders Vol.22 No.3

배경 및 목적: 소리는 음장을 지나 외이도, 중이, 내이 등으로 상행한다. 외이도는 음향에너지 특성이 유지되는 곳으로 공명에 의해 말소리의 음향학적 특성이 달라질 것으로 예상된다. 이 연구는 실이에서 음성의 포먼트 주파수를 분석하여, 외이 공명이 음성에 어떤 영향을 미치는지 알아보는데 목적이 있다. 방법: 모음은 사용 빈도가 높은 /ㅏ/, /ㅣ/, /ㅜ/, /ㅔ/, /ㅗ/를 사용하였다. 음성은 남자가 발성하여 여자 12명의 외이도 내부와 이개 상부에서 각각 녹음하였다. 이들 음성은 포먼트 주파수를 분석한(Praat ver. 6.0.19) 후 기술통계 하였고, 대응표본 t-test (SPSS ver. 22.0)와 Wilcoxon test로 검증하였다. 결과: 음장과 실이 음성 사이에서는 /ㅏ/의 F3, F4, /ㅣ/의 F2, F3, F4, /ㅜ/의 모든 포먼트 주파수, /ㅔ/의 F2, F4, /ㅗ/의 F1, F3, F4 등에서 통계적으로 유의한 차이가 관찰되었다(p<.05). 논의 및 결론: 실이 음성의 포먼트 주파수는 공명, 음원으로부터 거리 등의 영향을 받아 주파수가 모아진다. 이러한 변화는 음색 및 개인 목소리의 특성을 해석하고 어음을 이해하는데 긍정적인 영향을 줄 것으로 기대된다. Objectives: Voice in the external auditory canal (EAC) is expected to change while being affected by the resonance of the concha cavity and the EAC. Acoustical analysis should include the frequency range of EAC resonance. This study aims to determine the influence of the resonance of the EAC by analyzing formant. Methods: Male voiced monophthongs were used in this study; the most frequently used vowels were /a/, /i/, /u/, /e/, /o/. Experimental voice in the real ear and sound field was recorded by 12 healthy young female subjects. Voice characteristics were analyzed by Praat (ver. 6.0.19). The formant frequency of the sample and experimental voice were analyzed with descriptive statistics. The relationship between the sample voice and experimental voice was analyzed by a paired t-test. Results: The voices between the sound field and real ear demonstrated significant differences at F3 and F4 of /a/, F2, F3, and F4 of /i/, all formant frequencies of /u/, F2 and F4 of /e/, and F1, F3, and F4 of /o/ (p<.05). Conclusion: Voice in the real ear is collected under the influence of resonances, distance from the sound source, and rounding. Understanding these changes is expected to improve the analysis of timbre and individual voices and speech understanding.

디지털트윈 시티 구축을 위한 3D 데이터 구축기술 및 서비스 현황

남상관 한국경영정보학회 2021 한국경영정보학회 학술대회논문집 Vol.2021 No.6

증폭장치 사용 난청 청년의 삶의 질

허승덕(Seung-Deok Heo) 한국언어청각임상학회 2018 Communication Sciences and Disorders Vol.23 No.3

