Effect of Test Realism on Speech-in-noise Outcomes in Bilateral Cochlear Implant Users

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Javier Badajoz-Davila ◽  
Jörg M. Buchholz
Keyword(s):  
Cochlear Implant ◽  
Speech In Noise ◽  
Bilateral Cochlear Implant

scholarly journals Improving Localization and Speech Reception in Noise for Bilateral Cochlear Implant Recipients

2019 ◽  
Vol 23 ◽  
pp. 233121651983149 ◽  
Author(s):  
Wendy B. Potts ◽  
Lakshmish Ramanna ◽  
Trevor Perry ◽  
Christopher J. Long
Keyword(s):  
Cochlear Implant ◽  
Automatic Gain Control ◽  
Gain Control ◽  
Interaural Level Difference ◽  
Mean Square ◽  
Localization Accuracy ◽  
Speech In Noise ◽  
Speech Reception ◽  
Bilateral Cochlear Implant ◽  
Comparative Survey

This study looked at different methods to preserve interaural level difference (ILD) cues for bilateral cochlear implant (BiCI) recipients. One possible distortion to ILD is from automatic gain control (AGC). Localization accuracy of BiCI recipients using default versus increased AGC threshold and linked AGCs versus independent AGCs was examined. In addition, speech reception in noise was assessed using linked versus independent AGCs and enabling and disabling Autosensitivity™ Control. Subjective information via a diary and questionnaire was also collected about maps with linked and independent AGCs during a take-home experience. Localization accuracy improved in the increased AGC threshold and the linked AGCs conditions. Increasing the AGC threshold resulted in a 4° improvement in root mean square error averaged across all speaker locations. Using linked AGCs, BiCI participants experienced an 8° improvement for all speaker locations and a 19° improvement at the speaker location most affected by the AGC. Speech reception threshold in noise improved by an average of 2.5 dB when using linked AGCs versus independent AGCs. In addition, the effect of linked AGCs on speech in noise was compared with that of Autosensitivity™ Control. The Speech, Spatial, and Qualities of Hearing Scale-12 question comparative survey showed an improvement when using maps with linked AGCs. These findings support the hypothesis that ILD cues may be preserved by increasing the AGC threshold or linking AGCs.

Comparing the Effect of Different Hearing Aid Fitting Methods in Bimodal Cochlear Implant Users

2019 ◽  
Vol 28 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Jantien L. Vroegop ◽  
J. Gertjan Dingemanse ◽  
Marc P. van der Schroeff ◽  
André Goedegebure
Keyword(s):  
Cochlear Implant ◽  
Sound Localization ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
Speech In Noise ◽  
Localization Test ◽  
Fitting Procedures ◽  
Auditory Performance ◽  
Contralateral Ear ◽  
Noise Test

PurposeThe aim of the study was to investigate the effect of 3 hearing aid fitting procedures on provided gain of the hearing aid in bimodal cochlear implant users and their effect on bimodal benefit.MethodThis prospective study measured hearing aid gain and auditory performance in a cross-over design in which 3 hearing aid fitting methods were compared. Hearing aid fitting methods differed in initial gain prescription rule (NAL-NL2 and Audiogram+) and loudness balancing method (broadband vs. narrowband loudness balancing). Auditory functioning was evaluated by a speech-in-quiet test, a speech-in-noise test, and a sound localization test. Fourteen postlingually deafened adult bimodal cochlear implant users participated in the study.ResultsNo differences in provided gain and in bimodal performance were found for the different hearing aid fittings. For all hearing aid fittings, a bimodal benefit was found for speech in noise and sound localization.ConclusionOur results confirm that cochlear implant users with residual hearing in the contralateral ear substantially benefit from bimodal stimulation. However, on average, no differences were found between different types of fitting methods, varying in prescription rule and loudness balancing method.

scholarly journals Electro-haptic hearing: Speech-in-noise performance in cochlear implant users is enhanced by tactile stimulation of the wrists

2019 ◽  
Author(s):  
Mark D. Fletcher ◽  
Amatullah Hadeedi ◽  
Tobias Goehring ◽  
Sean R Mills
Keyword(s):  
Cochlear Implant ◽  
Speech Intelligibility ◽  
Tactile Stimulation ◽  
Electrical Signal ◽  
Noise Performance ◽  
Speech In Noise ◽  
Non Invasive ◽  
Real World Application ◽  
Before And After ◽  
Stimulation Of

