scholarly journals Bimodal Hearing in Individuals with Severe-to-Profound Hearing Loss: Benefits, Challenges, and Management

2018 ◽  
Vol 39 (04) ◽  
pp. 405-413 ◽  
Author(s):  
M. Dunbar ◽  
Sarah Warren
Keyword(s):  
Cochlear Implant ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Sound Quality ◽  
Profound Hearing Loss ◽  
Speech Understanding In Noise ◽  
Outcomes Measures ◽  
Spatial Sound ◽  
Integration Management ◽  
Bimodal Hearing

AbstractBinaural hearing offers numerous advantages over monaural hearing. While bilateral implants are a successful treatment option for some patients, many individuals choose to achieve binaural hearing by using a cochlear implant with a contralateral hearing aid. Compared with monaural hearing, benefits of bimodal hearing include improved speech perception in quiet and in noise, improved localization, and more natural sound quality. Despite the advantages, there exist disadvantages to bimodal hearing, primarily related to binaural integration. Management of these devices can be challenging in that the hearing aid and cochlear implant may be managed by different clinicians. When fitting devices, strategies are recommended to optimize the integration of input from both devices. In managing bimodal devices, recommended outcomes measures include those that would reflect bimodal benefit, such as speech understanding in noise and spatial sound quality perception.

scholarly journals Efficacy of Auditory Verbal Therapy on Listening and Linguistic Skills of a Child with Bimodal Hearing

2021 ◽  
Vol 28 (3) ◽  
pp. 277-281
Author(s):  
Joyanta Chandra Mandal ◽  
Indranil Chatterjee ◽  
Suman Kumar ◽  
Shilpi Chakraborty
Keyword(s):  
Early Intervention ◽  
Language Development ◽  
Cochlear Implant ◽  
Performance Indicator ◽  
Hearing Aid ◽  
Speech And Language ◽  
Profound Hearing Loss ◽  
Linguistic Skills ◽  
Auditory Verbal Therapy ◽  
Bimodal Hearing

Introduction This study aimed to document the effect of Auditory Verbal Therapy (AVT) with proper assessment and management in early intervention of a child with bimodal hearing. Bimodal Hearing is the use of a cochlear implant in one ear and a hearing aid in the opposite ear. Auditory Verbal Therapy is a highly specialist early intervention programme which equips parents with the skills to maximise their deaf child’s speech and language development. Case Report A male child aged 5 years 1 month had bilateral severe to profound hearing loss and speech-language problem. He was using cochlear implant in the right ear and BTE hearing aid in left ear (Bimodal hearing). Speech and language assessment revealed delayed semantic, syntax and pragmatic skills. Assessment of language development test showed poor receptive and expressive language score. The functional auditory performance indicator score indicated poor auditory function. Auditory verbal therapy hierarchy plan was used for treatment. Post 15 sessions after applying AVT the child’s listening and linguistic skills showed a great improvement. Discussion The scales used to measure the efficacy of AVT are found to be useful for the assessment and goal setting for intervention. Thus, appropriate quantification of various aspects of communication skills may describe its potential impact in this case under ADIP scheme.

scholarly journals When to provide bimodal stimulation in unilateral cochlear implant recepients

2016 ◽  
Vol 3 (1) ◽  
pp. 128
Author(s):  
Poonam Raj ◽  
Ruchika Mittal
Keyword(s):  
Cochlear Implant ◽  
Hearing Aid ◽  
Noisy Environment ◽  
Implant Surgery ◽  
Maximum Benefit ◽  
Cochlear Implant Surgery ◽  
Group 2 ◽  
Achieve Maximum Benefit ◽  
Group 1 ◽  
Bimodal Hearing

