scholarly journals The Effect of Binaural Beamforming Technology on Speech Intelligibility in Bimodal Cochlear Implant Recipients

2018 ◽  
Vol 23 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Jantien L. Vroegop ◽  
Nienke C. Homans ◽  
André Goedegebure ◽  
J. Gertjan Dingemanse ◽  
Teun van Immerzeel ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Repeated Measures ◽  
Speech Intelligibility ◽  
Real Life ◽  
Speech Comprehension ◽  
Noise Sources ◽  
Additional Advantage ◽  
Listening Condition ◽  
Repeated Measures Design ◽  
Speech Reception Thresholds

Although the benefit of bimodal listening in cochlear implant users has been agreed on, speech comprehension remains a challenge in acoustically complex real-life environments due to reverberation and disturbing background noises. One way to additionally improve bimodal auditory performance is the use of directional microphones. The objective of this study was to investigate the effect of a binaural beamformer for bimodal cochlear implant (CI) users. This prospective study measured speech reception thresholds (SRT) in noise in a repeated-measures design that varied in listening modality for static and dynamic listening conditions. A significant improvement in SRT of 4.7 dB was found with the binaural beamformer switched on in the bimodal static listening condition. No significant improvement was found in the dynamic listening condition. We conclude that there is a clear additional advantage of the binaural beamformer in bimodal CI users for predictable/static listening conditions with frontal target speech and spatially separated noise sources.

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 Bimodal Cochlear Implant Listeners’ Ability to Perceive Minimal Audible Angle Differences

2019 ◽  
Vol 30 (08) ◽  
pp. 659-671 ◽  
Author(s):  
Ashley Zaleski-King ◽  
Matthew J. Goupell ◽  
Dragana Barac-Cikoja ◽  
Matthew Bakke
Keyword(s):  
Cochlear Implant ◽  
Sound Localization ◽  
Repeated Measures ◽  
Free Field ◽  
Low Frequency ◽  
Spatial Location ◽  
Speech Understanding ◽  
Repeated Measures Design ◽  
Acoustic Environments ◽  
The Right

AbstractBilateral inputs should ideally improve sound localization and speech understanding in noise. However, for many bimodal listeners [i.e., individuals using a cochlear implant (CI) with a contralateral hearing aid (HA)], such bilateral benefits are at best, inconsistent. The degree to which clinically available HA and CI devices can function together to preserve interaural time and level differences (ITDs and ILDs, respectively) enough to support the localization of sound sources is a question with important ramifications for speech understanding in complex acoustic environments.To determine if bimodal listeners are sensitive to changes in spatial location in a minimum audible angle (MAA) task.Repeated-measures design.Seven adult bimodal CI users (28–62 years). All listeners reported regular use of digital HA technology in the nonimplanted ear.Seven bimodal listeners were asked to balance the loudness of prerecorded single syllable utterances. The loudness-balanced stimuli were then presented via direct audio inputs of the two devices with an ITD applied. The task of the listener was to determine the perceived difference in processing delay (the interdevice delay [IDD]) between the CI and HA devices. Finally, virtual free-field MAA performance was measured for different spatial locations both with and without inclusion of the IDD correction, which was added with the intent to perceptually synchronize the devices.During the loudness-balancing task, all listeners required increased acoustic input to the HA relative to the CI most comfortable level to achieve equal interaural loudness. During the ITD task, three listeners could perceive changes in intracranial position by distinguishing sounds coming from the left or from the right hemifield; when the CI was delayed by 0.73, 0.67, or 1.7 msec, the signal lateralized from one side to the other. When MAA localization performance was assessed, only three of the seven listeners consistently achieved above-chance performance, even when an IDD correction was included. It is not clear whether the listeners who were able to consistently complete the MAA task did so via binaural comparison or by extracting monaural loudness cues. Four listeners could not perform the MAA task, even though they could have used a monaural loudness cue strategy.These data suggest that sound localization is extremely difficult for most bimodal listeners. This difficulty does not seem to be caused by large loudness imbalances and IDDs. Sound localization is best when performed via a binaural comparison, where frequency-matched inputs convey ITD and ILD information. Although low-frequency acoustic amplification with a HA when combined with a CI may produce an overlapping region of frequency-matched inputs and thus provide an opportunity for binaural comparisons for some bimodal listeners, our study showed that this may not be beneficial or useful for spatial location discrimination tasks. The inability of our listeners to use monaural-level cues to perform the MAA task highlights the difficulty of using a HA and CI together to glean information on the direction of a sound source.

