Benefits of Bilateral Hearing on the Telephone for Cochlear Implant Recipients

2021 ◽  
Author(s):  
Sharon Miller ◽  
Jace Wolfe ◽  
Mila Duke ◽  
Erin Schafer ◽  
Smita Agrawal ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Repeated Measures ◽  
Recognition Performance ◽  
Primary Objective ◽  
Advanced Technology ◽  
Repeated Measures Design ◽  
Telephone Speech ◽  
Speech Recognition In Noise ◽  
Sound Processor

Abstract Background Cochlear implant (CI) recipients frequently experience difficulty understanding speech over the telephone and rely on hearing assistive technology (HAT) to improve performance. Bilateral inter-processor audio streaming technology using nearfield magnetic induction is an advanced technology incorporated within a hearing aid or CI processor that can deliver telephone audio signals captured at one sound processor to the sound processor at the opposite ear. To date, limited data exist examining the efficacy of this technology in CI users to improve speech understanding on the telephone. Purpose The primary objective of this study was to examine telephone speech recognition outcomes in bilateral CI recipients in a bilateral inter-processor audio streaming condition (DuoPhone) compared with a monaural condition (i.e., telephone listening with one sound processor) in quiet and in background noise. Outcomes in the monaural and bilateral conditions using either a telecoil or T-Mic2 technology were also assessed. The secondary aim was to examine how deactivating microphone input in the contralateral processor in the bilateral wireless streaming conditions, and thereby modifying the signal-to-noise ratio, affected speech recognition in noise. Research Design A repeated-measures design was used to evaluate speech recognition performance in quiet and competing noise with the telephone signal transmitted acoustically or via the telecoil to the ipsilateral sound processor microphone in monaural and bilateral wireless streaming listening conditions. Study Sample Nine bilateral CI users with Advanced Bionics HiRes 90K and/or CII devices were included in the study. Data Collection and Analysis The effects of phone input (monaural [DuoPhone Off] vs. bilateral [DuoPhone on]) and processor input (T-Mic2 vs. telecoil) on word recognition in quiet and noise were assessed using separate repeated-measures analysis of variance. Effect of the contralateral device mic deactivation on speech recognition outcomes for the T-Mic2 DuoPhone conditions was assessed using paired Student's t-tests. Results Telephone speech recognition was significantly better in the bilateral inter-processor streaming conditions relative to the monaural conditions in both quiet and noise. Speech recognition outcomes were similar in quiet and noise when using the T-Mic2 and telecoil in the monaural and bilateral conditions. For the acoustic DuoPhone conditions using the T-Mic2, speech recognition in noise was significantly better when the microphone of the contralateral processor was disabled. Conclusion Inter-processor audio streaming allows for bilateral listening on the telephone and produces better speech recognition in quiet and in noise compared with monaural listening conditions for adult CI recipients.

Electromagnetic versus Electrical Coupling of Personal Frequency Modulation (FM) Receivers to Cochlear Implant Sound Processors

2013 ◽  
Vol 24 (10) ◽  
pp. 927-940 ◽  
Author(s):  
Erin C. Schafer ◽  
Denise Romine ◽  
Elizabeth Musgrave ◽  
Sadaf Momin ◽  
Christy Huynh
Keyword(s):  
Speech Recognition ◽  
Frequency Modulation ◽  
Repeated Measures ◽  
Rating Scale ◽  
Recognition Performance ◽  
Subjective Rating ◽  
Subjective Ratings ◽  
Primary Analysis ◽  
Repeated Measures Design ◽  
Sound Processor

