Evaluation of a BICROS System with a Directional Microphone in the Receiver and Transmitter

2015 ◽  
Vol 26 (10) ◽  
pp. 856-871 ◽  
Author(s):  
Michael Valente ◽  
Kristi Oeding
Keyword(s):  
Repeated Measures ◽  
Final Visit ◽  
Listening Condition ◽  
Sentence Recognition ◽  
Directional Microphone ◽  
Hearing In Noise ◽  
Repeated Measures Analysis ◽  
Data Collection And Analysis ◽  
Speech Recognition In Noise ◽  
Asymmetric Sensorineural Hearing Loss

Background: The bilateral contralateral routing of signals (BICROS) system has provided limited benefit for speech recognition in noise for patients with asymmetric sensorineural hearing loss, even when an automatic adaptive multichannel directional microphone (DM) is in the receiver (Rx) and an omnidirectional microphone (OM) is in the transmitter (Tx). A recent BICROS system was introduced that can be programmed with a DM in the Rx and an OM or a DM in the Tx. Purpose: To examine if significant differences in sentence recognition in noise and subjective preferences are present between an OM and an adaptive broadband DM programmed in the Tx of a BICROS system with an automatic adaptive multichannel DM programmed in the Rx. Research Design: A randomized crossover single-blind design was used to assess differences between the OM and DM programmed in the Tx. Study Sample: Eighteen adult experienced BICROS system users were recruited. Data Collection and Analysis: The BICROS system was fit using real-ear insertion gain measures. The Tx was programmed with an OM and a DM and the Rx was always programmed with an automatic adaptive multichannel DM. The order of microphone condition in the Tx was counterbalanced. Participants acclimatized to the BICROS system for 4 weeks and returned and completed the Abbreviated Profile of Hearing Aid Benefit (APHAB) for the respective microphone condition. The Tx was then programmed with the other microphone condition and participants acclimatized for another four weeks. At the final visit, the APHAB was completed for the respective microphone condition. After eight weeks of acclimatization, Hearing in Noise Test sentences were presented in the R-Space™ system with the Tx in either the OM or DM condition for three listening conditions: (1) speech from 90° to the Rx and noise from 0°, 90°, and 180° to the Tx (Sp Rx/N Tx), (2) speech from 90° to the Tx and noise from 0°, 90°, and 180° to the Rx (Sp Tx/N Rx), and (3) speech from 0° and noise from eight surrounding loudspeakers separated by 45° (diffuse). Results: A two-factor repeated measures analysis of variance revealed no significant differences between the OM and DM microphone conditions for Sp Rx/N Tx listening condition. A significant mean disadvantage of 1.9 dB (p < 0.01) was revealed for the DM compared to the OM for Sp Tx/N Rx listening condition and a mean advantage of 2.6 dB (p < 0.001) for the DM compared to the OM in a diffuse listening condition. There were no significant differences in the APHAB aided problem and resulting benefit scores between the OM and DM for the following subscales: ease of communication, background noise, reverberation, and aversiveness of sounds. Conclusions: No significant differences were revealed between OM and DM for Sp Rx/N Tx. The DM performed significantly poorer than OM for the Sp Tx/N Rx listening condition. Results revealed significant benefit for the DM compared to OM for the diffuse listening condition. No significant differences were revealed between the OM and DM on the APHAB.

Efficacy of a Reverse Cardioid Directional Microphone

2012 ◽  
Vol 23 (01) ◽  
pp. 064-073 ◽  
Author(s):  
Francis Kuk ◽  
Denise Keenan
Keyword(s):  
Repeated Measures ◽  
Nonsense Syllable ◽  
Signal To Noise Ratio ◽  
Sound Field ◽  
Directional Microphones ◽  
Sentence Recognition ◽  
Repeated Measures Design ◽  
Directional Microphone ◽  
Speech Understanding In Noise ◽  
Hearing In Noise