<p class="abstract"><strong>Background:</strong> With the steady increase in unilateral cochlear implant surgery as management of bilateral sensorineural hearing loss, the benefits of bimodal hearing have been well documented. However very few studies are available on the timing of bimodal hearing stimulation after cochlear implantation. The present study deals with when to provide bimodal hearing in unilaterally implanted children to achieve maximum benefit<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> This study was carried out in 120 children aged between 3-5 years who underwent unilateral cochlear implant surgery. The implant was switched-on two weeks after surgery in all cases. The children were randomized into two groups of 60 each. Group 1 comprised of children who continued to use hearing aid in the non-implanted ear immediately after the cochlear implant surgery. Group 2 children discontinued using hearing aid in the non-implanted ear after surgery and restarted its usage after four weeks of switch on of the cochlear implant. The progress in both groups was monitored using category of auditory performance (CAP) scores and through a questionnaire<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> The mean age of the children was 3.55 years. 11.6 % of the recipients could localize sounds and 5% could understand speech in noisy environment in Group 2 whereas in 1.7% of the recipients could localize sounds and none of the recipient could understand speech in noisy environment in Group 1 after 3 months of follow up.  CAP scores increased steadily in Group 2 over the study period whereas Group 1 recipients did not show the same progress<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> We recommend that bimodal fitting should be the standard practice for clinical management of children who receive unilateral cochlear implant. The best practice is to restart the use of the hearing aid in the non-implanted ear, after one month of activation of the implant to achieve maximum benefit<span lang="EN-IN">.</span></p>

scholarly journals Recognition and Localization of Speech by Adult Cochlear Implant Recipients Wearing a Digital Hearing Aid in the Nonimplanted Ear (Bimodal Hearing)

2009 ◽  
Vol 20 (06) ◽  
pp. 353-373 ◽  
Author(s):  
Lisa G. Potts ◽  
Margaret W. Skinner ◽  
Ruth A. Litovsky ◽  
Michael J. Strube ◽  
Francis Kuk
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Repeated Measures ◽  
Dynamic Range ◽  
Hearing Aid ◽  
Bilateral Stimulation ◽  
Bimodal Condition ◽  
Digital Hearing Aid ◽  
Loudness Growth ◽  
Bimodal Hearing

Background: The use of bilateral amplification is now common clinical practice for hearing aid users but not for cochlear implant recipients. In the past, most cochlear implant recipients were implanted in one ear and wore only a monaural cochlear implant processor. There has been recent interest in benefits arising from bilateral stimulation that may be present for cochlear implant recipients. One option for bilateral stimulation is the use of a cochlear implant in one ear and a hearing aid in the opposite nonimplanted ear (bimodal hearing). Purpose: This study evaluated the effect of wearing a cochlear implant in one ear and a digital hearing aid in the opposite ear on speech recognition and localization. Research Design: A repeated-measures correlational study was completed. Study Sample: Nineteen adult Cochlear Nucleus 24 implant recipients participated in the study. Intervention: The participants were fit with a Widex Senso Vita 38 hearing aid to achieve maximum audibility and comfort within their dynamic range. Data Collection and Analysis: Soundfield thresholds, loudness growth, speech recognition, localization, and subjective questionnaires were obtained six–eight weeks after the hearing aid fitting. Testing was completed in three conditions: hearing aid only, cochlear implant only, and cochlear implant and hearing aid (bimodal). All tests were repeated four weeks after the first test session. Repeated-measures analysis of variance was used to analyze the data. Significant effects were further examined using pairwise comparison of means or in the case of continuous moderators, regression analyses. The speech-recognition and localization tasks were unique, in that a speech stimulus presented from a variety of roaming azimuths (140 degree loudspeaker array) was used. Results: Performance in the bimodal condition was significantly better for speech recognition and localization compared to the cochlear implant–only and hearing aid–only conditions. Performance was also different between these conditions when the location (i.e., side of the loudspeaker array that presented the word) was analyzed. In the bimodal condition, the speech-recognition and localization tasks were equal regardless of which side of the loudspeaker array presented the word, while performance was significantly poorer for the monaural conditions (hearing aid only and cochlear implant only) when the words were presented on the side with no stimulation. Binaural loudness summation of 1–3 dB was seen in soundfield thresholds and loudness growth in the bimodal condition. Measures of the audibility of sound with the hearing aid, including unaided thresholds, soundfield thresholds, and the Speech Intelligibility Index, were significant moderators of speech recognition and localization. Based on the questionnaire responses, participants showed a strong preference for bimodal stimulation. Conclusions: These findings suggest that a well-fit digital hearing aid worn in conjunction with a cochlear implant is beneficial to speech recognition and localization. The dynamic test procedures used in this study illustrate the importance of bilateral hearing for locating, identifying, and switching attention between multiple speakers. It is recommended that unilateral cochlear implant recipients, with measurable unaided hearing thresholds, be fit with a hearing aid.