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.

Effects of a Transient Noise Reduction Algorithm on Speech Understanding, Subjective Preference, and Preferred Gain

2013 ◽  
Vol 24 (09) ◽  
pp. 845-858 ◽  
Author(s):  
Petri Korhonen ◽  
Francis Kuk ◽  
Chi Lau ◽  
Denise Keenan ◽  
Jennifer Schumacher ◽  
...  
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Speech Intelligibility ◽  
Repeated Measures Design ◽  
Subjective Preference ◽  
Listening Environments ◽  
Speech Identification ◽  
Noise Reduction Algorithm ◽  
Phoneme Identification

Background: Today's compression hearing aids with noise reduction systems may not manage transient noises effectively because of the short duration of these sounds compared to the onset times of the compressors and/or noise reduction algorithms. Purpose: The current study was designed to evaluate the effect of a transient noise reduction (TNR) algorithm on listening comfort, speech intelligibility in quiet, and preferred wearer gain in the presence of transients. Research Design: A single-blinded, repeated-measures design was used. Study Sample: Thirteen experienced hearing aid users with bilaterally symmetrical (≤7.5 dB) sensorineural hearing loss participated in the study. Results: Speech identification in quiet (no transient noise) was identical between the TNR On and the TNR Off conditions. The participants showed subjective preference for the TNR algorithm when “comfortable listening” was used as the criterion. Participants preferred less gain than the default prescription in the presence of transient noise sounds. However, the preferred gain was 2.9 dB higher when the TNR was activated than when it was deactivated. This translated to 12.1% improvement in phoneme identification over the TNR Off condition for soft speech. Conclusions: This study demonstrated that the use of the TNR algorithm would not negatively affect speech identification. The results also suggested that this algorithm may improve listening comfort in the presence of transient noise sounds and ensure consistent use of prescribed gain. Such an algorithm may ensure more consistent audibility across listening environments.

Evaluation of a Wind Noise Attenuation Algorithm on Subjective Annoyance and Speech-in-Wind Performance

2017 ◽  
Vol 28 (01) ◽  
pp. 046-057 ◽  
Author(s):  
Petri Korhonen ◽  
Francis Kuk ◽  
Eric Seper ◽  
Martin Mørkebjerg ◽  
Majken Roikjer
Keyword(s):  
Hearing Aids ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Real Life ◽  
Subjective Rating ◽  
Noise Attenuation ◽  
Wind Noise ◽  
Wind Speeds ◽  
Repeated Measures Design ◽  
Phoneme Identification

AbstractWind noise is a common problem reported by hearing aid wearers. The MarkeTrak VIII reported that 42% of hearing aid wearers are not satisfied with the performance of their hearing aids in situations where wind is present.The current study investigated the effect of a new wind noise attenuation (WNA) algorithm on subjective annoyance and speech recognition in the presence of wind.A single-blinded, repeated measures design was used.Fifteen experienced hearing aid wearers with bilaterally symmetrical (≤10 dB) mild-to-moderate sensorineural hearing loss participated in the study.Subjective rating for wind noise annoyance was measured for wind presented alone from 0° and 290° at wind speeds of 4, 5, 6, 7, and 10 m/sec. Phoneme identification performance was measured using Widex Office of Clinical Amplification Nonsense Syllable Test presented at 60, 65, 70, and 75 dB SPL from 270° in the presence of wind originating from 0° at a speed of 5 m/sec.The subjective annoyance from wind noise was reduced for wind originating from 0° at wind speeds from 4 to 7 m/sec. The largest improvement in phoneme identification with the WNA algorithm was 48.2% when speech was presented from 270° at 65 dB SPL and the wind originated from 0° azimuth at 5 m/sec.The WNA algorithm used in this study reduced subjective annoyance for wind speeds ranging from 4 to 7 m/sec. The algorithm was effective in improving speech identification in the presence of wind originating from 0° at 5 m/sec. These results suggest that the WNA algorithm used in the current study could expand the range of real-life situations where a hearing-impaired person can use the hearing aid optimally.