Background: Directional microphones have been shown to improve a listener's ability to communicate in noise by improving the signal to noise ratio. However, their efficacy may be questioned in situations where the listener needs to understand speech originating from the back. Purpose: The goal of the study was to examine the performance of a directional microphone mode that has an automatic reverse cardioid polar pattern. Research Design: A single-blinded, factorial repeated-measures design was used to study the effect of microphone modes (reverse cardioid, omnidirectional, and front hypercardioid) and stimulus azimuths (front and back) on three outcome variables (aided thresholds, nonsense syllable identification in quiet, and sentence recognition in noise). Study Sample: Twenty adults with a mild-to-severe bilaterally symmetrical (±5 dB) sensorineural hearing loss participated. Intervention: Audibility in quiet was evaluated by obtaining aided sound field thresholds and speech identification at an input level of 50 dB SPL presented at 0 and 180° azimuths. In addition, speech understanding in noise was also assessed with the Hearing In Noise Test (HINT) sentences presented at both azimuths (0 and 180°) with a diffuse noise. Data Collection and Analysis: Repeated-measures analyses of variance (ANOVAs) were conducted to examine the effects of microphone mode (omnidirectional, front hypercardioid, reverse cardioid) and stimulus azimuth (0°, 180°) on aided thresholds, nonsense syllable identification, and HINT performance. Results: Results with the reverse cardioid directional microphone in both quiet conditions were similar to the omnidirectional microphone. The results of the reverse cardioid microphone in noise were significantly better than the omnidirectional microphone and front hypercardioid microphone when speech was presented from the back (p < 0.001). Conclusions: These results support the possible benefits of a reverse cardioid directional microphone when used in specific listening situations.

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

2009 ◽  
Vol 20 (07) ◽  
pp. 409-421 ◽  
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.

Evaluation of Speech Recognition of Cochlear Implant Recipients Using a Personal Digital Adaptive Radio Frequency System

2013 ◽  
Vol 24 (08) ◽  
pp. 714-724 ◽  
Author(s):  
Jace Wolfe ◽  
Mila Morais ◽  
Erin Schafer ◽  
Emily Mills ◽  
Hans E. Mülder ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Radio Frequency ◽  
Repeated Measures ◽  
Digital System ◽  
Superior Performance ◽  
Noise Levels ◽  
Transmission Systems ◽  
Repeated Measures Design ◽  
Data Collection And Analysis ◽  
Speech Recognition In Noise

Background: Previous research supports the use of frequency modulation (FM) systems for improving speech recognition in noise of individuals with cochlear implants (CIs). However, at this time, there is no published research on the potential speech recognition benefit of new digital adaptive wireless radio transmission systems. Purpose: The goal of this study was to compare speech recognition in quiet and in noise of CI recipients while using traditional, fixed-gain analog FM systems, adaptive analog FM systems, and adaptive digital wireless radio frequency transmission systems. Research Design: A three-way repeated-measures design was used to examine performance differences among devices, among speech recognition conditions in quiet and in increasing levels of background noise, and between users of Advanced Bionics and Cochlear CIs. Study Sample: Seventeen users of Advanced Bionics Harmony CI sound processors and 20 users of Cochlear Nucleus 5 sound processors were included in the study. Data Collection and Analysis: Participants were tested in a total of 32 speech-recognition-in noise-test conditions, which included one no-FM and three device conditions (fixed-gain FM, adaptive FM, and adaptive digital) at the following signal levels: 64 dBA speech (at the location of the participant) in quiet and 64 dBA speech with competing noise at 50, 55, 60, 65, 70, 75, and 80 dBA noise levels. Results: No significant differences were detected between the users of Advanced Bionics and Cochlear CIs. All of the radio frequency system conditions (i.e., fixed-gain FM, adaptive FM, and adaptive digital) outperformed the no-FM conditions in test situations with competing noise. Specifically, in conditions with 70, 75, and 80 dBA of competing noise, the adaptive digital system provided better performance than the fixed-gain and adaptive FM systems. The adaptive FM system did provide better performance than the fixed-gain FM system at 70 and 75 dBA of competing noise. At the lower noise levels of 50, 55, 60, and 65 dBA, no significant differences were detected across the three systems, and no significant differences were found across the quiet conditions. In all conditions, performance became poorer as the competing noise level increased. Conclusions: In high levels of noise, the adaptive digital system provides superior performance when compared to adaptive analog FM and fixed-gain FM systems.

