보청기 사용에 대한 임상적 고찰

Abstract

[한글]

최근 보청기의 수요와 공급의 증가로 난청치료에 지대한 영향을 주게 되었으며, 1970년 이래로 보청기의 보급이 증가됨에 따라 잘못 알거나 잘못 조작함으로서 충분한 보청효과를 얻기에 미흡한 점이 있었다.

이에 연세대학교 의과대학 이비인후과 교실에서는 1973년 3월부터 1975년 3월까지 만 2년간 의사의 처방없이 직접구입한 대상과 본 교실에서 처방한 처방구입군으로 나누워 비교검토하였으며 다음과 같은 결과를 얻어 문헌고찰과 함께 보고하는 바이다.

1) 직접구입군의 24.3%에서만 청력검사를 하였을 뿐 나머지 대부분은 청력 검사없이 직접 보청기 상으로부터 구입하였다.

2) 1970년 이후 우리나라에서도 보청기의 수요가 급격히 증가하고 있다.

3) 90% 이상이 강력형인 주머니형을 착용하고 있다.

4) 80% 이상이 감음신경성 난청이였으며 전음성난청은 1예도 없었다.

5) 취학전 연령군에서 54.7%가 농이였고 보청기없이는 대화가 불가능한 환자이였다. 또한 성인 연령군에서는 29.5%가 농으로 취학적 연령군보다 다소 낮은 현상을 보였다.

이와같은 결과는 성인에 있어서는 경한 난청에도 보청기를 착용하는 경향이 있다.

6) 직접구입군에서 보청효과를 보면, 만족하다가 13.5%, 다소 도움을 주었다가 64.9% 인데 반해 처방구입군에서는 어음탐지역치 및 어음청취역치로 볼 때 30∼40 dB의 증진을 보였으나 어음 판별역치는 일반적으로 감소현상을 보였으며 이는 청능훈련을 통해 많이 개선될 것으로 생각된다.

7) 취학전 연령군, 특히 3세 이하에서 청력 검사를 통한 보청기의 처방이 가능하게 되었으므로 농아교육에 대한 밝은 전망을 보였다.

[영문]

With the growing number of demand and interest for hearing aid, it has become a one of the major field of interest for hard of hearing problem.

Although there are rapidly increasing demand and supply of this hearing aid since early 1970th, there are many misunderstanding and mismanagement of these hearing aids among user and even doctors.

For these reasons the authors et al. had established hearing aid clinic in department of E.N.T. Severance Hospital in 1973 and had a questionaire study of the recent trend and actuality of hearing aid use in Korea and compaired these data as a direct purchase group with the result of clinical fitting method which we adapted since 1973.

The results were as follows;

1. Only 24.3% of direct purchase group may had audiologic test at hospital and the remainder had purchased it directly from the unqualified hearing aid dealer.

2. The hearing aid supply has rapidly grown since 1970 in Korea.

3. More than 90% of hearing aids were pocket type with strong gain.

4. Hearing loss type of clinical fitting group were; over 80% were sensory-neural and no one case of conductive hearing loss.

5. Degree of hearing loss were;

Among the children of preschool age; 54.7% were profound hearing loss and the remainder were also more than moderately severe which were unable to communicate without hearing aid. On the otherhand, only 29.5% of adult group were profound deaf and the remainder were diversely distributed even down to mild hearing loss. This result was interpreted as the child were hearing aid only when they are absolutely indicated and the adult were whenever they need it according to their business and social activity.

6. Degree of help among direct purchase group were;

Very satisfactory-13.5%, Some help-64.9% and among clinical fitting group; all of them had gain for speech detection or speech reception threshold averaging 30 to 40 dB.

But interestingly enough most of them except profound sensory-neural hearing loss group had rather loss of discrimination score.

There were interpreted as they may be caused by unadapted distorted electric sound and they may show increasement after auditory training.

7. The result which we could test early child even under 3 years old and can fit hearing aid with fair result were considered to be the great step up for hard of hearing problem.