A systematic review of the impact of adjusting input dynamic range (IDR), electrical threshold (T) level and rate of stimulation on speech perception ability in cochlear implant users

OBJECTIVE: To evaluate telephone speech perception in individuals who received cochlear implant in the period 1993-2003. METHODS: Twenty seven CI users were divided into pre and post-lingual groups, being the speech perception assessed in two stages: first by a list of sentences imposed on speakerphone with the same mapping used to evaluate the phone and, in a second stage, using the landline, landline phone adapter with CI and cell phone. RESULTS: In the group of pre-lingual hearing loss, 75% of subjects were able to maintain a dialogue with the interlocutor and 19% did so with difficulty. In the post-lingual group, 89% were able to maintain the dialogue with the interlocutor and 11% did so with difficulty. Both groups of subjects pre and post-lingual use the phone as a media, and most have satisfactory performance without the need for aid or CI accessories. CONCLUSION: One of the benefits of the CI is to introduce the life of the hearing impaired phone use regardless of their technology and accessories, as well as with the phone adapter and cell phone. In this study, most individuals CI users showed satisfactory performance in the comprehension of sentence and questions by the telephone, with better performance, although discrete, for the group post-lingual. Thus, there is the importance of careful indication of the IC and auditory rehabilitation program that minimize the impact of deafness in the communication, especially via telephone, regardless of the time when the hearing was acquired. So, this fact improves the conditions for CI users to maintain their daily activities, following the dynamism of contemporary life.

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Population-Based Prediction of Fitting Levels for Individual Cochlear Implant Recipients

Audiology and Neurotology ◽

10.1159/000362779 ◽

2014 ◽

Vol 20 (1) ◽

pp. 1-16 ◽

Cited By ~ 8

Author(s):

Feddo B. van der Beek ◽

Jeroen J. Briaire ◽

Johan H.M. Frijns

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Predictive Models ◽

Linear Models ◽

Dynamic Range ◽

Population Based ◽

Design Data ◽

Data Set ◽

Closed Set

Objectives: This study analyzed the predictability of fitting levels for cochlear implant recipients based on a review of the clinical levels of the recipients. Design: Data containing threshold levels (T-levels) and maximum comfort levels (M-levels) for 151 adult subjects using a CII/HiRes 90K cochlear implant with a HiFocus 1/1 J electrode were used. The 10th, 25th, 50th, 75th and 90th percentiles of the T- and M-levels are reported. Speech perception of the subjects, using a HiRes speech coding strategy, was measured during routine clinical follow-up. Results: T-levels for most subjects were between 20 and 35% of their M-levels and were rarely (<1/50) below 10% of the M-levels. Furthermore, both T- and M-levels showed an increase over the first year of follow-up. Interestingly, levels expressed in linear charge units showed a clear increase in dynamic range (DR) over 1 year (29.8 CU; SD 73.0), whereas the DR expressed in decibels remained stable. T-level and DR were the only fitting parameters for which a significant correlation with speech perception (r = 0.34, p < 0.01, and r = 0.33, p < 0.01, respectively) could be demonstrated. Additionally, analysis showed that T- and M-level profiles expressed in decibels were independent of the subjects' across-site mean levels. Using mixed linear models, predictive models were obtained for the T- and M-levels of all separate electrode contacts. Conclusions: On the basis of the data set from 151 subjects, clinically applicable predictive models for T- and M-levels have been obtained. Based on one psychophysical measurement and a population-based T- or M-level profile, individual recipients' T- and M-levels can be approximated with a closed-set formula. Additionally, the analyzed fitting level data can serve as a reference for future patients. i 2014 S. Karger AG, Basel

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The impact of cochlear implant microphone settings on the binaural hearing of experienced cochlear implant users with single-sided deafness

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-020-06450-5 ◽

2020 ◽

Author(s):

