A meta-analysis to compare speech recognition in noise with bilateral cochlear implants and bimodal stimulation

A meta-analytic approach was used to examine sixteen peer-reviewed publications related to speech-recognition performance in noise at fixed signal-to-noise ratios for participants who use bilateral cochlear implants (CIs) or bimodal stimulation. Two hundred eighty-seven analyses were conducted to compare the underlying contributions of binaural summation, binaural squelch, and the head-shadow effect compared to monaural conditions (CI or hearing aid). The analyses revealed an overall significant effect for binaural summation, binaural squelch, and head shadow for the bilateral and bimodal listeners relative to monaural conditions. In addition, all within-condition (bilateral or bimodal) comparisons were significant for the three binaural effects, with the exception of the bimodal condition compared to a monaural CI. No significant differences were detected between the bilateral and bimodal listeners for any of the binaural phenomena. Clinical implications and recommendations are discussed as they relate to empirical findings. Se utilizó un enfoque de meta-análisis para examinar dieciséis publicaciones con revisión editorial relacionadas con el desempeño en reconocimiento del lenguaje en medio de ruido a tasas de señal-ruido fijas, para participantes que usaban implantes cocleares bilaterales (IC) o estimulación bimodal. Se condujeron doscientos ochenta y siete análisis para comparar la contribución subyacente de la sumación bi-auricular, el chapoteo bi-auricular, y el efecto de sombra de la cabeza, en comparación con las condiciones mono-auriculares (IC y auxiliar auditivo). El análisis reveló un efecto global significativo para la sumación bi-auricular, el chapoteo bi-auricular y la sombra de la cabeza para el sujeto con audición bilateral y bimodal, en relación con las condiciones monoauriculares. Además, todas las comparaciones dentro de la misma condición (bilateral o bimodal) fueron significativas para los tres efectos bi-auriculares, con la excepción de la condición bimodal, comparada con un IC monoauricular. No se detectaron diferencias significativas entre sujetos en condición bilateral y bimodal para ninguno de los fenómenos bi-auriculares. Las implicaciones clínicas y las recomendaciones se discuten en tanto se relacionan con los hallazgos empíricos.

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

Journal of the American Academy of Audiology ◽

10.3766/jaaa.20.7.3 ◽

2009 ◽

Vol 20 (07) ◽

pp. 409-421 ◽

Cited By ~ 43

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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Restricted Speech Recognition in Noise and Quality of Life of Hearing-Impaired Children and Adolescents With Cochlear Implants – Need for Studies Addressing This Topic With Valid Pediatric Quality of Life Instruments

Frontiers in Psychology ◽

10.3389/fpsyg.2019.02085 ◽

2019 ◽

Vol 10 ◽

Cited By ~ 1

Author(s):

Maria Huber ◽

Clara Havas

Keyword(s):

Quality Of Life ◽

Speech Recognition ◽

Children And Adolescents ◽

Cochlear Implants ◽

Hearing Impaired ◽

Speech Recognition In Noise ◽

Impaired Children ◽

Quality Of Life Instruments ◽

Hearing Impaired Children

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A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance

Journal of Speech Language and Hearing Research ◽

10.1044/2016_jslhr-h-16-0175 ◽

2017 ◽

Vol 60 (1) ◽

pp. 276-287 ◽

Cited By ~ 12

Author(s):

Ruth M. Reeder ◽

Jill B. Firszt ◽

Jamie H. Cadieux ◽

Michael J. Strube

Keyword(s):

Longitudinal Study ◽

Speech Recognition ◽

Cochlear Implants ◽

Time Course ◽

Prospective Longitudinal Study ◽

Bilateral Cochlear Implants ◽

Hearing Aid Use ◽

Contralateral Ear ◽

Second Year ◽

Prospective Longitudinal

PurposeWhether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities.MethodA prospective longitudinal study included 24 bilaterally implanted children (mean ear surgeries at 5.11 and 14.25 years). Test intervals were every 3–6 months through 24 months postbilateral. Test conditions were each ear and bilaterally for speech recognition and localization.ResultsOverall, the rate of progress for the second implanted ear was gradual. Improvements in quiet continued through the second year of bilateral use. Improvements in noise were more modest and leveled off during the second year. On all measures, results from the second ear were poorer than the first. Bilateral scores were better than either ear alone for all measures except sentences in quiet and localization.ConclusionsOlder sequentially implanted children with several years between surgeries may obtain speech understanding in the second implanted ear; however, performance may be limited and rate of progress gradual. Continued contralateral ear hearing aid use and reduced time between surgeries may enhance outcomes.

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List Equivalency of the AzBio Sentence Test in Noise for Listeners with Normal-Hearing Sensitivity or Cochlear Implants

Journal of the American Academy of Audiology ◽

10.3766/jaaa.23.7.2 ◽

2012 ◽

Vol 23 (07) ◽

pp. 501-509 ◽

Cited By ~ 15

Author(s):

Erin C. Schafer ◽

Jody Pogue ◽

Tyler Milrany

Keyword(s):