Effect of Age on Directional Microphone Hearing Aid Benefit and Preference

2010 ◽  
Vol 21 (02) ◽  
pp. 078-089 ◽  
Author(s):  
Yu-Hsiang Wu
Keyword(s):  
Hearing Aids ◽  
Linear Models ◽  
Paired Comparison ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Noisy Environments ◽  
Directional Microphone ◽  
Data Collection And Analysis ◽  
Speech Recognition In Noise ◽  
Directional Benefit

Background: Despite the recognition that the directional microphone hearing aid (DMHA) is an important intervention aimed at helping older hearing-impaired adults understand speech in noisy environments, there is little evidence that older listeners can actually benefit from directional processing. Purpose: The objective of this study was to determine if older and younger adults can obtain and perceive comparable benefit afforded by DMHAs. Study Sample: Twenty-four hearing-impaired adults aged 36 through 79 yr were fit with switchable-microphone hearing aids and tested in the laboratory and the field. Data Collection and Analysis: In the laboratory, the listeners’ directional benefit and preferences for microphone modes (directional vs. omnidirectional) were assessed using various speech-recognition-in-noise tests. In the four-week field trial, a paired-comparison technique and paper-and-pencil journals were used to determine the benefit provided by directional processing. The effects of age on directional benefit/preference were analyzed using generalized linear models with controlling for the effect of hearing loss. Results: The results revealed that age did not have a significant effect on directional benefit and preference as measured in the laboratory. However, the field data showed that older age was significantly associated with a lower preference for the directional mode. Conclusion: These results indicate that although listeners of different ages may obtain and perceive comparable benefit from DMHAs in laboratory testing, older users tend to perceive less benefit than do younger users in the real world. The implications of these findings are discussed.

scholarly journals Effectiveness of the Directional Microphone in the ®Baha® Divino™

2010 ◽  
Vol 21 (08) ◽  
pp. 546-557 ◽  
Author(s):  
Kristi Oeding ◽  
Michael Valente ◽  
Jessica Kerckhoff
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Recognition Performance ◽  
Great Difficulty ◽  
Repeated Measures Design ◽  
Directional Microphone ◽  
Paired Samples ◽  
Speech Recognition In Noise

Background: Patients with unilateral sensorineural hearing loss (USNHL) experience great difficulty listening to speech in noisy environments. A directional microphone (DM) could potentially improve speech recognition in this difficult listening environment. It is well known that DMs in behind-the-ear (BTE) and custom hearing aids can provide a greater signal-to-noise ratio (SNR) in comparison to an omnidirectional microphone (OM) to improve speech recognition in noise for persons with hearing impairment. Studies examining the DM in bone anchored auditory osseointegrated implants (Baha), however, have been mixed, with little to no benefit reported for the DM compared to an OM. Purpose: The primary purpose of this study was to determine if there are statistically significant differences in the mean reception threshold for sentences (RTS in dB) in noise between the OM and DM in the Baha® Divino™. The RTS of these two microphone modes was measured utilizing two loudspeaker arrays (speech from 0° and noise from 180° or a diffuse eight-loudspeaker array) and with the better ear open or closed with an earmold impression and noise attenuating earmuff. Subjective benefit was assessed using the Abbreviated Profile of Hearing Aid Benefit (APHAB) to compare unaided and aided (Divino OM and DM combined) problem scores. Research Design: A repeated measures design was utilized, with each subject counterbalanced to each of the eight treatment levels for three independent variables: (1) microphone (OM and DM), (2) loudspeaker array (180° and diffuse), and (3) better ear (open and closed). Study Sample: Sixteen subjects with USNHL currently utilizing the Baha were recruited from Washington University's Center for Advanced Medicine and the surrounding area. Data Collection and Analysis: Subjects were tested at the initial visit if they entered the study wearing the Divino or after at least four weeks of acclimatization to a loaner Divino. The RTS was determined utilizing Hearing in Noise Test (HINT) sentences in the R-Space™ system, and subjective benefit was determined utilizing the APHAB. A three-way repeated measures analysis of variance (ANOVA) and a paired samples t-test were utilized to analyze results of the HINT and APHAB, respectively. Results: Results revealed statistically significant differences within microphone (p < 0.001; directional advantage of 3.2 dB), loudspeaker array (p = 0.046; 180° advantage of 1.1 dB), and better ear conditions (p < 0.001; open ear advantage of 4.9 dB). Results from the APHAB revealed statistically and clinically significant benefit for the Divino relative to unaided on the subscales of Ease of Communication (EC) (p = 0.037), Background Noise (BN) (p < 0.001), and Reverberation (RV) (p = 0.005). Conclusions: The Divino's DM provides a statistically significant improvement in speech recognition in noise compared to the OM for subjects with USNHL. Therefore, it is recommended that audiologists consider selecting a Baha with a DM to provide improved speech recognition performance in noisy listening environments.