Anja Kurz ◽

Maren Zanzinger ◽

Rudolf Hagen ◽

Kristen Rak

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Binaural Hearing ◽

Sound Quality ◽

Noise Sources ◽

Shadow Effect ◽

Spatial Release ◽

Release From Masking ◽

Single Sided Deafness ◽

The Impact

Abstract Objective Cochlear implantation has become a well-accepted treatment option for people with single-sided deafness (SSD) and has become a clinical standard in many countries. A cochlear implant (CI) is the only device which restores binaural hearing. The effect of microphone directionality (MD) settings has been investigated in other CI indication groups, but its impact on speech perception in noise has not been established in CI users with SSD. The focus of this investigation was, therefore, to assess binaural hearing effects using different MD settings in CI users with SSD. Methods Twenty-nine experienced CI users with SSD were recruited to determine speech reception thresholds with varying target and noise sources to define binaural effects (head shadow, squelch, summation, and spatial release from masking), sound localization, and sound quality using the SSQ12 and HISQUI19 questionnaires. Outcome measures included the MD settings “natural”, “adaptive”, and “omnidirectional”. Results The 29 participants involved in the study were divided into two groups: 11 SONNET users and 18 OPUS 2/RONDO users. In both groups, a significant head shadow effect of 7.4–9.2 dB was achieved with the CI. The MD setting “adaptive” provided a significant head shadow effect of 9.2 dB, a squelch effect of 0.9 dB, and spatial release from masking of 7.6 dB in the SONNET group. No significant summation effect could be determined in either group with CI. Outcomes with the omnidirectional setting were not significantly different between groups. For both groups, localization improved significantly when the CI was activated and was best when the omnidirectional setting was used. The groups’ sound quality scores did not significantly differ. Conclusions Adaptive directional microphone settings improve speech perception and binaural hearing abilities in CI users with SSD. Binaural effect measures are valuable to quantify the benefit of CI use, especially in this indication group.

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A Longitudinal Study of Speech Perception Skills and Device Characteristics of Adolescent Cochlear Implant Users

Journal of the American Academy of Audiology ◽

10.3766/jaaa.23.5.5 ◽

2012 ◽

Vol 23 (05) ◽

pp. 341-349 ◽

Cited By ~ 5

Author(s):

Elizabeth J. Robinson ◽

Lisa S. Davidson ◽

Rosalie M. Uchanski ◽

Christine M. Brenner ◽

Ann E. Geers

Keyword(s):

High School ◽

Longitudinal Study ◽

Speech Perception ◽

Cochlear Implant ◽

Dynamic Range ◽

Elementary Grades ◽

Comfort Levels ◽

Technology Type ◽

Over Time ◽

Technology Map

Background: For pediatric cochlear implant (CI) users, CI processor technology, map characteristics, and fitting strategies are known to have a substantial impact on speech perception scores at young ages. It is unknown whether these benefits continue over time as these children reach adolescence. Purpose: To document changes in CI technology, map characteristics, and speech perception scores in children between elementary grades and high school, and to describe relations between map characteristics and speech perception scores over time. Research Design: A longitudinal design with participants 8–9-yr-old at session 1 and 15–18-yr-old at session 2. Study Sample: Participants were 82 adolescents with unilateral CIs, who are a subset of a larger longitudinal study. Mean age at implantation was 3.4 yr (range: 1.7–5.4), and mean duration of device use was 5.5 yr (range: 3.8–7.5) at session 1 and 13.3 yr (range: 10.9–15) at session 2. Data Collection and Analysis: Speech perception tests at sessions 1 and 2 were the Lexical Neighborhood Test (LNT) presented at 70 dB SPL (LNT-70) and Bamford-Kowal-Bench sentences in quiet (BKB-Q) presented at 70 dB SPL. At session 2, the LNT was also administered at 50 dB SPL (LNT-50), and BKB sentences were administered in noise with a +10 dB SNR (BKB-N). CI processor technology type and CI map characteristics (coding strategy, number of electrodes, threshold levels, and comfort levels) were obtained at both sessions. Electrical dynamic range was computed, and descriptive statistics, correlations, and repeated-measures ANOVAs were employed. Results: Participants achieved significantly higher LNT and BKB scores, at 70 dB SPL, at ages 15–18 than at ages 8–9 yr. Forty-two participants had 1–3 electrodes either activated or deactivated in their map between test sessions, and 40 had no change in number of active electrodes (mean change: −0.5; range: −3 to +2). After conversion from arbitrary clinical map units to charge-per-phase in nanocoulombs (nC), no significant difference was found for T levels across time. Average comfort levels (C levels) decreased by 19 nC. Seventy-three participants (89%) upgraded their CI processor technology type. At both sessions, significant correlations were found between electrical dynamic range (EDR) and all speech perception measures except LNT-50 (r range: .31 to .47; p < 0.01). Similarly, significant correlations were also found between C levels and all speech perception measures (r range: .29 to .49; p < 0.01). At session 2, a significant correlation was found between processor technology type and the LNT-50 scores (r = .38; p < 0.01). Conclusions: Significant improvement in speech scores was observed between elementary grades and high school for children who had used a CI since preschool. On average, T levels (nC) and electrode function remained stable for these long-term pediatric users. Analyses of maps did not allow for the determination of the exact cause of C level reductions, though power limitations in new processor systems and changes in perceived loudness over time are possible. Larger EDRs and higher C levels were associated with better speech scores. Newer speech processor technology was associated with better speech scores at a softer level.

