Effect of Increased IIDR in the Nucleus Freedom Cochlear Implant System

2007 ◽  
Vol 18 (09) ◽  
pp. 777-793 ◽  
Author(s):  
Laura K. Holden ◽  
Margaret W. Skinner ◽  
Marios S. Fourakis ◽  
Timothy A. Holden

The objective of this study was to evaluate the effect of the increased instantaneous input dynamic range (IIDR) in the Nucleus Freedom cochlear implant (CI) system on recipients' ability to perceive soft speech and speech in noise. Ten adult Freedom CI recipients participated. Two maps differing in IIDR were placed on each subject's processor at initial activation. The IIDR was set to 30 dB for one map and 40 dB for the other. Subjects used both maps for at least one month prior to speech perception testing. Results revealed significantly higher scores for words (50 dB SPL), for sentences in background babble (65 dB SPL), and significantly lower sound field threshold levels with the 40 compared to the 30 dB IIDR map. Ceiling effects may have contributed to non-significant findings for sentences in quiet (50 dB SPL). The Freedom's increased IIDR allows better perception of soft speech and speech in noise. El objetivo de este estudio fue evaluar el efecto del rango dinámico aumentado instantáneo de ingreso (IIDR) en el sistema de implante coclear (IC) Nucleus Freedom, sobre la capacidad de sujetos implantados para percibir lenguaje a bajo volumen y lenguaje en ruido. Diez sujetos implantados con el IC Freedom participaron. En la activación inicial, dos mapas con una diferencia en cuanto al IIDR se colocaron en el procesador de cada sujeto. El IIDR fue ajustado a 30 dB para un mapa y a 40 dB para el otro. Los sujetos utilizaron ambos mapas por al menos un mes, antes de una evaluación de percepción del lenguaje. Los resultados revelaron puntajes significativamente más altos para palabras (50 dB SPL), para frases en balbuceo de fondo (65 dB SPL), y niveles umbrales en campo libre significativamente más bajos con el mapa de IIDR de 40 comparado con el de 30. Efectos tope pueden haber contribuido a los hallazgos no significativos para frases en silencio (50 dB SPL). El IIDR aumentado para Freedom permite mejor percepción para el lenguaje a bajo volumen y el lenguaje en medio de ruido.

1992 ◽  
Vol 101 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Kiyoshi Honda ◽  
Kumiko Yukawa ◽  
Masae Shiroma ◽  
Noboru Yamanaka ◽  
Kozo Kumakawa ◽  
...  

A study was carried out to determine which factors contributed to the vowel and consonant recognition ability of recipients of the 22-channel cochlear implant system. On the basis of the statistical analysis, no isolated factor showed a strong correlation with vowel recognition score. On the other hand, negative correlations were found between patients' consonant recognition scores and postoperative psychophysical percepts such as threshold levels and maximum comfortable loudness levels. However, multiple regression analysis also showed that the combination of lower threshold levels, a larger number of usable electrodes, and wider dynamic ranges contributed to higher consonant recognition scores.


2021 ◽  
Vol 32 (08) ◽  
pp. 478-486
Author(s):  
Lisa G. Potts ◽  
Soo Jang ◽  
Cory L. Hillis

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.


2011 ◽  
Vol 50 (4) ◽  
pp. 255-269 ◽  
Author(s):  
Laura K. Holden ◽  
Ruth M. Reeder ◽  
Jill B. Firszt ◽  
Charles C. Finley

2003 ◽  
Vol 69 ◽  
pp. 91-103
Author(s):  
Petra Jongmans

A CI (Cochlear Implant) is a medical device that electrically stimulates the hearing nerve in the cochlea (inner ear). Combined with actively training the hearing, it allows Cl-patients to hear again. In my research, I approached the model underlying the training programme linguistically, to see which theories on speech perception could also apply to the speech perception of CI-patients. Specifically, I examined their speech perception on phoneme level using VC-word lists. With the goal of contributing to an effective hearing training, I have tried to answer the following questions: - which phonemes are particularly difficult for patients? - what kind of confusions are made between phonemes? Mainly based on the literature on hard-of-hearing and normally hearing people, some hypotheses and a research question were formulated. Data-analysis was used to further investigate these hypotheses. A number of significant differences in difficulty were found between different phoneme categories, as well as patterns in the confusion of phonemes. It was found, for example, that long vowels are easier to perceive than short vowels and that for consonants a division can be made between plosives and fricatives on the one hand and nasals and approximants on the other, the latter group causing more problems. The research results are now being used for training CI-patients in Leiden.


2016 ◽  
Vol 21 (1) ◽  
pp. 54-67 ◽  
Author(s):  
Feddo B. van der Beek ◽  
Jeroen J. Briaire ◽  
Kim S. van der Marel ◽  
Berit M. Verbist ◽  
Johan H.M. Frijns