scholarly journals Speech and Sound Quality Recognition in Adults Bimodal Cochlear Implant Listeners

2021 ◽  
Vol 17 (2) ◽  
pp. 198-205
Author(s):  
Leehwa Park ◽  
Soo Hee Oh
Keyword(s):  
Cochlear Implant ◽  
Sound Pressure ◽  
Hearing Aid ◽  
Sound Quality ◽  
Pressure Level ◽  
Story Comprehension ◽  
Monosyllabic Word ◽  
Quality Dimensions ◽  
Basic Evaluation

Purpose: Recent bimodal studies identified a lack of bimodal evaluation and fitting protocols to improve bimodal benefits. The purpose of this study is to measure bimodal benefits in speech and sound quality recognition and identify bimodal fitting issues with adult cochlear implant listeners to establish bimodal fitting guidelines and evaluation protocol.Methods: A total of 20 adult cochlear implant users were participated in this study. The experimental procedures included basic evaluation, hearing aid evaluation, and bimodal benefits evaluation. In order to evaluate bimodal benefits, speech and sound quality recognition tests were performed. Matrix sentences in quiet and noise (5 and 10 dB sound pressure level), consonant-vowel-consonant words, and story comprehension tasks were provided. Participants judged sound qualities for six sound quality dimensions and a tester performed real ear measurements to verify hearing aid gains.Results: Results showed that bimodal listeners had some bimodal benefits in the sentence and monosyllabic word recognition in quiet. The benefits of sound quality judgments were also observed for six sound quality dimensions. Bimodal cochlear implant listeners of this study demonstrated less real-ear insertion gains than target gains across test frequencies.Conclusion: Speech and sound quality recognition tests are useful tools to measure bimodal benefits. Additional care for bimodal listeners is needed to optimize bimodal fitting and improve the quality of bimodal hearing aid fitting services.

scholarly journals An introductory overview of bimodal fitting

2021 ◽  
Author(s):  
Mahdieh Hasanalifard ◽  
Younes Lotfi ◽  
Abdollah Moossavi
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Residual Hearing ◽  
Sound Perception ◽  
Speech Perception In Noise ◽  
Musical Perception ◽  
Introductory Overview ◽  
Wide Range

Background and Aim: In a bimodal fitting, one ear is stimulated acoustically with a hearing aid and the other is stimulated electrically with a cochlear implant. This paper provides a brief summary of the concept of bimodal fitting, binaural hearing and its importance, the hearing benefits of binaural hearing in bimodal fitting, candidacy and hearing aid adjustment in bimodal fitting cases. Recent Findings: Researches have shown that bimodal fitting offers a wide range of hearing benefits over unilateral cochlear implants, such as better speech perception in noise, better musical perception, and a better understanding of pitch and tone perception and naturalness of sound perception. Conclusion: Considering the binaural hearing advantages in bimodal fitting users, it can be concluded that users of unilateral cochlear implants who have measurable residual hearing in their non-implanted ear can use a hearing aid in that ear and enjoy binaural hearing advantages. The hearing aid should be fitted in a way to complement the information obtained through cochlear implantation. Keywords: Bimodal fitting; cochlear implant; binaural hearing

scholarly journals Transitioning From Bimodal to Bilateral Cochlear Implant Listening: Speech Recognition and Localization in Four Individuals