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Effect of Increased IIDR in the Nucleus Freedom Cochlear Implant System

Journal of the American Academy of Audiology ◽

10.3766/jaaa.18.9.6 ◽

2007 ◽

Vol 18 (09) ◽

pp. 777-793 ◽

Cited By ~ 18

Author(s):

Laura K. Holden ◽

Margaret W. Skinner ◽

Marios S. Fourakis ◽

Timothy A. Holden

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Dynamic Range ◽

Sound Field ◽

The Other ◽

Threshold Levels ◽

Speech In Noise ◽

El Sistema ◽

Initial Activation ◽

Implant System

The objective of this study was to evaluate the effect of the increased instantaneous input dynamic range (IIDR) in the Nucleus Freedom cochlear implant (CI) system on recipients' ability to perceive soft speech and speech in noise. Ten adult Freedom CI recipients participated. Two maps differing in IIDR were placed on each subject's processor at initial activation. The IIDR was set to 30 dB for one map and 40 dB for the other. Subjects used both maps for at least one month prior to speech perception testing. Results revealed significantly higher scores for words (50 dB SPL), for sentences in background babble (65 dB SPL), and significantly lower sound field threshold levels with the 40 compared to the 30 dB IIDR map. Ceiling effects may have contributed to non-significant findings for sentences in quiet (50 dB SPL). The Freedom's increased IIDR allows better perception of soft speech and speech in noise. El objetivo de este estudio fue evaluar el efecto del rango dinámico aumentado instantáneo de ingreso (IIDR) en el sistema de implante coclear (IC) Nucleus Freedom, sobre la capacidad de sujetos implantados para percibir lenguaje a bajo volumen y lenguaje en ruido. Diez sujetos implantados con el IC Freedom participaron. En la activación inicial, dos mapas con una diferencia en cuanto al IIDR se colocaron en el procesador de cada sujeto. El IIDR fue ajustado a 30 dB para un mapa y a 40 dB para el otro. Los sujetos utilizaron ambos mapas por al menos un mes, antes de una evaluación de percepción del lenguaje. Los resultados revelaron puntajes significativamente más altos para palabras (50 dB SPL), para frases en balbuceo de fondo (65 dB SPL), y niveles umbrales en campo libre significativamente más bajos con el mapa de IIDR de 40 comparado con el de 30. Efectos tope pueden haber contribuido a los hallazgos no significativos para frases en silencio (50 dB SPL). El IIDR aumentado para Freedom permite mejor percepción para el lenguaje a bajo volumen y el lenguaje en medio de ruido.

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Psychoacoustic dynamic range and cochlear implant speech-perception performance in Nucleus 22 users

Cochlear Implants International ◽

10.1002/cii.279 ◽

2005 ◽

Vol 6 (S1) ◽

pp. 31-34 ◽

Cited By ~ 3

Author(s):

Ricardo Ferreira Bento ◽

Rubens Vuono De Brito Neto ◽

Arthur Menino Castilho ◽

M Valéria Schmidt Goffi Gomez ◽

Sandra Barreto Giorgi Sant'anna ◽

...

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Dynamic Range

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Interleaved Acoustic Environments: Impact of an Auditory Scene Classification Procedure on Speech Perception in Cochlear Implant Users

Trends in Hearing ◽

10.1177/23312165211014118 ◽

2021 ◽

Vol 25 ◽

pp. 233121652110141

Author(s):

