scholarly journals Application of Digital Remote Wireless Microphone Technology in Single-Sided Deaf Cochlear Implant Recipients

2020 ◽  
Vol 31 (04) ◽  
pp. 246-256 ◽  
Author(s):  
Thomas Wesarg ◽  
Yvonne Stelzig ◽  
Dan Hilgert-Becker ◽  
Bjorn Kathage ◽  
Konstantin Wiebe ◽  
...  

Abstract Background Previous research showed benefits of remote wireless technology in bilaterally moderate- to-severe hearing-impaired participants provided with hearing aid(s), cochlear implant(s) (CIs), or bimodal devices as well as in single-sided deaf (SSD) cochlear implant recipients (with CI from Cochlear™) and normal-hearing (NH) participants. Purpose To evaluate the effect of the digital remote wireless microphone system, Roger™, on speech recognition at different levels of multisource noise in SSD CI recipients using MED-EL CI sound processor OPUS 2. Outcomes were assessed as a function of the listening condition (NH only, NH + CI, NH + CIRog, NHRog + CI, and NHRog + CIRog), Roger™ receiver type (Roger™ Focus for NH; Roger™ Xand Roger™ MyLink for CI) and accessory mixing ratio. Study Sample Eleven adult, SSD participants aided with CI from MED-EL. Data Collection and Analysis Speech recognition in noise was assessed in two no-Roger™ conditions, one Roger™ X condition, and two Roger™ MyLink conditions. For the Roger™ X and no-Roger™ conditions, speech recognition was tested at 60.3 dB(A) with the Oldenburg Sentence Test in classroom noise at levels of 55, 65, and 75 dB(A). For the two Roger™ MyLink conditions, speech recognition at 60.3 dB(A) was measured at a noise level of 75 dB(A). Roger™ X was assessed with an accessory mixing ratio of 1:1 (summation of unattenuated microphone and audio accessory input). For Roger™ MyLink, two accessory mixing ratios were investigated, MT (1:1, summation of unattenuated microphone and telecoil input) and T with maximum attenuation of microphone input. Results Speech recognition at higher noise levels (65 and 75 dB(A)) improved significantly with Roger™ in both unilateral use conditions (NH + CIRog and NHRog + CI) as well as bilateral use condition (NHRog + CIRog). Both the bilateral application of Roger™ and the unilateral Roger™ application on the NH ear outperformed the Roger™ application on CI alone. There was no statistically significant effect of type of CI Roger™ receiver (Roger™ X or Roger™ MyLink) and the accessory mixing ratio (MT or T) on speech recognition. Conclusions Speech recognition for distant speakers in multisource noise improved significantly with the application of Roger™ in SSD CI recipients. Both the unilateral Roger™ application on the NH ear or the CI as well as the bilateral Roger™ application can be recommended.

2008 ◽  
Vol 19 (08) ◽  
pp. 585-594 ◽  
Author(s):  
Jace Wolfe ◽  
Erin C. Schafer

Background: Use of personal frequency modulated (FM) systems significantly improves speech recognition in noise for users of cochlear implants (CI). There are, however, a number of adjustable parameters of the cochlear implant and FM receiver that may affect performance and benefit, and there is limited evidence to guide audiologists in optimizing these parameters. Purpose: This study examined the effect of two sound processor audio-mixing ratios (30/70 and 50/50) on speech recognition and functional benefit for adults with CIs using the Advanced Bionics Auria® sound processors. Research Design: Fully-repeated repeated measures experimental design. Each subject participated in every speech-recognition condition in the study, and qualitative data was collected with subject questionnaires. Study Sample: Twelve adults using Advanced Bionics Auria sound processors. Participants had greater than 20% correct speech recognition on consonant-nucleus-consonant (CNC) monosyllabic words in quiet and had used their CIs for at least six months. Intervention: Performance was assessed at two audio-mixing ratios (30/70 and 50/50). For the 50/50 mixing ratio, equal emphasis is placed on the signals from the sound processor and the FM system. For the 30/70 mixing ratio, the signal from the microphone of the sound processor is attenuated by 10 dB. Data Collection and Analysis: Speech recognition was assessed at two audio-mixing ratios (30/70 and 50/50) in quiet (35 and 50 dB HL) and in noise (+5 signal-to-noise ratio) with and without the personal FM system. After two weeks of using each audio-mixing ratio, the participants completed subjective questionnaires. Results: Study results suggested that use of a personal FM system resulted in significant improvements in speech recognition in quiet at low-presentation levels, speech recognition in noise, and perceived benefit in noise. Use of the 30/70 mixing ratio resulted in significantly poorer speech recognition for low-level speech that was not directed to the FM transmitter. There was no significant difference in speech recognition in noise or functional benefit between the two audio-mixing ratios. Conclusions: Use of a 50/50 audio-mixing ratio is recommended for optimal performance with an FM system in quiet and noisy listening situations.


2019 ◽  
Vol 30 (07) ◽  
pp. 607-618 ◽  
Author(s):  
Thomas Wesarg ◽  
Susan Arndt ◽  
Konstantin Wiebe ◽  
Frauke Schmid ◽  
Annika Huber ◽  
...  

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.