Background: Previous research has suggested that electrically coupled frequency modulation (FM) systems substantially improved speech-recognition performance in noise in individuals with cochlear implants (CIs). However, there is limited evidence to support the use of electromagnetically coupled (neck loop) FM receivers with contemporary CI sound processors containing telecoils. Purpose: The primary goal of this study was to compare speech-recognition performance in noise and subjective ratings of adolescents and adults using one of three contemporary CI sound processors coupled to electromagnetically and electrically coupled FM receivers from Oticon. Research Design: A repeated-measures design was used to compare speech-recognition performance in noise and subjective ratings without and with the FM systems across three test sessions (Experiment 1) and to compare performance at different FM-gain settings (Experiment 2). Descriptive statistics were used in Experiment 3 to describe output differences measured through a CI sound processor. Study Sample: Experiment 1 included nine adolescents or adults with unilateral or bilateral Advanced Bionics Harmony (n = 3), Cochlear Nucleus 5 (n = 3), and MED-EL OPUS 2 (n = 3) CI sound processors. In Experiment 2, seven of the original nine participants were tested. In Experiment 3, electroacoustic output was measured from a Nucleus 5 sound processor when coupled to the electromagnetically coupled Oticon Arc neck loop and electrically coupled Oticon R2. Data Collection and Analysis: In Experiment 1, participants completed a field trial with each FM receiver and three test sessions that included speech-recognition performance in noise and a subjective rating scale. In Experiment 2, participants were tested in three receiver-gain conditions. Results in both experiments were analyzed using repeated-measures analysis of variance. Experiment 3 involved electroacoustic-test measures to determine the monitor-earphone output of the CI alone and CI coupled to the two FM receivers. Results: The results in Experiment 1 suggested that both FM receivers provided significantly better speech-recognition performance in noise than the CI alone; however, the electromagnetically coupled receiver provided significantly better speech-recognition performance in noise and better ratings in some situations than the electrically coupled receiver when set to the same gain. In Experiment 2, the primary analysis suggested significantly better speech-recognition performance in noise for the neck-loop versus electrically coupled receiver, but a second analysis, using the best performance across gain settings for each device, revealed no significant differences between the two FM receivers. Experiment 3 revealed monitor-earphone output differences in the Nucleus 5 sound processor for the two FM receivers when set to the +8 setting used in Experiment 1 but equal output when the electrically coupled device was set to a +16 gain setting and the electromagnetically coupled device was set to the +8 gain setting. Conclusions: Individuals with contemporary sound processors may show more favorable speech-recognition performance in noise electromagnetically coupled FM systems (i.e., Oticon Arc), which is most likely related to the input processing and signal processing pathway within the CI sound processor for direct input versus telecoil input. Further research is warranted to replicate these findings with a larger sample size and to develop and validate a more objective approach to fitting FM systems to CI sound processors.

Improving Hearing Performance for Cochlear Implant Recipients with Use of a Digital, Wireless, Remote-Microphone, Audio-Streaming Accessory

2015 ◽  
Vol 26 (06) ◽  
pp. 532-539 ◽  
Author(s):  
Jace Wolfe ◽  
Mila Morais ◽  
Erin Schafer
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Effective Means ◽  
Audio Signals ◽  
Noise Levels ◽  
Repeated Measures Design ◽  
Accessory Device ◽  
Sound Processor

Background: Cochlear implant (CI) recipients experience difficulty understanding speech in noise. Remote-microphone technology that improves the signal-to-noise ratio is recognized as an effective means to improve speech recognition in noise; however, there are no published studies evaluating the potential benefits of a wireless, remote-microphone, digital, audio-streaming accessory device (heretofore referred to as a remote-microphone accessory) designed to deliver audio signals directly to a CI sound processor. Purpose: The objective of this study was to compare speech recognition in quiet and in noise of recipients while using their CI alone and with a remote-microphone accessory. Research Design: A two-way repeated measures design was used to evaluate performance differences obtained in quiet and in increasing levels of competing noise with the CI sound processor alone and with the sound processor paired to the remote microphone accessory. Study Sample: Sixteen users of Cochlear Nucleus 24 Freedom, CI512, and CI422 implants were included in the study. Data Collection and Analysis: Participants were evaluated in 14 conditions including use of the sound processor alone and with the remote-microphone accessory in quiet and at the following signal levels: 65 dBA speech (at the location of the participant; 85 dBA at the location of the remote microphone) in quiet and competing noise at 50, 55, 60, 65, 70, and 75 dBA noise levels. Speech recognition was evaluated in each of these conditions with one full list of AzBio sentences. Results: Speech recognition in quiet and in all competing noise levels, except the 75 dBA condition, was significantly better with use of the remote-microphone accessory compared with participants’ performance with the CI sound processor alone. As expected, in all technology conditions, performance was significantly poorer as the competing noise level increased. Conclusions: Use of a remote-microphone accessory designed for a CI sound processor provides superior speech recognition in quiet and in noise when compared with performance obtained with the CI sound processor alone.