Speech Perception in Noise Using Directional Microphones in Open-Canal Hearing Aids

2008 ◽  
Vol 19 (07) ◽  
pp. 571-578 ◽  
Author(s):  
Emily J. Klemp ◽  
Sumitrajit Dhar
Keyword(s):  
Data Collection ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Analysis Data ◽  
Impaired Hearing ◽  
Directional Microphones ◽  
Hearing In Noise ◽  
Hearing Instruments ◽  
Data Collection And Analysis ◽  
Bilateral Sensorineural Hearing Loss

Background: Individuals with impaired hearing find it difficult to understand speech in the presence of background noise—a problem addressed effectively by directional microphones. As open-canal fittings have become increasingly popular in the recent past, so has the debate about the effective directional benefit available from these devices. Purpose: This study investigates the benefit of directional microphones in two commercially available open-canal behind-the-ear hearing aids using the Hearing in Noise Test (HINT). Study Sample: Sixteen individuals, between 50 and 85 year of age, with high-frequency bilateral sensorineural hearing loss and no previous hearing aid experience participated in this study. Data Collection and Analysis: Data Collection and Analysis: Individuals were asked to repeat sentences (presented at 0° azimuth) in the presence of a diffuse-field uncorrelated broadband speech-shaped noise. HINT performance was compared across hearing instruments and conditions using a linear model with repeated measures. Results: There was a directional advantage of 2.6 dB as compared to the unaided condition. Average performance was worse in the omnidirectional mode as compared to the unaided condition. Conclusions: These results suggest that directional signal processing should not be precluded in open-canal instruments for listening in noisy environments.

scholarly journals Changes over Time in the Predictors of Athletic Training Program Commitment

2014 ◽  
Vol 9 (2) ◽  
pp. 64-71 ◽  
Author(s):  
Windee M. Weiss ◽  
Peter J. Neibert
Keyword(s):  
Training Program ◽  
Athletic Training ◽  
Repeated Measures ◽  
Social Constraints ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Repeated Measures Analysis ◽  
Data Collection And Analysis ◽  
Changes Over Time ◽  
Over Time

