目的:采用病例对照研究方法分析单侧先天性小耳畸形外耳道闭锁患者与听力正常者在安静及噪声环境中言语识别率(SDS)的差异,了解单侧外耳道闭锁患者在噪声下的言语识别结果,为临床早期干预提供科学依据。方法:单侧先天性小耳畸形合并外耳道闭锁患者(畸形组)20例,同时选取年龄完全匹配的正常受试者20例作为对照组,应用普通话言语测听材料,在声场下测试所有受试者安静及噪声环境中的SDS。结果:声场内安静条件下70dB SPL给声,畸形组与对照组的SDS比较差异无统计学意义。信噪分离时,畸形组(言语信号在患侧、噪声在健侧)与对照组(右侧言语声刺激,左侧噪声刺激)比较差异有统计学意义(单音节、双音节、语句;S/N=0和S/N=-10)(P<0.05);当畸形组言语信号刺激健侧、噪声刺激患侧时,两组比较差异无统计学意义。信噪同侧时,两组的单音节词的SDS差异有统计学意义(S/N=0和S/N=-5)(P<0.05),而双音节词和语句的SDS差异无统计学意义(P>0.05)。结论:单侧先天性小耳畸形外耳道闭锁患者在噪声条件下SDS低于正常受试者。对患耳听力进行干预可提高患者噪声条件下的SDS。 OBJECTIVE: To analyze the difference of Speech Recognition (SDS) between quiet and noisy patients with unilateral congenital small ear malformations in patients with unilateral ear canal atresia and understand the speech recognition results under noise of patients with unilateral external auditory canal obstruction by case-control study. Provide a scientific basis for clinical early intervention. Methods: Twenty patients with unilateral congenital malformations of the ear canal (deformity group) with 20 cases of congenital malformations of the external ear were selected. At the same time, 20 normal subjects with complete age were selected as the control group. All subjects SDS in quiet and noisy environment. Results: There was no significant difference in SDS between the deformity group and the control group in the sound field under the quiet condition of 70 dB SPL. There was significant difference between the normal group (verbal signal at the affected side and noise at the contralateral side) and the control group (verbal stimulation at the right and noise stimulation at the left) at the time of signal-to-noise separation (monosyllable, disyllable, sentence; S / N = 0 and S / N = -10) (P <0.05). There was no significant difference between the two groups when the speech signal of the deformity group stimulated the contralateral side and the noise stimulated the affected side. There were significant differences in SDS between two groups of monosyllabic words (S / N = 0 and S / N = -5) (P <0.05), while there was no statistical difference in SDS disyllabic words and sentences Significance (P> 0.05). CONCLUSIONS: Patients with unilateral congenital malformations of ear canal atresia have lower SDS than normal subjects under noise conditions. Interfering with hearing loss can increase SDS in patients with noisy conditions.