scholarly journals Speech Perception for Adult Cochlear Implant Recipients in a Realistic Background Noise: Effectiveness of Preprocessing Strategies and External Options for Improving Speech Recognition in Noise

2010 ◽  
Vol 21 (07) ◽  
pp. 441-451 ◽  
Author(s):  
René H. Gifford ◽  
Lawrence J. Revit
Keyword(s):  
Speech Recognition ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Repeated Measures ◽  
Recognition Performance ◽  
Single Subject ◽  
Repeated Measures Design ◽  
Listening Environments ◽  
Improved Performance ◽  
Listening In Noise

Background: Although cochlear implant patients are achieving increasingly higher levels of performance, speech perception in noise continues to be problematic. The newest generations of implant speech processors are equipped with preprocessing and/or external accessories that are purported to improve listening in noise. Most speech perception measures in the clinical setting, however, do not provide a close approximation to real-world listening environments. Purpose: To assess speech perception for adult cochlear implant recipients in the presence of a realistic restaurant simulation generated by an eight-loudspeaker (R-SPACE™) array in order to determine whether commercially available preprocessing strategies and/or external accessories yield improved sentence recognition in noise. Research Design: Single-subject, repeated-measures design with two groups of participants: Advanced Bionics and Cochlear Corporation recipients. Study Sample: Thirty-four subjects, ranging in age from 18 to 90 yr (mean 54.5 yr), participated in this prospective study. Fourteen subjects were Advanced Bionics recipients, and 20 subjects were Cochlear Corporation recipients. Intervention: Speech reception thresholds (SRTs) in semidiffuse restaurant noise originating from an eight-loudspeaker array were assessed with the subjects' preferred listening programs as well as with the addition of either Beam™ preprocessing (Cochlear Corporation) or the T-Mic® accessory option (Advanced Bionics). Data Collection and Analysis: In Experiment 1, adaptive SRTs with the Hearing in Noise Test sentences were obtained for all 34 subjects. For Cochlear Corporation recipients, SRTs were obtained with their preferred everyday listening program as well as with the addition of Focus preprocessing. For Advanced Bionics recipients, SRTs were obtained with the integrated behind-the-ear (BTE) mic as well as with the T-Mic. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of the preprocessing strategy or external accessory in reducing the SRT in noise. In addition, a standard t-test was run to evaluate effectiveness across manufacturer for improving the SRT in noise. In Experiment 2, 16 of the 20 Cochlear Corporation subjects were reassessed obtaining an SRT in noise using the manufacturer-suggested “Everyday,” “Noise,” and “Focus” preprocessing strategies. A repeated-measures ANOVA was employed to assess the effects of preprocessing. Results: The primary findings were (i) both Noise and Focus preprocessing strategies (Cochlear Corporation) significantly improved the SRT in noise as compared to Everyday preprocessing, (ii) the T-Mic accessory option (Advanced Bionics) significantly improved the SRT as compared to the BTE mic, and (iii) Focus preprocessing and the T-Mic resulted in similar degrees of improvement that were not found to be significantly different from one another. Conclusion: Options available in current cochlear implant sound processors are able to significantly improve speech understanding in a realistic, semidiffuse noise with both Cochlear Corporation and Advanced Bionics systems. For Cochlear Corporation recipients, Focus preprocessing yields the best speech-recognition performance in a complex listening environment; however, it is recommended that Noise preprocessing be used as the new default for everyday listening environments to avoid the need for switching programs throughout the day. For Advanced Bionics recipients, the T-Mic offers significantly improved performance in noise and is recommended for everyday use in all listening environments.