배경 및 목적: 청력손실은 증폭장치로 보상할 수 있으며, 청력손실을 효과적으로 보상하면 난청자(person with hearing impaired, HI) 의 삶의 질(quality of life, QOL)도 개선할 수 있다. 이를 위해서는 증폭기를 사용하고 있는 난청자(HI)들의 QOL을 분석할 필요가 있다. 이 연구는 난청 청년(HI_youth)의 QOL을 알아보는 데 있다. 방법: 참가자는 SNS 서비스를 통해 무작위로 선정된 20세부터 29세 사이의 성인으로 하였다. 이들은 청력손실이 없는 46명과 보청기나 인공와우를 사용하고 있는 19명의 두 군으로 구분하였다. 설문은 World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF)을 사용하였다. 응답은 신뢰도를 분석하였고(Cronbach’s α=.923), 두 군 사이 관계는 일원분산 분석하였다. 결과: 두 군 사이에는 신체적 범주에서 유의한 차이가 관찰되었다(p < .05). 하위 항목에서 ‘청력손실이 일을 방해 한다’ (p =.000), ‘보청기가 필요하다’ (p =.000) (이상 신체적 범주), ‘삶이 충분히 의미 있다’ (p =.013) (이상 심리적 범주), ‘안전한 삶’ (p =.012), ‘정보 접근성’ (p =.010), ‘지역 의료서비스 만족도’ (p =.017) (이상 환경 조건) 등이 유의하였 다. 논의 및 결론: 난청 청년들은 증폭장치 사용, 안전한 삶, 정보 및 의료서비스 접근, 삶의 의미 부분에서 다소 만족스럽지 못한 평가를 내렸다. Objectives: It is possible to compensate for hearing loss with an amplification system. When the hearing loss is compensated for effectively, the quality of life (QOL) of a person with a hearing impairment can be improved. In the interest of this improvement, it is necessary to analyze the QOL of hearing impaired (HI) individuals who are using an amplifier. This study aims to examine the QOL of HI-youth. Methods: The participants were adult males and females, aged 20- to 29-year-old who were randomly selected through a social network service (SNS). They were classified into two groups: 19 participants who were using a hearing aid and/or cochlear implant, and 46 participants who had no hearing loss. The questionnaire that was used was the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). Response reliability was analyzed with Cronbach’s α (= .923), response scores were analyzed with descriptive statistics, and a one-way analysis of variance was used to analyze the relationship between two groups. Results: When the two groups were compared, there was a significant difference in the average response scores regarding physical health according to category of the participants (p < .05). Significant differences were also observed in the sub-domains, including ‘hearing loss disturbs mywork’ (p = .000), ‘the hearing aid is needed’ (p = .000) (physical domain), ‘life is sufficiently meaningful’ (p = .013) (psychological domain), ‘life security’ (p = .012), ‘information accessibility’ (p = .010), ‘satisfaction with local health care service’ (p = .017) (environment domain), etc. Conclusion: The responses of HI-youth indicated dissatisfaction in respect to using the amplifier, safety of life, accessibility to information and health care service, and the meaningfulness of life.

Hearing Handicap Inventory for Elderly (HHIE)로 확인한 노인성 난청 실태

허승덕(Seung Deok Heo) 한국언어청각임상학회 2017 Communication Sciences and Disorders Vol.22 No.1

배경 및 목적: 이 연구는 수정한 우리말 Hearing Handicap Inventory for Elderly (HHIE)를 스마트폰 기반으로 조사하여 도시 및 도농 지역 노인성 난청 실태를 확인하고자 한다. 방법: 연구 대상은 도시 지역 거주 65세 이상 92명으로 하였다. 이들은 나이에 따라 65-69세를 1군, 70-79세를 2군, 80세 이상을 3군으로 각각 분류하였다. 설문은 증폭기 사용자 10명을 제외한 82명을 조사하였고, 응답은 79명이 완성하였다. 내적타당도는 Cronbach s alpha coefficient로(α=.918), 난청 의심 기준은 18점 이상으로 하였다. 난청 실태는 증폭기 사용자와 모든 설문을 응답한 89명을 대상으로 분석하였다(one-way ANOVA, Pearson 상관분석). 결과: HHIE로 확인한 유소견자 비율은 1군부터 16.7%, 25.5%, 45%로 집단 간 차이가 있었고(p=.003), 나이가 들수록 유의하게 높아졌다(r=.392, p=.01). 증폭기 사용자를 포함한 난청 실태는 같은 순서로, 22.2%, 37.3%, 60%로 집단 간 차이가 있었고(p=.004), 나이가 들수록 유의하게 증가하였다(r=.319, p=.01). 논의 및 결론: 노인성 난청은 나이가 들어가면서 급격하게 증가하고 있으며, HHIE는 청력검사와 마찬가지로 유용한 청각선별 도구로 사용할 수 있다. Objectives: The goal of this study is to discern the effects of age-related hearing loss using the Hearing Handicap Inventory for Elderly (HHIE) via a smartphone platform with elderly individuals who are urban residents. Methods: Ninety-two elderly 65 years of age or older participated in this study, divided into groups by age. Group 1 subjects were 65 to 69 years, group 2 subjects were 70 to 79 years, and group 3 were 80 years or older. The questionnaire surveyed 82 participants excluding 10 amplifier users; 79 participants completed the questionnaire. The internal consistency marker was Cronbach s alpha coefficient (α=.918), and the criterion for suspected hearing loss criteria was 18 points or more. The status of presbycusis was analyzed in 89 subjects who were amplified users and completed questionnaires (one-way ANOVA, Pearson correlation analysis). Results: The rate of suspected hearing loss confirmed by HHIE was 16.7% in group 1, 25.5% in group 2, and 45% in group 3, respectively. The rate increased with age significantly (r=.392, p=.01). The status of presbycusis including amplifier users was 22.2%, 37.3%, and 60 % in the same order. The status of presbycusis also increased with age significantly (r=.319, p=.01). Conclusion: Presbycusis increases rapidly with age, and HHIE can be a useful tool for hearing screening of the elderly.