Cochlear implant (CI) users receive only limited sound information through their implant, which means that they struggle to understand speech in noisy environments. Recent work has suggested that combining the electrical signal from the CI with a haptic signal that provides crucial missing sound information (“electro-haptic stimulation”; EHS) could improve speech-in-noise performance. The aim of the current study was to test whether EHS could enhance speech-in-noise performance in CI users using: (1) a tactile signal derived using an algorithm that could be applied in real time, (2) a stimulation site appropriate for a real-world application, and (3) a tactile signal that could readily be produced by a compact, portable device. We measured speech intelligibility in multi-talker noise with and without vibro-tactile stimulation of the wrist in CI users, before and after a short training regime. No effect of EHS was found before training, but after training EHS was found to improve the number of words correctly identified by an average of 8.3 %-points, with some users improving by more than 20 %-points. Our approach could offer an inexpensive and non-invasive means of improving speech-in-noise performance in CI users.

Evaluation of Automatic Directional Processing with Cochlear Implant Recipients

2021 ◽  
Vol 32 (08) ◽  
pp. 478-486
Author(s):  
Lisa G. Potts ◽  
Soo Jang ◽  
Cory L. Hillis
Keyword(s):  
Signal Processing ◽  
Speech Recognition ◽  
Cochlear Implant ◽  
Mixed Model ◽  
Dynamic Range ◽  
Individual Variability ◽  
Noise Performance ◽  
Mixed Model Analysis ◽  
Speech In Noise ◽  
Speech Recognition In Noise

Abstract Background For cochlear implant (CI) recipients, speech recognition in noise is consistently poorer compared with recognition in quiet. Directional processing improves performance in noise and can be automatically activated based on acoustic scene analysis. The use of adaptive directionality with CI recipients is new and has not been investigated thoroughly, especially utilizing the recipients' preferred everyday signal processing, dynamic range, and/or noise reduction. Purpose This study utilized CI recipients' preferred everyday signal processing to evaluate four directional microphone options in a noisy environment to determine which option provides the best speech recognition in noise. A greater understanding of automatic directionality could ultimately improve CI recipients' speech-in-noise performance and better guide clinicians in programming. Study Sample Twenty-six unilateral and seven bilateral CI recipients with a mean age of 66 years and approximately 4 years of CI experience were included. Data Collection and Analysis Speech-in-noise performance was measured using eight loudspeakers in a 360-degree array with HINT sentences presented in restaurant noise. Four directional options were evaluated (automatic [SCAN], adaptive [Beam], fixed [Zoom], and Omni-directional) with participants' everyday use signal processing options active. A mixed-model analysis of variance (ANOVA) and pairwise comparisons were performed. Results Automatic directionality (SCAN) resulted in the best speech-in-noise performance, although not significantly better than Beam. Omni-directional performance was significantly poorer compared with the three other directional options. A varied number of participants performed their best with each of the four-directional options, with 16 performing best with automatic directionality. The majority of participants did not perform best with their everyday directional option. Conclusion The individual variability seen in this study suggests that CI recipients try with different directional options to find their ideal program. However, based on a CI recipient's motivation to try different programs, automatic directionality is an appropriate everyday processing option.

scholarly journals Computer-Based Connected-Text Training of Speech-in-Noise Perception for Cochlear Implant Users

2019 ◽  
Vol 23 ◽  
pp. 233121651984387 ◽  
Author(s):  
Tim Green ◽  
Andrew Faulkner ◽  
Stuart Rosen
Keyword(s):  
Cochlear Implant ◽  
Cognitive Abilities ◽  
Digit Span ◽  
Clinical Intervention ◽  
Primary Outcome Measure ◽  
Training Performance ◽  
Sentence Recognition ◽  
Speech In Noise ◽  
Connected Text ◽  
Computer Based

An interactive method for training speech perception in noise was assessed with adult cochlear implant users. The method employed recordings of connected narratives divided into phrases of 4 to 10 words, presented in babble. After each phrase, the listener identified key words from the phrase from among similar sounding foil words. Nine postlingually deafened adult cochlear implant users carried out 12 hr of training over a 4-week period. Training was carried out at home on tablet computers. The primary outcome measure was sentence recognition in babble. Vowel and consonant identification in speech-shaped noise were also assessed, along with digit span in noise, intended as a measure of some important underlying cognitive abilities. Talkers for speech tests were different from those used in training. To control for procedural learning, the test battery was administered repeatedly prior to training. Performance was assessed immediately after training and again after a further 4 weeks during which no training occurred. Sentence recognition in babble improved significantly after training, with an improvement in speech reception threshold of approximately 2 dB, which was maintained at the 4-week follow-up. There was little evidence of improvement in the other measures. It appears that the method has potential as a clinical intervention. However, the underlying sources of improvement and the extent to which benefits generalize to real-world situations remain to be determined.

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