Basic Study Designs

2018 ◽  
pp. 68-86
Author(s):  
Alexandra Gomez ◽  
Felipe Fregni ◽  
Vera Novak ◽  
Andre Brunoni
Keyword(s):  
Repeated Measures ◽  
Real Life ◽  
Basic Study ◽  
Repeated Measures Design ◽  
Parallel Group ◽  
Control Comparison ◽  
Quasi Experimental ◽  
Comparison Trial ◽  
Study Designs

This chapter on basic study designs provides an overview of the most common design methodologies used in interventional studies. The chapter discusses both the advantages and limitations of parallel group designs (placebo or active control comparison trial, factorial design), repeated measures design (cross-over or between-subjects design), and quasi-experimental designs. It provides examples and discusses designs that are used in specific settings (for example, rare diseases, phases of dug development, and interventions in real life, including large simple trials, N-of-1). The chapter ends with a case study that illustrates the in-depth application of the available options into practice.

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 Self-Confidence and Perceptions of Athletic Training Students Following Simulated Experiences: A Mixed-Methods Pilot Study

2021 ◽  
Author(s):  
Hannah Stedge ◽  
Valerie Herzog
Keyword(s):  
Mixed Methods ◽  
Athletic Training ◽  
Clinical Education ◽  
Repeated Measures ◽  
Real Life ◽  
Future Research ◽  
High Fidelity ◽  
Athletic Training Students ◽  
Repeated Measures Design ◽  
Self Confidence

Purpose: Athletic training clinical education provides students with a variety of real-life patient encounters under the supervision of a credentialed athletic trainer. However, clinical education experiences may not allow for all students to practice more invasive or less common skills such as rectal thermometry. The purpose of this study was two-fold: 1) determine the effect of a series of low to high-fidelity simulated rectal thermometry experiences on athletic training students’ self-confidence scores; and 2) through a phenomenological qualitative approach, explore athletic training students’ perceptions following the simulated rectal thermometry experiences. Method: This study used a quasi-experimental, mixed methods, one-group repeated measures design. Participants were nine first year professional Master of Athletic Training students who completed four simulated experiences on the skill of rectal thermometry. The outcome measures were The Athletic Trainer’s Self-Confidence Scale (ATSCS) and qualitative semi-structured open-ended interviews. Results: Friedman’s ANOVA revealed a statistically significant improvement from the participant’s baseline ATSCS scores to the last post-test scores. We identified three major themes following qualitative interviews: 1) Perception changes before and after participation; 2) Benefits of a series of four simulations; 3) Explanations for the improvements in confidence and competence. Conclusions: A series of simulated learning activities using high-fidelity and standardized patient interactions can help improve athletic training students’ self-confidence. Though future research is needed, athletic training education programs should consider implementing simulated experiences to equip athletic training students to transition to practice.

scholarly journals Transient noise reduction in cochlear implant users: a multi-band approach

2016 ◽  
Vol 6 (2) ◽  
Author(s):  
Karl-Heinz Dyballa ◽  
Phillipp Hehrmann ◽  
Volkmar Hamacher ◽  
Thomas Lenarz ◽  
Andreas Buechner
Keyword(s):  
Cochlear Implant ◽  
Noise Reduction ◽  
Speech Intelligibility ◽  
Single Band ◽  
Processing Conditions ◽  
Multiple Frequency ◽  
Speech Processor ◽  
Speech Reception ◽  
Speech Reception Thresholds ◽  
Multi Band

A previously-tested transient noise reduction (TNR) algorithm for cochlear implant (CI) users was modified to detect and attenuate transients independently across multiple frequency-bands. Since speech and transient noise are often spectrally distinct, we hypothesized that benefits in speech intelligibility can be achieved over the earlier single- band design. Fifteen experienced CI users (49 to 72 years) were tested unilaterally using pre-processed stimuli delivered directly to a speech processor. Speech intelligibility in transient and soft stationary noise, subjective sound quality and the recognition of warning signals was investigated in three processing conditions: no TNR (TNRoff), single- band TNR (TNRsgl) and multi-band TNR (TNRmult). Notably, TNRmult improved speech reception thresholds (SRTs) in cafeteria noise and office noise by up to 3 dB over both TNRoff and TNRsgl, and yielded higher comfort and clarity ratings in cafeteria noise. Our results indicate that multi-band transient noise reduction may be advantageous compared to a single-band approach, and reveal a substantial overall potential for TNR to improve speech perception and listening comfort in CI users.

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.

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