scholarly journals Speech Recognition in Noise in Single-Sided Deaf Cochlear Implant Recipients Using Digital Remote Wireless Microphone Technology

2019 ◽  
Vol 30 (07) ◽  
pp. 607-618 ◽  
Author(s):  
Thomas Wesarg ◽  
Susan Arndt ◽  
Konstantin Wiebe ◽  
Frauke Schmid ◽  
Annika Huber ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Repeated Measures ◽  
Pairwise Comparison ◽  
Noise Levels ◽  
Percent Correct ◽  
Repeated Measures Design ◽  
Wireless Microphone ◽  
Significant Difference ◽  
Speech Recognition In Noise

AbstractPrevious research in cochlear implant (CI) recipients with bilateral severe-to-profound sensorineural hearing loss showed improvements in speech recognition in noise using remote wireless microphone systems. However, to our knowledge, no previous studies have addressed the benefit of these systems in CI recipients with single-sided deafness.The objective of this study was to evaluate the potential improvement in speech recognition in noise for distant speakers in single-sided deaf (SSD) CI recipients obtained using the digital remote wireless microphone system, Roger. In addition, we evaluated the potential benefit in normal hearing (NH) participants gained by applying this system.Speech recognition in noise for a distant speaker in different conditions with and without Roger was evaluated with a two-way repeated-measures design in each group, SSD CI recipients, and NH participants. Post hoc analyses were conducted using pairwise comparison t-tests with Bonferroni correction.Eleven adult SSD participants aided with CIs and eleven adult NH participants were included in this study.All participants were assessed in 15 test conditions (5 listening conditions × 3 noise levels) each. The listening conditions for SSD CI recipients included the following: (I) only NH ear and CI turned off, (II) NH ear and CI (turned on), (III) NH ear and CI with Roger 14, (IV) NH ear with Roger Focus and CI, and (V) NH ear with Roger Focus and CI with Roger 14. For the NH participants, five corresponding listening conditions were chosen: (I) only better ear and weaker ear masked, (II) both ears, (III) better ear and weaker ear with Roger Focus, (IV) better ear with Roger Focus and weaker ear, and (V) both ears with Roger Focus. The speech level was fixed at 65 dB(A) at 1 meter from the speech-presenting loudspeaker, yielding a speech level of 56.5 dB(A) at the recipient's head. Noise levels were 55, 65, and 75 dB(A). Digitally altered noise recorded in school classrooms was used as competing noise. Speech recognition was measured in percent correct using the Oldenburg sentence test.In SSD CI recipients, a significant improvement in speech recognition was found for all listening conditions with Roger (III, IV, and V) versus all no-Roger conditions (I and II) at the higher noise levels (65 and 75 dB[A]). NH participants significantly benefited from the application of Roger in noise for higher levels, too. In both groups, no significant difference was detected between any of the different listening conditions at 55 dB(A) competing noise. There was also no significant difference between any of the Roger conditions III, IV, and V across all noise levels.The application of the advanced remote wireless microphone system, Roger, in SSD CI recipients provided significant benefits in speech recognition for distant speakers at higher noise levels. In NH participants, the application of Roger also produced a significant benefit in speech recognition in noise.

scholarly journals Effect of Microphone Configuration and Sound Source Location on Speech Recognition for Adult Cochlear Implant Users with Current-Generation Sound Processors

2020 ◽  
Vol 31 (08) ◽  
pp. 578-589
Author(s):  
Robert T. Dwyer ◽  
Jillian Roberts ◽  
René H. Gifford
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Sound Source ◽  
Repeated Measures ◽  
Source Location ◽  
Adaptive Beamforming ◽  
Ear Canal ◽  
Repeated Measures Design ◽  
Previous Generation ◽  
Sound Processor

