Amount of Frequency Compression in Bimodal Cochlear Implant Users Is a Poor Predictor for Audibility and Spatial Hearing

Purpose Speech understanding in noise and horizontal sound localization is poor in most cochlear implant (CI) users with a hearing aid (bimodal stimulation). This study investigated the effect of static and less-extreme adaptive frequency compression in hearing aids on spatial hearing. By means of frequency compression, we aimed to restore high-frequency audibility, and thus improve sound localization and spatial speech recognition. Method Sound-detection thresholds, sound localization, and spatial speech recognition were measured in eight bimodal CI users, with and without frequency compression. We tested two compression algorithms: a static algorithm, which compressed frequencies beyond the compression knee point (160 or 480 Hz), and an adaptive algorithm, which aimed to compress only consonants leaving vowels unaffected (adaptive knee-point frequencies from 736 to 2946 Hz). Results Compression yielded a strong audibility benefit (high-frequency thresholds improved by 40 and 24 dB for static and adaptive compression, respectively), no meaningful improvement in localization performance (errors remained > 30 deg), and spatial speech recognition across all participants. Localization biases without compression (toward the hearing-aid and implant side for low- and high-frequency sounds, respectively) disappeared or reversed with compression. The audibility benefits provided to each bimodal user partially explained any individual improvements in localization performance; shifts in bias; and, for six out of eight participants, benefits in spatial speech recognition. Conclusions We speculate that limiting factors such as a persistent hearing asymmetry and mismatch in spectral overlap prevent compression in bimodal users from improving sound localization. Therefore, the benefit in spatial release from masking by compression is likely due to a shift of attention to the ear with the better signal-to-noise ratio facilitated by compression, rather than an improved spatial selectivity. Supplemental Material https://doi.org/10.23641/asha.16869485

Effects of Adaptive Non-linear Frequency Compression in Hearing Aids on Mandarin Speech and Sound-Quality Perception

ObjectiveThis study was aimed at examining the effects of an adaptive non-linear frequency compression algorithm implemented in hearing aids (i.e., SoundRecover2, or SR2) at different parameter settings and auditory acclimatization on speech and sound-quality perception in native Mandarin-speaking adult listeners with sensorineural hearing loss.DesignData consisted of participants’ unaided and aided hearing thresholds, Mandarin consonant and vowel recognition in quiet, and sentence recognition in noise, as well as sound-quality ratings through five sessions in a 12-week period with three SR2 settings (i.e., SR2 off, SR2 default, and SR2 strong).Study SampleTwenty-nine native Mandarin-speaking adults aged 37–76 years old with symmetric sloping moderate-to-profound sensorineural hearing loss were recruited. They were all fitted bilaterally with Phonak Naida V90-SP BTE hearing aids with hard ear-molds.ResultsThe participants demonstrated a significant improvement of aided hearing in detecting high frequency sounds at 8 kHz. For consonant recognition and overall sound-quality rating, the participants performed significantly better with the SR2 default setting than the other two settings. No significant differences were found in vowel and sentence recognition among the three SR2 settings. Test session was a significant factor that contributed to the participants’ performance in all speech and sound-quality perception tests. Specifically, the participants benefited from a longer duration of hearing aid use.ConclusionFindings from this study suggested possible perceptual benefit from the adaptive non-linear frequency compression algorithm for native Mandarin-speaking adults with moderate-to-profound hearing loss. Periods of acclimatization should be taken for better performance in novel technologies in hearing aids.

The Effect of Nonlinear Frequency Compression on Acoustic Change Complex Responses in High-Frequency Dead-Regioned Hearing Loss

Purpose The study is concern with the distinguishing of the stimuli containing high frequency information with the frequency compression feature at the cortical level using the acoustic change complex (ACC) and the comparison of such with the ACC answers of individuals with normal hearing. Research Design This is a case–control study. Study Sample Thirty adults (21 males and nine females) with normal hearing, ranging in age between 16 and 63 years (mean: 36.7 ± 12.9 years) and 20 adults (16 males and four females) with hearing loss ranging in age between 16 and 70 years (mean:49.0 ± 19.8 years) have been included in this study. Data Collection and Analysis A total of 1,000 ms long stimulus containing 500 and 4,000 Hz tonal stimuli was used for ACC recording. The start frequency (SF) and compression ratio (CR) parameters of the hearing aids were programmed according to the default settings (SFd, CRd) in the device software, the optimal setting (SFo, CRo), and the extra compression (SFe, CRe) requirements and ACC has been recorded for each condition. Evaluation has been performed according to P1-N1-P2 wave complex and ACC complex wave latencies. Independent samples t-test was used to test the significance of the differences between the groups. Results In all individuals ACC has been observed. There was a significant difference between the wave latencies in normal hearing- and hearing-impaired groups. All wave latency averages of the individuals with hearing impairment were longer than the individuals with normal hearing. There were statistically significant differences between SFd-SFo, SFd-SFe, and SFo-SFe parameters. But there was no difference between CRd, CRo, and CRe in terms of CRs. Conclusion In order to discriminate high frequency information at the cortical level we should not rely on default settings of the SF and CR of the hearing aids. Optimal bandwidth must be adjusted without performing insufficient compression or over-compression. ACC can be used besides the real ear measurement for hearing aid fitting.