인공와우 이식 수술 중 확인한 비정상 전극 저항 1례

허승덕(Seung-Deok Heo),이상흔(Sang-Heun Lee) 단국대학교 특수교육연구소 2021 특수교육논총 Vol.37 No.1

연구목적: 인공와우 수술 과정에서는 생체 이물, 구조상 변형 등의 문제가 생길 수 있다. 생체 이물은 뼈 가루, 혈액, 조직 등이 있으며, 전극의 접점을 차단하기도 한다. 변형은 전극 틀의 뒤틀림, 구부러짐, 꺽임 등이 있으며, 전류 흐름을 왜곡시키기도 한다. 접점이 차단되거나 전류 흐름이 왜곡되면, 와우축으로 향하는 전류전도효율과 주파수 분해능을 낮아지게 하여 전반적인 수행력을 저하시킨다. 시행한 전극-조직 간 저항(이하 저항)을 수술 중 시행하면, 전극 틀의 삽입 상태를 예측하는데 도움이 된다. 이 연구 목적은 수술 중 저항이 높은 전극의 재삽입 결정에 대해 알아보는데 있다. 연구방법: 연구 대상은 고도 이상의 후천성 난청으로 인공와우(MedEl Synchrony, Flex 28)를 왼쪽으로 이식한 여자 1명(60세)이었다. 연구는 impedance 결과를 후향적으로 분석하였다. 연구결과: 연구 결과, 저항은 2, 3, 4, 5번 채널에서 22.8, 22.7, 22.9, 22.8 ㏀ 이상, 나머지 채널에서 1.48-5.32 ㏀ 범위로 관찰되었다. 결론: 결론적으로, 저항이 높은 전극의 재삽입 결정은 와우의 해부학적 구조와 수술 중 특이 사항 등을 함께 고려하는 것이 필요하다. Purpose: In cochlear implant surgery, a number of complications may arise, including biological foreign body (FB) and structural deformation (deform). FB would has bone dust, blood, tissue, etc., and It’s blocks the contact electrodes. Deform includes twist, curvature, and kinking of the electrode array, and may seriously distort the current flow. If the contact is cut off or the current flow is distorted, the current efficiency and frequency selectivity to the modiolus are lowered, thereby reducing overall auditory performances. If the electrode-to-tissue impedance during surgery can help to predict the insertion of the electrode array. The aims of this study is to investigate the determination of reinsertion of high-impedance electrodes during surgery. Method: The participant was 1 woman (60 years old) who had a cochlear implantation (MedEl Synchrony, Flex 28) to the left for severely acquired hearing loss. The study was analyzed the impedance results retrospectively. Result: As a result, the impedance was observed more than 22.8, 22.7, 22.9, 22.8 ㏀ for channel 2, 3, 4, and 5, respectively, and in the range of 1.48-5.32 ㏀ for the other electrode channels. Conclusion: It is necessary to consider the anatomy of the cochlea and the process of insertion during surgery to determine the reinsertion of the high-impedance electrode array.