Context Understanding changes in athletic training program (ATP) commitment over time is crucial in retaining high-quality students in an ATP. Objective The purpose of this study was to examine if changes over time in ATP commitment determinants are related to actual changes in ATP commitment. Design Longitudinal and cross-sectional survey. Setting Commission on Accreditation of Athletic Training Education-accredited ATP. Patients or Other Participants A total of 99 male and female athletic training students participated in Time 1. A total of 71 (39% males, 61% females) of the original 99 participants participated in Time 2. Participants ranged in age from 18 to 24 years (mean = 20.05, standard deviation = 1.28). Data Collection and Analysis Previously validated measures assessed students' perceptions of enjoyment, attractive alternatives, investments, social constraints and support, benefits and costs, and commitment to ATP over time. Change scores for Times 1 and 2 were calculated for each predictor and commitment to ATP. Two multiple regression analyses determined which changes in the determinants of commitment predicted a change in commitment. A repeated-measures analysis of variance (ANOVA) determined the magnitude of change in the model variables over time. Lastly, a multivariate ANOVA compared who continued, graduated, and discontinued in the ATP. Results Increases in investments and enjoyment predicted positive changes in commitment from Time 1 to Time 2. Additionally, decreases in classmates' social constraints and increases in professors' social constraints positively predicted changes in commitment. When exploring the magnitude of change in the model variables, only increases and decreases in enjoyment from Time 1 to Time 2 were related to concomitant changes in commitment. Lastly, graduating students reported lower commitment and enjoyment and higher perceived costs than did those students who remained in the ATP and had not yet graduated. Conclusions Athletic training program commitment predictors tend to change over time; ATP enjoyment is critical to continued motivation.

scholarly journals Aripiprazole in the treatment of the psychosis prodrome

2007 ◽  
Vol 191 (S51) ◽  
pp. s96-s101 ◽  
Author(s):  
Scott W. Woods ◽  
Elizabeth M. Tully ◽  
Barbara C. Walsh ◽  
Keith A. Hawkins ◽  
Jennifer L. Callahan ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Psychotic Disorders ◽  
Preliminary Evidence ◽  
Final Visit ◽  
Efficacy And Safety ◽  
Open Label ◽  
Prodromal Phase ◽  
Neuropsychological Measures ◽  
Repeated Measures Analysis ◽  
Psychosis Prodrome

BackgroundResearch studies for the treatment of the putative prodromal phase of psychotic disorders have begun to appearAimsTo obtain preliminary evidence of the short-term efficacy and safety of aripiprazole treatment in people with the psychosis prodromeMethodFifteen participants meeting prodrome criteria (mean age 17.1 years, s.d.=5.5) enrolled in an open-label, single-site trial with fixed-flexible dosing of aripiprazole (5–30 mg/day) for 8 weeksResultsIn the mixed-effects repeated-measures analysis, improvement from baseline on the Scale of Prodromal Symptoms total score was statistically significant by the first week. No participant converted to psychosis and 13 completed treatment. Neuropsychological measures showed no consistent improvement; mean weight gain was 1.2 kg. Akathisia emerged in 8 participants, but the mean Barnes Akathisia Scale score fell to baseline levels by the final visit. Adverse events were otherwise minimalConclusionsAripiprazole shows a promising efficacy and safety profile for the psychosis prodrome. Placebo-controlled studies are indicated

Evaluation of Speech Recognition of Cochlear Implant Recipients Using Adaptive, Digital Remote Microphone Technology and a Speech Enhancement Sound Processing Algorithm

2015 ◽  
Vol 26 (05) ◽  
pp. 502-508 ◽  
Author(s):  
Jace Wolfe ◽  
Mila Morais ◽  
Erin Schafer ◽  
Smita Agrawal ◽  
Dawn Koch
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Repeated Measures ◽  
Processing Algorithm ◽  
Full Time ◽  
Sound Processing ◽  
Sentence Recognition ◽  
Repeated Measures Design ◽  
Simultaneous Use ◽  
Speech Recognition In Noise