Speech Perception and Sound-Quality Rating with an Adaptive Nonlinear Frequency Compression Algorithm in Mandarin-Speaking Hearing Aid Users

Background Mandarin Chinese has a rich repertoire of high-frequency speech sounds. This may pose a remarkable challenge to hearing-impaired listeners who speak Mandarin Chinese because of their high-frequency sloping hearing loss. An adaptive nonlinear frequency compression (adaptive NLFC) algorithm has been implemented in contemporary hearing aids to alleviate the problem. Purpose The present study examined the performance of speech perception and sound-quality rating in Mandarin-speaking hearing-impaired listeners using hearing aids fitted with adaptive NLFC (i.e., SoundRecover2 or SR2) at different parameter settings. Research Design Hearing-impaired listeners' phoneme detection thresholds, speech reception thresholds, and sound-quality ratings were collected with various SR2 settings. Study Sample The participants included 15 Mandarin-speaking adults aged 32 to 84 years old who had symmetric sloping severe-to-profound sensorineural hearing loss. Intervention The participants were fitted bilaterally with Phonak Naida V90-SP hearing aids. Data Collection and Analysis The outcome measures included phoneme detection threshold using the Mandarin Phonak Phoneme Perception test, speech reception threshold using the Mandarin hearing in noise test (M-HINT), and sound-quality ratings on human speech in quiet and noise, bird chirps, and music in quiet. For each test, five experimental settings were applied and compared: SR2-off, SR2-weak, SR2-default, SR2-strong 1, and SR2-strong 2. Results The results showed that listeners performed significantly better with SR2-strong 1 and SR2-strong 2 settings than with SR2-off or SR2-weak settings for speech reception threshold and phoneme detection threshold. However, no significant improvement was observed in sound-quality ratings among different settings. Conclusions These preliminary findings suggested that the adaptive NLFC algorithm provides perceptual benefit to Mandarin-speaking people with severe-to-profound hearing loss.

Sound Quality Effects of an Adaptive Nonlinear Frequency Compression Processor with Normal-Hearing and Hearing-Impaired Listeners

Frequency lowering (FL) technology offers a means of improving audibility of high-frequency sounds. For some listeners, the benefit of such technology can be accompanied by a perceived degradation in sound quality, depending on the strength of the FL setting.The studies presented in this article investigate the effect of a new type of FL signal processing for hearing aids, adaptive nonlinear frequency compression (ANFC), on subjective speech quality.Listener ratings of sound quality were collected for speech stimuli processed with systematically varied fitting parameters.Study 1 included 40 normal-hearing (NH) adult and child listeners. Study 2 included 11 hearing-impaired (HI) adult and child listeners. HI listeners were fitted with laboratory-worn hearing aids for use during listening tasks.Speech quality ratings were assessed across test conditions consisting of various strengths of static nonlinear frequency compression (NFC) and ANFC speech. Test conditions included those that were fine-tuned on an individual basis per hearing aid fitting and conditions that were modified to intentionally alter the sound quality of the signal.Listeners rated speech quality using the MUlti Stimulus test with Hidden Reference and Anchor (MUSHRA) test paradigm. Ratings were analyzed for reliability and to compare results across conditions.Results show that interrater reliability is high for both studies, indicating that NH and HI listeners from both adult and child age groups can reliably complete the MUSHRA task. Results comparing sound quality ratings across experimental conditions suggest that both the NH and HI listener groups rate the stimuli intended to have poor sound quality (e.g., anchors and the strongest available parameter settings) as having below-average sound quality ratings. A different trend in the results is reported when considering the other experimental conditions across the listener groups in the studies. Speech quality ratings measured with NH listeners improve as the strength of ANFC decreases, with a range of bad to good ratings reported, on average. Speech quality ratings measured with HI listeners are similar and above-average for many of the experimental stimuli, including those with fine-tuned NFC and ANFC parameters.Overall, HI listeners provide similar sound quality ratings when comparing static and adaptive forms of frequency compression, especially when considering the individualized parameter settings. These findings suggest that a range in settings may result in above-average sound quality for adults and children with hearing impairment. Furthermore, the fitter should fine-tune FL parameters for each individual listener, regardless of type of FL technology.