Author(s):  
Sharon Miller ◽  
Jace Wolfe ◽  
Mila Duke ◽  
Erin Schafer ◽  
Smita Agrawal ◽  
...  

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.


2016 ◽  
Vol 21 (Suppl. 1) ◽  
pp. 48-54 ◽  
Author(s):  
Feike de Graaff ◽  
Elke Huysmans ◽  
Obaid ur Rehman Qazi ◽  
Filiep J. Vanpoucke ◽  
Paul Merkus ◽  
...  

The number of cochlear implant (CI) users is increasing annually, resulting in an increase in the workload of implant centers in ongoing patient management and evaluation. Remote testing of speech recognition could be time-saving for both the implant centers as well as the patient. This study addresses two methodological challenges we encountered in the development of a remote speech recognition tool for adult CI users. First, we examined whether speech recognition in noise performance differed when the steady-state masking noise was presented throughout the test (i.e. continuous) instead of the standard clinical use for evaluation where the masking noise stops after each stimulus (i.e. discontinuous). A direct coupling between the audio port of a tablet computer to the accessory input of the sound processor with a personal audio cable was used. The setup was calibrated to facilitate presentation of stimuli at a predefined sound level. Finally, differences in frequency response between the audio cable and microphones were investigated.


Author(s):  
I. Speck ◽  
T. Müller ◽  
T. F. Jakob ◽  
K. Wiebe ◽  
A. Aschendorff ◽  
...  

Abstract Background Previous research demonstrated benefits of adaptive digital microphone technologies (ADMTs) in adults with single-sided deafness (SSD) having a cochlear implant (CI). Children with SSD are especially affected by background noise because of their noise exposure in kindergarten and school. Purpose This article aims to evaluate possible effects of ADMT on speech recognition in background noise in children with SSD who use a CI. Study Sample Ten children between 5 and 11 years of age were included. Data Collection and Analysis Speech recognition in noise was assessed for one frontal distant and two lateral speakers. The speech stimulus was presented at a speech level of 65 dB(A) and noise at a level of 55 dB(A). For the presentation condition with one frontal speaker, four listening conditions were assessed: (1) normal-hearing (NH) ear and CI turned off; (2) NH ear and CI; (3) NH ear and CI with ADMT; and (4) NH ear with ADMT and CI. Listening conditions (2) to (4) were also tested for each lateral speaker. The frontal speaker was positioned directly in front of the participant, whereas the lateral speakers were positioned at angles of 90 degrees and –90 degrees to the participant's head. Results Children with SSD who use a CI significantly benefit from the application of ADMT in speech recognition in noise for frontal distant and for lateral speakers. Speech recognition improved significantly with ADMT at the CI and the NH ears. Conclusion Application of ADMT significantly improves speech recognition in noise in children with SSD who use a CI and can therefore be highly recommended. The decision of whether to apply ADMT at the CI NH ear or bilaterally should be made for each child individually.


2021 ◽  
pp. 1-11
Author(s):  
Stefanie Bruschke ◽  
Uwe Baumann ◽  
Timo Stöver

Background: The cochlear implant (CI) is a standard procedure for the treatment of patients with severe to profound hearing loss. In the past, a standard healing period of 3–6 weeks occurred after CI surgery before the sound processor was initially activated. Advancements of surgical techniques and instruments allow an earlier initial activation of the processor within 14 days after surgery. Objective: Evaluation of the early CI device activation after CI surgery within 14 days, comparison to the first activation after 4–6 weeks, and assessment of the feasibility and safety of the early fitting over a 12 month observation period were the objectives of this study. Method: In a prospective study, 127 patients scheduled for CI surgery were divided into early fitting group (EF, n = 67) and control group (CG, n = 60). Individual questionnaires were used to evaluate medical and technical outcomes of the EF. Medical side effects, speech recognition, and follow-up effort were compared with the CG within the first year after CI surgery. Results: The early fitting was feasible in 97% of the EF patients. In the EF, the processor was activated 25 days earlier than in the CG. No major complications were observed in either group. At the follow-up appointments, side effects such as pain and balance problems occurred with comparable frequency in both groups. At initial fitting, the EF showed a significantly higher incidence of medical minor complications (p < 0.05). When developing speech recognition within the first year of CI use, no difference was observed. Furthermore, the follow-up effort within the first year after CI surgery was comparable in both groups. Conclusions: Early fitting of the sound processor is a feasible and safe procedure with comparable follow-up effort. Although more early minor complications were observed in the EF, there were no long-term wound healing problems caused by the early fitting. Regular inspection of the magnet strength is recommended as part of the CI follow-up since postoperative wound swelling must be expected. The early fitting procedure enabled a clear reduction in the waiting time between CI surgery and initial sound processor activation.


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.


2015 ◽  
Vol 26 (06) ◽  
pp. 532-539 ◽  
Author(s):  
Jace Wolfe ◽  
Mila Morais ◽  
Erin Schafer

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.


2004 ◽  
Vol 115 (4) ◽  
pp. 1729-1735 ◽  
Author(s):  
Christopher W. Turner ◽  
Bruce J. Gantz ◽  
Corina Vidal ◽  
Amy Behrens ◽  
Belinda A. Henry

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