Objectives: In this study, the effects of the intracochlear position of cochlear implants on the clinical fitting levels were analyzed. Design: A total of 130 adult subjects who used a CII/HiRes 90K cochlear implant with a HiFocus 1/1J electrode were included in the study. The insertion angle and the distance to the modiolus of each electrode contact were determined using high-resolution CT scanning. The threshold levels (T-levels) and maximum comfort levels (M-levels) at 1 year of follow-up were determined. The degree of speech perception of the subjects was evaluated during routine clinical follow-up. Results: The depths of insertion of all the electrode contacts were determined. The distance to the modiolus was significantly smaller at the basal and apical cochlear parts compared with that at the middle of the cochlea (p < 0.05). The T-levels increased toward the basal end of the cochlea (3.4 dB). Additionally, the M-levels, which were fitted in our clinic using a standard profile, also increased toward the basal end, although with a lower amplitude (1.3 dB). Accordingly, the dynamic range decreased toward the basal end (2.1 dB). No correlation was found between the distance to the modiolus and the T-level or the M-level. Furthermore, the correlation between the insertion depth and stimulation levels was not affected by the duration of deafness, age at implantation or the time since implantation. Additionally, the T-levels showed a significant correlation with the speech perception scores (p < 0.05). Conclusions: The stimulation levels of the cochlear implants were affected by the intracochlear position of the electrode contacts, which were determined using postoperative CT scanning. Interestingly, these levels depended on the insertion depth, whereas the distance to the modiolus did not affect the stimulation levels. The T-levels increased toward the basal end of the cochlea. The level profiles were independent of the overall stimulation levels and were not affected by the biographical data of the patients, such as the duration of deafness, age at implantation or time since implantation. Further research is required to elucidate how fitting using level profiles with an increase toward the basal end of the cochlea benefits speech perception. Future investigations may elucidate an explanation for the effects of the intracochlear electrode position on the stimulation levels and might facilitate future improvements in electrode design.


2021 ◽  
pp. 1-12
Author(s):  
Stephanie L. Fowler ◽  
Hannah Calhoun ◽  
Andrea D. Warner-Czyz

Purpose Adult cochlear implant (CI) users rate music as one of the most important auditory stimuli, second to speech perception. However, few studies simultaneously examine music perception and speech-in-noise perception in adult CI recipients. This study explores the effect of auditory status on music perception and speech-in-noise perception recognition in noise as well as the relationship among music engagement, music perception, and speech-in-noise perception. Method Participants include 10 adults with typical hearing (TH) and 10 adults with long-term CI use. All participants completed the Music-Related Quality of Life Questionnaire, which assesses subjective music experiences and their importance; the Pitch Direction Discrimination, Familiar Melody Recognition, and Timbre Recognition subtests of the Clinical Assessment of Music Perception for Cochlear Implants; the Unfamiliar Melody Recognition subtest of the Profile of Music Perception Skills; and the Bamford–Kowal–Bench Speech-in-Noise Test . Results The TH group significantly outperformed the CI group for speech-in-noise perception and on all four music perception tasks. The CI group exhibited not only significantly poorer mean scores but also greater variability in performance compared to the TH group. Only Familiar Melody Recognition and Unfamiliar Melody Recognition subtests significantly correlated with speech-in-noise scores. Conclusions Patients and professionals should not assume speech perception and music perception in adult CI users derive from the same auditory or cognitive foundations. The lack of significant relationships among music engagement, music perception, and speech-in-noise perception scores in adult CI users suggests this population enjoys music despite poor and variable performance in discrete music tasks.


2014 ◽  
Vol 20 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Feddo B. van der Beek ◽  
Jeroen J. Briaire ◽  
Johan H.M. Frijns

Objectives: This study analyzed the predictability of fitting levels for cochlear implant recipients based on a review of the clinical levels of the recipients. Design: Data containing threshold levels (T-levels) and maximum comfort levels (M-levels) for 151 adult subjects using a CII/HiRes 90K cochlear implant with a HiFocus 1/1 J electrode were used. The 10th, 25th, 50th, 75th and 90th percentiles of the T- and M-levels are reported. Speech perception of the subjects, using a HiRes speech coding strategy, was measured during routine clinical follow-up. Results: T-levels for most subjects were between 20 and 35% of their M-levels and were rarely (<1/50) below 10% of the M-levels. Furthermore, both T- and M-levels showed an increase over the first year of follow-up. Interestingly, levels expressed in linear charge units showed a clear increase in dynamic range (DR) over 1 year (29.8 CU; SD 73.0), whereas the DR expressed in decibels remained stable. T-level and DR were the only fitting parameters for which a significant correlation with speech perception (r = 0.34, p < 0.01, and r = 0.33, p < 0.01, respectively) could be demonstrated. Additionally, analysis showed that T- and M-level profiles expressed in decibels were independent of the subjects' across-site mean levels. Using mixed linear models, predictive models were obtained for the T- and M-levels of all separate electrode contacts. Conclusions: On the basis of the data set from 151 subjects, clinically applicable predictive models for T- and M-levels have been obtained. Based on one psychophysical measurement and a population-based T- or M-level profile, individual recipients' T- and M-levels can be approximated with a closed-set formula. Additionally, the analyzed fitting level data can serve as a reference for future patients. i 2014 S. Karger AG, Basel


2015 ◽  
Vol 129 (3) ◽  
pp. 238-243 ◽  
Author(s):  
J B Spitzer ◽  
D Chari ◽  
E Machmer ◽  
S Lipson ◽  
L Rouse ◽  
...  

AbstractObjective:To examine the relationship between pre-operative electronystagmography and videonystagmography test results and post-operative outcomes in dizziness, auditory sensitivity and speech recognition.Methods:A retrospective chart review was performed. Auditory sensitivity and speech perception ability were tested pre- and post-operatively in 37 adult cochlear implant recipients. Auditory sensitivity was evaluated using either pure tones (for testing with earphones) or frequency-modulated warble tones (for sound-field testing). Speech perception ability was evaluated using Northwestern University Auditory Test Number 6.Results:No correlation was found between pre-operative electronystagmography test results and post-operative subjective dizziness. However, pre-operative electronystagmography testing and post-operative hearing sensitivity as measured by warble tone average (dB HL) correlated significantly at six months or later after cochlear implant activation (r ≥  −0.34,n = 34,p < 0.05).Conclusion:This study, which has a level of evidence 4, demonstrates that pre-operative electronystagmography testing has a potential use in predicting post-operative outcomes in hearing sensitivity following cochlear implantation. However, larger studies are needed to confirm this novel finding.


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