Anja Eichenauer ◽

Uwe Baumann ◽

Timo Stöver ◽

Tobias Weissgerber

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Signal To Noise Ratio ◽

Scene Classification ◽

Signal To Noise ◽

Acoustic Environment ◽

The Mean ◽

Noise Ratio ◽

Acoustic Environments ◽

The Impact

Clinical speech perception tests with simple presentation conditions often overestimate the impact of signal preprocessing on speech perception in complex listening environments. A new procedure was developed to assess speech perception in interleaved acoustic environments of different complexity that allows investigation of the impact of an automatic scene classification (ASC) algorithm on speech perception. The procedure was applied in cohorts of normal hearing (NH) controls and uni- and bilateral cochlear implant (CI) users. Speech reception thresholds (SRTs) were measured by means of a matrix sentence test in five acoustic environments that included different noise conditions (amplitude modulated and continuous), two spatial configurations, and reverberation. The acoustic environments were encapsulated in a randomized, mixed order single experimental run. Acoustic room simulation was played back with a loudspeaker auralization setup with 128 loudspeakers. 18 NH, 16 unilateral, and 16 bilateral CI users participated. SRTs were evaluated for each individual acoustic environment and as mean-SRT. Mean-SRTs improved by 2.4 dB signal-to-noise ratio for unilateral and 1.3 dB signal-to-noise ratio for bilateral CI users with activated ASC. Without ASC, the mean-SRT of bilateral CI users was 3.7 dB better than the SRT of unilateral CI users. The mean-SRT indicated significant differences, with NH group performing best and unilateral CI users performing worse with a difference of up to 13 dB compared to NH. The proposed speech test procedure successfully demonstrated that speech perception and benefit with ASC depend on the acoustic environment.

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Psychoacoustic dynamic range and cochlear implant speech-perception performance in Nucleus 22 users

Cochlear Implants International ◽

10.1179/cim.2005.6.supplement-1.31 ◽

2005 ◽

Vol 6 (sup1) ◽

pp. 31-34 ◽

Cited By ~ 1

Author(s):

Ricardo Ferreira Bento ◽

Rubens Vuono De Brito Neto ◽

Arthur Menino Castilho ◽

M Valéria Schmidt Goffi Gomez ◽

Sandra Barreto Giorgi Sant'anna ◽

...

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Dynamic Range

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The Contribution of a Frequency-Compression Hearing Aid to Contralateral Cochlear Implant Performance

Journal of the American Academy of Audiology ◽

10.3766/jaaa.24.2.4 ◽

2013 ◽

Vol 24 (02) ◽

pp. 105-120 ◽

Cited By ~ 13

Author(s):

Ann E. Perreau ◽

Ruth A. Bentler ◽

Richard S. Tyler

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Hearing Aids ◽

Speech Intelligibility ◽

Hearing Aid ◽

Self Report ◽

Vowel Perception ◽

Frequency Compression ◽

Significant Difference ◽

The Impact

Background: Frequency-lowering signal processing in hearing aids has re-emerged as an option to improve audibility of the high frequencies by expanding the input bandwidth. Few studies have investigated the usefulness of the scheme as an option for bimodal users (i.e., combined use of a cochlear implant and a contralateral hearing aid). In this study, that question was posed. Purpose: The purposes of this study were (1) to determine if frequency compression was a better bimodal option than conventional amplification and (2) to determine the impact of a frequency-compression hearing aid on speech recognition abilities. Research Design: There were two separate experiments in this study. The first experiment investigated the contribution of a frequency-compression hearing aid to contralateral cochlear implant (CI) performance for localization and speech perception in noise. The second experiment assessed monaural consonant and vowel perception in quiet using the frequency-compression and conventional hearing aid without the use of a contralateral CI or hearing aid. Study Sample: Ten subjects fitted with a cochlear implant and hearing aid participated in the first experiment. Seventeen adult subjects with a cochlear implant and hearing aid or two hearing aids participated in the second experiment. To be included, subjects had to have a history of postlingual deafness, a moderate or moderate-to-severe hearing loss, and have not worn this type of frequency-lowering hearing aid previously. Data Collection and Analysis: In the first experiment, performance using the frequency-compression and conventional hearing aids was assessed on tests of sound localization, speech perception in a background of noise, and two self-report questionnaires. In the second experiment, consonant and vowel perception in quiet was assessed monaurally for the two conditions. In both experiments, subjects alternated daily between a frequency-compression and conventional hearing aid for 2 mo. The parameters of frequency compression were set individually for each subject, and audibility was measured for the frequency compression and conventional hearing aid programs by comparing estimations of the Speech Intelligibility Index (SII) using a modified algorithm (Bentler et al, 2011). In both experiments, the outcome measures were administered following the hearing aid fitting to assess performance at baseline and after 2 mo of use. Results: For this group of subjects, the results revealed no significant difference between the frequency-compression and conventional hearing aid on tests of localization and consonant recognition. Spondee-in-noise and vowel perception scores were significantly higher with the conventional hearing aid compared to the frequency-compression hearing aid after 2 mo of use. Conclusions: These results suggest that, for the subjects in this study, frequency compression is not a better bimodal option than conventional amplification. In addition, speech perception may be negatively influenced by frequency compression because formant frequencies are too severely compressed and can no longer be distinguished.

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