Background: Cochlear implant recipients often experience difficulty with understanding speech in the presence of noise. Cochlear implant manufacturers have developed sound processing algorithms designed to improve speech recognition in noise, and research has shown these technologies to be effective. Remote microphone technology utilizing adaptive, digital wireless radio transmission has also been shown to provide significant improvement in speech recognition in noise. There are no studies examining the potential improvement in speech recognition in noise when these two technologies are used simultaneously. Purpose: The goal of this study was to evaluate the potential benefits and limitations associated with the simultaneous use of a sound processing algorithm designed to improve performance in noise (Advanced Bionics ClearVoice) and a remote microphone system that incorporates adaptive, digital wireless radio transmission (Phonak Roger). Research Design: A two-by-two way repeated measures design was used to examine performance differences obtained without these technologies compared to the use of each technology separately as well as the simultaneous use of both technologies. Study Sample: Eleven Advanced Bionics (AB) cochlear implant recipients, ages 11 to 68 yr Data Collection and Analysis: AzBio sentence recognition was measured in quiet and in the presence of classroom noise ranging in level from 50 to 80 dBA in 5-dB steps. Performance was evaluated in four conditions: (1) No ClearVoice and no Roger, (2) ClearVoice enabled without the use of Roger, (3) ClearVoice disabled with Roger enabled, and (4) simultaneous use of ClearVoice and Roger. Results: Speech recognition in quiet was better than speech recognition in noise for all conditions. Use of ClearVoice and Roger each provided significant improvement in speech recognition in noise. The best performance in noise was obtained with the simultaneous use of ClearVoice and Roger. Conclusions: ClearVoice and Roger technology each improves speech recognition in noise, particularly when used at the same time. Because ClearVoice does not degrade performance in quiet settings, clinicians should consider recommending ClearVoice for routine, full-time use for AB implant recipients. Roger should be used in all instances in which remote microphone technology may assist the user in understanding speech in the presence of noise.

Effects of Training on the Use of a Manual Microphone Shutoff on a BiCROS Device

2015 ◽  
Vol 26 (05) ◽  
pp. 478-493 ◽  
Author(s):  
Francis Kuk ◽  
Eric Seper ◽  
Chi Lau ◽  
Bryan Crose ◽  
Petri Korhonen
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Real Life ◽  
Final Visit ◽  
Repeated Measures Design ◽  
Negative Effect ◽  
Speech Recognition In Noise ◽  
Study Participants

Background: Bilateral contralateral routing of signals (BiCROS) hearing aids function to restore audibility of sounds originating from the side of the unaidable ear. However, when speech is presented to the side of the aidable ear and noise to the side of the unaidable ear, a BiCROS arrangement may reduce intelligibility of the speech signal. This negative effect may be circumvented if an on/off switch is available on the contralateral routing of signals (CROS) transmitter. Purpose: This study evaluated if the proper use of the on/off switch on a CROS transmitter could enhance speech recognition in noise and sound localization abilities. The participants’ subjective reactions to the use of the BiCROS, including the use of the on/off switch in real-life were also evaluated. Research Design: A between-subjects, repeated-measures design was used to assess differences in speech recognition (in quiet and in noise) and localization abilities under four hearing aid conditions (unaided, unilaterally aided, fixed BiCROS setting, and adjusted BiCROS setting) with speech and noise stimuli presented from different azimuths. Participants were trained on the use of the on/off switch on the BiCROS transmitter before testing in the adjusted BiCROS settings. Subjective ratings were obtained with the Speech, Spatial, and Sound Quality (SSQ) questionnaire and a custom questionnaire. Study Sample: Nine adult BiCROS candidates participated in this study. Data Collection and Analysis: Participants wore the Widex Dream-m-CB hearing aid on the aidable ear for 1 week. They then wore the BiCROS for the remainder of the study. Speech recognition and localization testing were completed in four hearing aid conditions (unaided, unilateral aided, fixed BiCROS, and adjusted BiCROS). Speech recognition was evaluated during the first three visits, whereas localization was evaluated over the course of the study. Participants completed the SSQ questionnaire before each visit. The CROS questionnaire was completed at the final visit. A repeated measures analysis of variance with Bonferroni post hoc analysis was used to evaluate the significance of the results on speech recognition, localization, and the SSQ. Results: The results revealed that the adjusted BiCROS condition improved speech recognition scores by 20 rau (rationalized arcsine unit) when speech was presented to the aidable ear and localization by 37% when sounds are presented from the side of the unaidable ear over the fixed BiCROS condition. Statistically significant benefit on the SSQ was also noted with the adjusted BiCROS condition compared to the unilateral fitting. Conclusions: These findings supported the value of an on/off switch on a CROS transmitter because it allows convenient selective transmission of sounds. It also highlighted the importance of instructions and practice in using the BiCROS hearing aid successfully.

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