Abstract Background Microphone location has been shown to influence speech recognition with a microphone placed at the entrance to the ear canal yielding higher levels of speech recognition than top-of-the-pinna placement. Although this work is currently influencing cochlear implant programming practices, prior studies were completed with previous-generation microphone and sound processor technology. Consequently, the applicability of prior studies to current clinical practice is unclear. Purpose To investigate how microphone location (e.g., at the entrance to the ear canal, at the top of the pinna), speech-source location, and configuration (e.g., omnidirectional, directional) influence speech recognition for adult CI recipients with the latest in sound processor technology. Research Design Single-center prospective study using a within-subjects, repeated-measures design. Study Sample Eleven experienced adult Advanced Bionics cochlear implant recipients (five bilateral, six bimodal) using a Naída CI Q90 sound processor were recruited for this study. Data Collection and Analysis Sentences were presented from a single loudspeaker at 65 dBA for source azimuths of 0°, 90°, or 270° with semidiffuse noise originating from the remaining loudspeakers in the R-SPACE array. Individualized signal-to-noise ratios were determined to obtain 50% correct in the unilateral cochlear implant condition with the signal at 0°. Performance was compared across the following microphone sources: T-Mic 2, integrated processor microphone (formerly behind-the-ear mic), processor microphone + T-Mic 2, and two types of beamforming: monaural, adaptive beamforming (UltraZoom) and binaural beamforming (StereoZoom). Repeated-measures analyses were completed for both speech recognition and microphone output for each microphone location and configuration as well as sound source location. A two-way analysis of variance using mic and azimuth as the independent variables and output for pink noise as the dependent variable was used to characterize the acoustic output characteristics of each microphone source. Results No significant differences in speech recognition across omnidirectional mic location at any source azimuth or listening condition were observed. Secondary findings were (1) omnidirectional microphone configurations afforded significantly higher speech recognition for conditions in which speech was directed to ± 90° (when compared with directional microphone configurations), (2) omnidirectional microphone output was significantly greater when the signal was presented off-axis, and (3) processor microphone output was significantly greater than T-Mic 2 when the sound originated from 0°, which contributed to better aided detection at 2 and 6 kHz with the processor microphone in this group. Conclusions Unlike previous-generation microphones, we found no statistically significant effect of microphone location on speech recognition in noise from any source azimuth. Directional microphones significantly improved speech recognition in the most difficult listening environments.

scholarly journals Effectiveness of the Directional Microphone in the ®Baha® Divino™

2010 ◽  
Vol 21 (08) ◽  
pp. 546-557 ◽  
Author(s):  
Kristi Oeding ◽  
Michael Valente ◽  
Jessica Kerckhoff
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Recognition Performance ◽  
Great Difficulty ◽  
Repeated Measures Design ◽  
Directional Microphone ◽  
Paired Samples ◽  
Speech Recognition In Noise

Background: Patients with unilateral sensorineural hearing loss (USNHL) experience great difficulty listening to speech in noisy environments. A directional microphone (DM) could potentially improve speech recognition in this difficult listening environment. It is well known that DMs in behind-the-ear (BTE) and custom hearing aids can provide a greater signal-to-noise ratio (SNR) in comparison to an omnidirectional microphone (OM) to improve speech recognition in noise for persons with hearing impairment. Studies examining the DM in bone anchored auditory osseointegrated implants (Baha), however, have been mixed, with little to no benefit reported for the DM compared to an OM. Purpose: The primary purpose of this study was to determine if there are statistically significant differences in the mean reception threshold for sentences (RTS in dB) in noise between the OM and DM in the Baha® Divino™. The RTS of these two microphone modes was measured utilizing two loudspeaker arrays (speech from 0° and noise from 180° or a diffuse eight-loudspeaker array) and with the better ear open or closed with an earmold impression and noise attenuating earmuff. Subjective benefit was assessed using the Abbreviated Profile of Hearing Aid Benefit (APHAB) to compare unaided and aided (Divino OM and DM combined) problem scores. Research Design: A repeated measures design was utilized, with each subject counterbalanced to each of the eight treatment levels for three independent variables: (1) microphone (OM and DM), (2) loudspeaker array (180° and diffuse), and (3) better ear (open and closed). Study Sample: Sixteen subjects with USNHL currently utilizing the Baha were recruited from Washington University's Center for Advanced Medicine and the surrounding area. Data Collection and Analysis: Subjects were tested at the initial visit if they entered the study wearing the Divino or after at least four weeks of acclimatization to a loaner Divino. The RTS was determined utilizing Hearing in Noise Test (HINT) sentences in the R-Space™ system, and subjective benefit was determined utilizing the APHAB. A three-way repeated measures analysis of variance (ANOVA) and a paired samples t-test were utilized to analyze results of the HINT and APHAB, respectively. Results: Results revealed statistically significant differences within microphone (p < 0.001; directional advantage of 3.2 dB), loudspeaker array (p = 0.046; 180° advantage of 1.1 dB), and better ear conditions (p < 0.001; open ear advantage of 4.9 dB). Results from the APHAB revealed statistically and clinically significant benefit for the Divino relative to unaided on the subscales of Ease of Communication (EC) (p = 0.037), Background Noise (BN) (p < 0.001), and Reverberation (RV) (p = 0.005). Conclusions: The Divino's DM provides a statistically significant improvement in speech recognition in noise compared to the OM for subjects with USNHL. Therefore, it is recommended that audiologists consider selecting a Baha with a DM to provide improved speech recognition performance in noisy listening environments.