2014 ◽  
Vol 23 (1) ◽  
pp. 79-92 ◽  
Author(s):  
Lisa G. Potts ◽  
Ruth Y. Litovsky
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Hearing Aid ◽  
Strong Preference ◽  
Bilateral Stimulation ◽  
Test Procedures ◽  
Performance Differences ◽  
Bilateral Cochlear Implant ◽  
Better Than ◽  
Bimodal Hearing

Purpose The use of bilateral stimulation is becoming common for cochlear implant (CI) recipients with either (a) a CI in one ear and a hearing aid (HA) in the nonimplanted ear (CI&HA—bimodal) or (b) CIs in both ears (CI&CI—bilateral). The objective of this study was to evaluate 4 individuals who transitioned from bimodal to bilateral stimulation. Method Participants had completed a larger study of bimodal hearing and subsequently received a second CI. Test procedures from the bimodal study, including roaming speech recognition, localization, and a questionnaire (the Speech, Spatial, and Qualities of Hearing Scale; Gatehouse & Noble, 2004) were repeated after 6–7 months of bilateral CI experience. Results Speech recognition and localization were not significantly different between bimodal and unilateral CI. In contrast, performance was significantly better with CI&CI compared with unilateral CI. Speech recognition with CI&CI was significantly better than with CI&HA for 2 of 4 participants. Localization was significantly better for all participants with CI&CI compared with CI&HA. CI&CI performance was rated as significantly better on the Speech, Spatial, and Qualities of Hearing Scale compared with CI&HA. Conclusions There was a strong preference for CI&CI for all participants. The variability in speech recognition and localization, however, suggests that performance under these stimulus conditions is individualized. Differences in hearing and/or HA history may explain performance differences.

Qualification of unilateral cochlear implant recipients for a second device

2019 ◽  
Vol 73 (6) ◽  
pp. 8-17 ◽  
Author(s):  
Maria Drela ◽  
Karolina Haber ◽  
Iwona Wrukowska ◽  
Michael Puricelli ◽  
Anna Sinkiewicz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Short Interval ◽  
Binaural Hearing ◽  
Speech Development ◽  
Vestibular Organ ◽  
Profound Hearing Loss ◽  
Potential Benefits ◽  
Effective Use

Introduction: Although it is recommended to perform cochlear implantation in both ears at the same time for management of profound hearing loss in children, many centers prefer to perform sequential implantation. There are many reasons as to why a simultaneous bilateral implantation is not commonly accepted and performed. The major risk is the possibility of bilateral vestibular organ impairment. However, it is beyond doubt that children who received the first implant should be given a chance for binaural hearing and associated benefits. In the literature, there are no homogenous criteria for bilateral implantation, and it is hard to find uniform and convincing algorithms for second cochlear implantation. The aim of this study is an attempt to identify a safe way of qualifying for second cochlear implantation in children. Material and methods: Forty children with one cochlear implant were qualified for the second implantation. During qualification, the following were taken into account: time of the first implantation, audiometry results, use of the hearing aid in the ear without an implant and benefit of the device, speech and hearing development, and vestibular organ function. R esults: Fifteen out of forty children (38%) were qualified for the second implantation. In 35% of children, the decision was delayed with possible second implantation in the future. Eleven children (27%) were disqualified from the second surgery. Discussion: During evaluation according to the protocol presented in our study, 38% of children with a single cochlear implant were qualified for the second implantation with a chance for an optimal development and effective use of the second cochlear implant. We are convinced that sequential implantation with a short interval between surgeries and with an examination of the vestibular organ, hearing and speech development as well as an assessment of potential benefits from the second implant (bimodal stimulation) before the second implantation is the safest and most beneficial solution for children with severe hearing loss.