Speech Recognition ◽

Cochlear Implants ◽

Repeated Measures ◽

Normative Data ◽

Normal Hearing ◽

Published Data ◽

Repeated Measures Design ◽

Published Evidence ◽

Starting Point ◽

Speech Recognition In Noise

Background: Speech recognition abilities of adults and children using cochlear implants (CIs) are significantly degraded in the presence of background noise, making this an important area of study and assessment by CI manufacturers, researchers, and audiologists. However, at this time there are a limited number of fixed-intensity sentence recognition tests available that also have multiple, equally intelligible lists in noise. One measure of speech recognition, the AzBio Sentence Test, provides 10-talker babble on the commercially available compact disc; however, there is no published evidence to support equivalency of the 15-sentence lists in noise for listeners with normal hearing (NH) or CIs. Furthermore, there is limited or no published data on the reliability, validity, and normative data for this test in noise for listeners with CIs or NH. Purpose: The primary goals of this study were to examine the equivalency of the AzBio Sentence Test lists at two signal-to-noise ratios (SNRs) in participants with NH and at one SNR for participants with CIs. Analyses were also conducted to establish the reliability, validity, and preliminary normative data for the AzBio Sentence Test for listeners with NH and CIs. Research Design: A cross-sectional, repeated measures design was used to assess speech recognition in noise for participants with NH or CIs. Study Sample: The sample included 14 adults with NH and 12 adults or adolescents with Cochlear Freedom CI sound processors. Participants were recruited from the University of North Texas clinic population or from local CI centers. Data Collection and Analysis: Speech recognition was assessed using the 15 lists of the AzBio Sentence Test and the 10-talker babble. With the intensity of the sentences fixed at 73 dB SPL, listeners with NH were tested at 0 and −3 dB SNRs, and participants with CIs were tested at a +10 dB SNR. Repeated measures analysis of variance (ANOVA) was used to analyze the data. Results: The primary analyses revealed significant differences in performance across the 15 lists on the AzBio Sentence Test for listeners with NH and CIs. However, a follow-up analysis revealed no significant differences in performance across 10 of the 15 lists. Using the 10, equally-intelligible lists, a comparison of speech recognition performance across the two groups suggested similar performance between NH participants at a −3 dB SNR and the CI users at a +10 SNR. Several additional analyses were conducted to support the reliability and validity of the 10 equally intelligible AzBio sentence lists in noise, and preliminary normative data were provided. Conclusions: Ten lists of the commercial version of the AzBio Sentence Test may be used as a reliable and valid measure of speech recognition in noise in listeners with NH or CIs. The equivalent lists may be used for a variety of purposes including audiological evaluations, determination of CI candidacy, hearing aid and CI programming considerations, research, and recommendations for hearing assistive technology. In addition, the preliminary normative data provided in this study establishes a starting point for the creation of comprehensive normative data for the AzBio Sentence Test.

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Speech Recognition and Subjective Perceptions of Neck-Loop FM Receivers With Cochlear Implants

American Journal of Audiology ◽

10.1044/1059-0889(2012/11-0032) ◽

2013 ◽

Vol 22 (1) ◽

pp. 53-64 ◽

Cited By ~ 5

Author(s):

Erin C. Schafer ◽

Christy Huynh ◽

Denise Romine ◽

Rebecca Jimenez

Keyword(s):

Speech Recognition ◽

Cochlear Implants ◽

Rating Scale ◽

Subjective Rating ◽

Trial Period ◽

Noisy Environments ◽

Subjective Perceptions ◽

Before And After ◽

Subjective Rating Scale ◽

Speech Recognition In Noise

Purpose The goal of this investigation was to determine the potential benefit of using electromagnetically coupled frequency modulation (FM) neck-loop receivers to address common communication difficulties of adults and adolescents with cochlear implants (CIs). Method Fourteen participants with CIs used the neck-loop FM receiver for a trial period and participated in pre- and posttrial sessions consisting of speech-recognition-in-noise measures with and without the FM system and a subjective rating scale. Most participants also recorded their experiences during the FM-system trial period in a journal. Results The results suggested significantly improved speech recognition in noise with the neck-loop FM system before and after the trial period, with no changes in performance between test sessions. On average, the rating scale and journals revealed improvements with the FM system, relative to the CI alone, in noisy environments or situations at a distance from the primary talker or sound source. Conclusion The results of the study suggest that neck-loop FM receivers significantly improved speech recognition in noise and everyday listening challenges of people using the CIs in 2 separate test sessions. Additional research is warranted for other types of neck-loop receivers and CI sound processors.

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Speech Recognition Abilities of Adults Using Cochlear Implants with FM Systems

Journal of the American Academy of Audiology ◽

10.3766/jaaa.15.10.3 ◽

2004 ◽

Vol 15 (10) ◽

pp. 678-691 ◽

Cited By ~ 35

Author(s):

Erin C. Schafer ◽

Linda M. Thibodeau

Keyword(s):

Speech Recognition ◽

Cochlear Implants ◽

Sound Field ◽

Normal Hearing ◽

Classroom Setting ◽

Percent Correct ◽

Word Repetition ◽

Hearing In Noise ◽

Noise Test ◽

Speech Recognition In Noise

Speech recognition was evaluated for ten adults with normal hearing and eight adults with Nucleus cochlear implants (CIs) at several different signal-to-noise ratios (SNRs) and with three frequency modulated (FM) system arrangements: desktop, body worn, and miniature direct connect. Participants were asked to repeat Hearing in Noise Test (HINT) sentences presented with speech noise in a classroom setting and percent correct word repetition was determined. Performance was evaluated for both normal-hearing and CI participants with the desktop soundfield system. In addition, speech recognition for the CI participants was evaluated using two FM systems electrically coupled to their speech processors. When comparing the desktop sound field and the No-FM condition, only the listeners with normal hearing made significant improvements in speech recognition in noise. When comparing the performance across the three FM conditions for the CI listeners, the two electrically coupled FM systems resulted in significantly greater improvements in speech recognition in noise relative to the desktop soundfield system.

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