scholarly journals Benefits in Speech Recognition in Noise with Remote Wireless Microphones in Group Settings

2020 ◽  
Vol 31 (06) ◽  
pp. 404-411 ◽  
Author(s):  
Linda M. Thibodeau
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Recognition Performance ◽  
Round Table ◽  
Group Setting ◽  
Repeated Measures Design ◽  
Wireless Microphone ◽  
Speech Recognition In Noise

Abstract Background Although hearing aids (HAs) and cochlear implants (CIs) can provide significant benefits to persons with hearing loss, users frequently report difficulty hearing in noisy environments, particularly when there are multiple talkers. Little is known about the benefits provided by currently available wireless microphones in multitalker situations. Purpose The purpose of this study was to compare the benefits received in speech recognition in noise by adults with hearing loss when using two different wireless microphone types in a simulated group setting. Research Design A quasi-experimental, repeated-measures design was used where performance in a control condition, HA/CI alone, was compared with performance in two wireless microphone intervention conditions. Study Sample Participants included ten listeners, aged 20-92 years, with bilateral sensorineural hearing loss who were experienced HA or CI users. Intervention The two wireless microphones by Phonak, Roger Pen, and Roger Select used the same digital modulation protocol to transmit the signal to compatible receivers. However, the Roger Pen operated in a fixed omnidirectional mode, whereas the Roger Select operated in an adaptive directional mode. Data Collection and Analysis Participants were asked to repeat Hearing in Noise Test sentences presented in restaurant noise in three conditions: HA/CI alone, HA/CI with a Roger Pen, or HA/CI with a Roger Select microphone placed in the center of a round table. Sentences were presented from one of five loudspeakers equally spaced with the participant, while restaurant noise was presented on each side at four signal-to-noise ratios (SNRs), including +5, 0, −5, and −10 dB. A two-way, repeated-measures analysis of variance was performed with main effects of listening condition and noise level. Results Significantly  greater speech recognition performance was achieved with the wireless microphones than with listening with just the HA or CI. Furthermore, at the −5- and −10-dB SNR conditions, the Roger Select resulted in significantly better performance than the Roger Pen microphone. Conclusions The results suggest that the Roger Select microphone can provide significant benefits in speech recognition in noise over the use of HA/CI alone (61%) and also significant benefits over the use of a Roger Pen (16%) in a simulated group dining experience.