Sound Localization and Binaural Hearing in Children with a Hearing Aid and a Cochlear Implant

2010 ◽  
Vol 15 (1) ◽  
pp. 36-43 ◽  
Author(s):  
J. Beijen ◽  
A.F.M. Snik ◽  
L.V. Straatman ◽  
E.A.M. Mylanus ◽  
L.H.M. Mens
Keyword(s):  
Cochlear Implant ◽  
Sound Localization ◽  
Hearing Aid ◽  
Binaural Hearing

scholarly journals Comparison of Speech Perception Abilities of Children using Bimodal Hearing with Children using Cochlear Implant Alone

2020 ◽  
Author(s):  
Gauri Belsare ◽  
Sharda Sarda ◽  
Prakash Bhardwaj ◽  
Sai Belsare
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Test Pattern ◽  
Hearing Aid ◽  
Pattern Perception ◽  
Oral Performance ◽  
Identification Test ◽  
Monosyllabic Words ◽  
Age Range ◽  
Bimodal Hearing

Abstract Introduction There are very few studies comparing speech perception abilities of children using bimodal hearing over monaural cochlear implant and factors related to benefit of bimodal hearing. The aim of this study is to compare speech perception abilities of children using bimodal fitting versus children using cochlear implant alone and explore factors related to benefit of bimodal hearing. Materials and Methods In the present study, 20 cochlear implantees with the hearing age range of 3 to 8 years were included. Speech perception performance was assessed by means of Parent’s Evaluation of Aural/Oral Performance of Children scale and early speech perception (ESP) test: Pattern Perception Words, Monosyllabic Words, Bisyllabic, and Trisyllabic Words Identification test. ESP test was carried out in two conditions cochlear implant with hearing aid in opposite ear (CIHA), bimodal, and cochlear implant (CI) alone. Aided audiometry was also carried out in above mentioned two conditions. Results and Discussion On aided audiometry test, aided thresholds were improved by 5 to 6 dB in CIHA condition as compared to CI alone condition in 14 out of 20 children. Whereas on speech perception test, there was a significant improvement of 15 to 20% on domains of ESP test in these children. Factors such as implant age, chronological age, and number of hours of hearing aid usage were not significantly associated with benefit. Nevertheless aided threshold at 4,000 Hz was found to be significantly associated with bimodal benefit. Conclusion Bimodal hearing is beneficial in most of the children than monaural hearing through cochlear implant.

Bilateral Digital Hearing Aids for Binaural Hearing

1994 ◽  
Vol 73 (3) ◽  
pp. 176-179 ◽  
Author(s):  
Barry P. Kimberley ◽  
Rob Dymond ◽  
Abram Gamer
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Digital Signal ◽  
Binaural Hearing ◽  
Hearing Impaired ◽  
Digital Hearing Aids ◽  
Speech Understanding In Noise ◽  
Psychophysical Testing ◽  
Localization Performance ◽  
Localization Ability

The rehabilitation of binaural hearing performance in hearing impaired listeners has received relatively little attention to date. Both localization ability and speech-understanding-in noise are affected in the impaired listener. When localization performance is tested in impaired ears with conventional hearing aid fittings it is found to be worse than the unaided condition. Advances in electronic design now permit speculation about the implementation of complex digital filters within the confines of an in-the-ear hearing aid. We have begun exploring strategies to enhance the localization performance of impaired listeners with bilateral digital signal processing. We are examining three strategies in bilateral hearing aid design to improve localization performance in hearing impaired listeners, namely 1) more accurate fitting of individual ear losses, 2) equalization of the effect of the hearing aid itself on the acoustics within the ear canal, and 3) binaural fitting strategies which in effect modify individual ear fittings to enhance localization performance. The results of early psychophysical testing suggests that localization performance can be improved with these strategies.

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