객관적 평가를 이용한 과대 난청 평가

허승덕(Seung-Deok Heo),이재명(Jae-Myeong Lee),박지상(Ji-Sang Park),최아현(Ah-Hyun Choi),강명구(Myung-Koo Kang) 한국언어청각임상학회 2008 Communication Sciences and Disorders Vol.13 No.3

배경 및 목적: 이 연구는 사회경제적 이득을 목적으로 방문한 피 검자의 순음청력검사(pure tone audiometry: PTA, 이하 PTA) 반응 양상, 어음청력검사(speech audiometry: SA, 이하 SA) 그리고 청성뇌간유발반응(auditory brainstem response: ABR, 이하 ABR) 결과들을 이용하여 사청 비율과 과대 난청 정도를 예측하고자 수행되었다. 방법: 2006년 6월 부터 2007년 9월까지 청각학적 진단을 위해 방문하였던 18.4세부터 86.9세 사이의 54(남 48, 여 6)명 의 의무기록을 후향적으로 분석하였다. 이들의 반응 양상을 기준으로 사청군과 대조군으로 분류하 고 두 군간 차이를 통계학적으로 검증하였다. 결과: 하강법과 상승법 반응 역치의 차이는 1㎑에서 사청군이 24.77㏈, 대조군이 -1.11㏈의 유의한 차이를 보였다(p < .001). 검사간 차이로 반응 역치 평균 (pure tone averages: PTAs, 이하 PTAs)인 2 PTAs 와 어음청취역치(speech reception threshold: SRT, 이하 SRT; p < .001), ABR 역치와 high 3 PTAs (p = .002), ABR 역치와 SRT (p < .001)는 모 두 통계학적으로 유의하였다. 논의 및 결론: 이 연구에서 확인한 사청비율은 84.48%였으며, 이들의 과대 난청 정도는 상승법 반응 역치를 기준으로 34.48(±22.79)㏈이었다. Background & Objectives: This study was performed to investigate the rate of malingering deafness and to predict the degree of exaggerated-hearing loss using pattern of response of pure tone audiometry(PTA), speech audiometry(SA) and auditory brainstem response (ABR) in subjects with a purpose of socioeconomic benefit. Methods: We reviewed the medical records of 54 subjects. The subjects were divided into the malingering group and the control group in accordance with pattern of response. These results were analyzed statistically. Results: The responded-thresholds of ascending and descending methods in 1 kHz between the malingering group and the control group were significantly different. The differences between 2 PTAs(pure tone averages between 0.5 and 1kHz) and SRT(speech reception threshold) (P < .001), ABR threshold and high 3 PTAs(pure tone averages between 0.5, 1 and 2kHz) (P = .002), ABR threshold and SRT (P < .001) were statistically significant. Discussion & Conclusion: It was concluded that the rate of malingering deafness was 84.48%, and the degree of exaggerated-hearing loss was 34.48dB respondedthreshold of ascending method.

○○ 요양병원 재원 노인의 청각선별 결과

허승덕(Heo, Seung-Deok) 대한치료과학회 2021 대한치료과학회지 Vol.13 No.1

Objective: The elderly hearing in nursing hospital is important for care giving and communication with their family. This study aims to investigate the elderly hearing in the nursing hospital with the otoacoustic emission (OAE). Participants & Method: 58 of whom aged from 65 to 91 were analyzed for the results. The signal-to- noise ratio (SNR) was used for transient evoked OAE (TEOAE) and distortion product OAE (DPOAE). OAE lower than 5 ㏈ SNR at speech and high frequency range was categorized to suspicious hearing loss. Results: It was impossible to evaluate 10.53 % and 13.16% of all participants because it was to have issues in the external and middle ear, and brain problems. The suspicious rate at TEOAE was 31.03, 8.62, 10.34, 48.28, 53.45 % at right ear and 39.66, 12.07, 13.79, 41.38, 67.24 % at left ear in 1000, 1414, 2000, 2828, and 4000 Hz. The mean of speech and high-frequency range were observed to be 15.52, 55.17 % at right ear, 15.52, 48.28 % at left ear. The dB SNR at speech range in the 60s, 70s, and 80s were significantly decreased to 16.1, 13.41, and 8.28 dB SNR, on average. Conclusion: The SNR of TEOAE was significantly lower in the high-pitched range than in the speech range according to frequency and showed a tendency to worsen with age. For hearing screening in the elderly, TEOAE is more useful than DPOAE with a higher referral rate of 81.03~98.28 %.