Background: Difficulty understanding speech in the presence of background noise is a common report among cochlear implant (CI) recipients. Several speech-processing options designed to improve speech recognition, especially in noise, are currently available in the Cochlear Nucleus CP810 speech processor. These include adaptive dynamic range optimization (ADRO), autosensitivity control (ASC), Beam, and Zoom.
Purpose: The purpose of this study was to evaluate CI recipients’ speech-in-noise recognition to determine which currently available processing option or options resulted in best performance in a simulated restaurant environment.
Research Design: Experimental study with one study group. The independent variable was speech-processing option, and the dependent variable was the reception threshold for sentences score.
Study Sample: Thirty-two adult CI recipients.
Intervention: Eight processing options were tested: Beam, Beam + ASC, Beam + ADRO, Beam + ASC + ADRO, Zoom, Zoom + ASC, Zoom + ADRO, and Zoom + ASC + ADRO.
Data Collection and Analysis: Participants repeated Hearing in Noise Test sentences presented at a 0° azimuth, with R-Space restaurant noise presented from a 360° eight-loudspeaker array at 70 dB sound pressure level. A one-way repeated-measures analysis of variance was used to analyze differences in Beam options, Zoom options, and Beam versus Zoom options.
Results: Among the Beam options, Beam + ADRO was significantly poorer than Beam only, Beam + ASC, and Beam + ASC + ADRO. A 1.6-dB difference was observed between the best (Beam only) and poorest (Beam + ADRO) options. Among the Zoom options, Zoom only and Zoom + ADRO were significantly poorer than Zoom + ASC. A 2.2-dB difference was observed between the best (Zoom + ASC) and poorest (Zoom only) options. The comparison between Beam and Zoom options showed one significant difference, with Zoom only significantly poorer than Beam only. No significant difference was found between the other Beam and Zoom options (Beam + ASC vs Zoom + ASC, Beam + ADRO vs Zoom + ADRO, and Beam + ASC + ADRO vs Zoom + ASC + ADRO). The best processing option varied across subjects, with an almost equal number of participants performing best with a Beam option (n = 15) compared with a Zoom option (n = 17). There were no significant demographic or audiological moderating variables for any option.
Conclusions: The results showed no significant differences between adaptive directionality (Beam) and fixed directionality (Zoom) when ASC was active in the R-Space environment. This finding suggests that noise-reduction processing is extremely valuable in loud semidiffuse environments in which the effectiveness of directional filtering might be diminished. However, there was no significant difference between the Beam-only and Beam + ASC options, which is most likely related to the additional noise cancellation performed by the Beam option (i.e., two-stage directional filtering and noise cancellation). In addition, the processing options with ADRO resulted in the poorest performances. This could be related to how the CI recipients were programmed or the loud noise level used in this study. The best processing option varied across subjects, but the majority performed best with directional filtering (Beam or Zoom) in combination with ASC. Therefore in a loud semidiffuse environment, the use of either Beam + ASC or Zoom + ASC is recommended.
Differential recruitment of the speech processing system in healthy subjects and rehabilitated cochlear implant patients