Evaluation of Speech Recognition of Cochlear Implant Recipients Using Adaptive, Digital Remote Microphone Technology and a Speech Enhancement Sound Processing Algorithm

2015 ◽  
Vol 26 (05) ◽  
pp. 502-508 ◽  
Author(s):  
Jace Wolfe ◽  
Mila Morais ◽  
Erin Schafer ◽  
Smita Agrawal ◽  
Dawn Koch
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Repeated Measures ◽  
Processing Algorithm ◽  
Full Time ◽  
Sound Processing ◽  
Sentence Recognition ◽  
Repeated Measures Design ◽  
Simultaneous Use ◽  
Speech Recognition In Noise

Background: Cochlear implant recipients often experience difficulty with understanding speech in the presence of noise. Cochlear implant manufacturers have developed sound processing algorithms designed to improve speech recognition in noise, and research has shown these technologies to be effective. Remote microphone technology utilizing adaptive, digital wireless radio transmission has also been shown to provide significant improvement in speech recognition in noise. There are no studies examining the potential improvement in speech recognition in noise when these two technologies are used simultaneously. Purpose: The goal of this study was to evaluate the potential benefits and limitations associated with the simultaneous use of a sound processing algorithm designed to improve performance in noise (Advanced Bionics ClearVoice) and a remote microphone system that incorporates adaptive, digital wireless radio transmission (Phonak Roger). Research Design: A two-by-two way repeated measures design was used to examine performance differences obtained without these technologies compared to the use of each technology separately as well as the simultaneous use of both technologies. Study Sample: Eleven Advanced Bionics (AB) cochlear implant recipients, ages 11 to 68 yr Data Collection and Analysis: AzBio sentence recognition was measured in quiet and in the presence of classroom noise ranging in level from 50 to 80 dBA in 5-dB steps. Performance was evaluated in four conditions: (1) No ClearVoice and no Roger, (2) ClearVoice enabled without the use of Roger, (3) ClearVoice disabled with Roger enabled, and (4) simultaneous use of ClearVoice and Roger. Results: Speech recognition in quiet was better than speech recognition in noise for all conditions. Use of ClearVoice and Roger each provided significant improvement in speech recognition in noise. The best performance in noise was obtained with the simultaneous use of ClearVoice and Roger. Conclusions: ClearVoice and Roger technology each improves speech recognition in noise, particularly when used at the same time. Because ClearVoice does not degrade performance in quiet settings, clinicians should consider recommending ClearVoice for routine, full-time use for AB implant recipients. Roger should be used in all instances in which remote microphone technology may assist the user in understanding speech in the presence of noise.

Recognition of Speech from the Television with Use of a Wireless Technology Designed for Cochlear Implants

2016 ◽  
Vol 27 (05) ◽  
pp. 388-394 ◽  
Author(s):  
Mila Morais Duke ◽  
Jace Wolfe ◽  
Erin Schafer
Keyword(s):  
Speech Recognition ◽  
Repeated Measures ◽  
Light Emitting Diode ◽  
Computer Assisted ◽  
Repeated Measures Design ◽  
Sentence Level ◽  
Television Use ◽  
Speech Recognition In Noise ◽  
Sound Processor ◽  
Experience Difficulty

Background: Cochlear implant (CI) recipients often experience difficulty understanding speech in noise and speech that originates from a distance. Many CI recipients also experience difficulty understanding speech originating from a television. Use of hearing assistance technology (HAT) may improve speech recognition in noise and for signals that originate from more than a few feet from the listener; however, there are no published studies evaluating the potential benefits of a wireless HAT designed to deliver audio signals from a television directly to a CI sound processor. Purpose: The objective of this study was to compare speech recognition in quiet and in noise of CI recipients with the use of their CI alone and with the use of their CI and a wireless HAT (Cochlear Wireless TV Streamer). Research Design: A two-way repeated measures design was used to evaluate performance differences obtained in quiet and in competing noise (65 dBA) with the CI sound processor alone and with the sound processor coupled to the Cochlear Wireless TV Streamer. Study Sample: Sixteen users of Cochlear Nucleus 24 Freedom, CI512, and CI422 implants were included in the study. Data Collection and Analysis: Participants were evaluated in four conditions including use of the sound processor alone and use of the sound processor with the wireless streamer in quiet and in the presence of competing noise at 65 dBA. Speech recognition was evaluated in each condition with two full lists of Computer-Assisted Speech Perception Testing and Training Sentence-Level Test sentences presented from a light-emitting diode television. Results: Speech recognition in noise was significantly better with use of the wireless streamer compared to participants’ performance with their CI sound processor alone. There was also a nonsignificant trend toward better performance in quiet with use of the TV Streamer. Performance was significantly poorer when evaluated in noise compared to performance in quiet when the TV Streamer was not used. Conclusions: Use of the Cochlear Wireless TV Streamer designed to stream audio from a television directly to a CI sound processor provides better speech recognition in quiet and in noise when compared to performance obtained with use of the CI sound processor alone.

Evaluation of Speech Recognition in Noise with Cochlear Implants and Dynamic FM

2009 ◽  
Vol 20 (07) ◽  
pp. 409-421 ◽  
Author(s):  
Jace Wolfe ◽  
Erin C. Schafer ◽  
Benjamin Heldner ◽  
Hans Mülder ◽  
Emily Ward ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Cochlear Implants ◽  
Noise Level ◽  
Repeated Measures ◽  
Group Performance ◽  
Signal To Noise Ratio ◽  
Speech Processor ◽  
Repeated Measures Design ◽  
Hearing In Noise ◽  
Speech Recognition In Noise

Background: Use of personal frequency-modulated (FM) systems significantly improves speech recognition in noise for users of cochlear implants (CIs). Previous studies have shown that the most appropriate gain setting on the FM receiver may vary based on the listening situation and the manufacturer of the CI system. Unlike traditional FM systems with fixed-gain settings, Dynamic FM automatically varies the gain of the FM receiver with changes in the ambient noise level. There are no published reports describing the benefits of Dynamic FM use for CI recipients or how Dynamic FM performance varies as a function of CI manufacturer. Purpose: To evaluate speech recognition of Advanced Bionics Corporation or Cochlear Corporation CI recipients using Dynamic FM vs. a traditional FM system and to examine the effects of Autosensitivity on the FM performance of Cochlear Corporation recipients. Research Design: A two-group repeated-measures design. Participants were assigned to a group according to their type of CI. Study Sample: Twenty-five subjects, ranging in age from 8 to 82 years, met the inclusion criteria for one or more of the experiments. Thirteen subjects used Advanced Bionics Corporation, and 12 used Cochlear Corporation implants. Intervention: Speech recognition was assessed while subjects used traditional, fixed-gain FM systems and Dynamic FM systems. Data Collection and Analysis: In Experiments 1 and 2, speech recognition was evaluated with a traditional, fixed-gain FM system and a Dynamic FM system using the Hearing in Noise Test sentences in quiet and in classroom noise. A repeated-measures analysis of variance (ANOVA) was used to evaluate effects of CI manufacturer (Advanced Bionics and Cochlear Corporation), type of FM system (traditional and dynamic), noise level, and use of Autosensitivity for users of Cochlear Corporation implants. Experiment 3 determined the effects of Autosensitivity on speech recognition of Cochlear Corporation implant recipients when listening through the speech processor microphone with the FM system muted. A repeated-measures ANOVA was used to examine the effects of signal-to-noise ratio and Autosensitivity. Results: In Experiment 1, use of Dynamic FM resulted in better speech recognition in noise for Advanced Bionics recipients relative to traditional FM at noise levels of 65, 70, and 75 dB SPL. Advanced Bionics recipients obtained better speech recognition in noise with FM use when compared to Cochlear Corporation recipients. When Autosensitivity was enabled in Experiment 2, the performance of Cochlear Corporation recipients was equivalent to that of Advanced Bionics recipients, and Dynamic FM was significantly better than traditional FM. Results of Experiment 3 indicate that use of Autosensitivity improves speech recognition in noise of signals directed to the speech processor relative to no Autosensitivity. Conclusions: Dynamic FM should be considered for use with persons with CIs to improve speech recognition in noise. At default CI settings, FM performance is better for Advanced Bionics recipients when compared to Cochlear Corporation recipients, but use of Autosensitivity by Cochlear Corporation users results in equivalent group performance.

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