Bimodal Hearing in Individuals with Severe-to-Profound Hearing Loss: Benefits, Challenges, and Management

Warren, Sarah E.; Dunbar, M

doi:10.1055/s-0038-1670706

Cited by 13 publications

(5 citation statements)

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“…Extensive auditory training is necessary to achieve this and to adapt to the new set of acoustic-phonetic cues. While there is evidence for a bimodal benefit in speech perception tests (11,12), neurophysiological alterations associated with successful bimodal comprehension remain to be explored. It is likely that cognitive (top-down) processing compensates for some of the binaural discrepancies in sensory (bottom-up) processing.…”

Section: Introductionmentioning

confidence: 99%

Changes in Speech-Related Brain Activity During Adaptation to Electro-Acoustic Hearing

et al. 2020

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Objectives: Hearing improves significantly with bimodal provision, i.e., a cochlear implant (CI) at one ear and a hearing aid (HA) at the other, but performance shows a high degree of variability resulting in substantial uncertainty about the performance that can be expected by the individual CI user. The objective of this study was to explore how auditory event-related potentials (AERPs) of bimodal listeners in response to spoken words approximate the electrophysiological response of normal hearing (NH) listeners. Study Design: Explorative prospective analysis during the first 6 months of bimodal listening using a within-subject repeated measures design. Setting: Academic tertiary care center. Participants: Twenty-seven adult participants with bilateral sensorineural hearing loss who received a HiRes 90K CI and continued use of a HA at the non-implanted ear. Age-matched NH listeners served as controls. Intervention: Cochlear implantation. Main Outcome Measures: Obligatory auditory evoked potentials N1 and P2, and the event-related N2 potential in response to monosyllabic words and their reversed sound traces before, as well as 3 and 6 months post-implantation. The task required word/nonword classification. Stimuli were presented within speech-modulated noise. Loudness of word/non-word signals was adjusted individually to achieve the same intelligibility across groups and assessments. Results: Intelligibility improved significantly with bimodal hearing, and the N1-P2 response approximated the morphology seen in NH with enhanced and earlier responses to the words compared to their reversals. For bimodal listeners, a prominent negative deflection was present between 370 and 570 ms post stimulus onset (N2), irrespective of stimulus type. This was absent for NH controls; hence, this response did not approximate the NH response during the study interval. N2 source localization evidenced extended activation of general cognitive areas in frontal and prefrontal brain areas in the CI group. Balkenhol et al. Adaptation to Electro-Acoustic Hearing Conclusions: Prolonged and spatially extended processing in bimodal CI users suggests employment of additional auditory-cognitive mechanisms during speech processing. This does not reduce within 6 months of bimodal experience and may be a correlate of the enhanced listening effort described by CI listeners.

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Section: Introductionmentioning

confidence: 99%

Changes in Speech-Related Brain Activity During Adaptation to Electro-Acoustic Hearing

et al. 2020

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“…Bimodal hearing, on the other hand, enhances the perceived acoustic information by providing more detailed and natural auditory signals (46,47). Both clinical and research experiences show that "bimodal" in general reflects preserved low frequency hearing combined with electric hearing as this preservation improves spectral resolution and perception of temporal fine structure information (48).…”

Section: Discussionmentioning

confidence: 99%

Listening Effort in Prelingual Cochlear Implant Recipients: Effects of Spectral and Temporal Auditory Processing and Contralateral Acoustic Hearing

2022

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Objective: Considering the impact of listening effort (LE) on auditory perception, attention, and memory, it is a significant aspect in the daily hearing experiences of cochlear implant (CI) recipients. Reduced spectral and temporal information on an acoustic signal can make listening more difficult; as a result, it is important to understand the relationship between LE and spectral and temporal auditory processing capacities in CI receivers. Study Design, Setting, and Patients: This study used spectral ripple discrimination and temporal modulation transfer function to evaluate 20 prelingually deafened and early implanted CI recipients. The speech perception in noise test (primary) and the digit recall task (DRT-secondary) were used to assess LE using the dual-task paradigm. To assess the effects of acoustic hearing, contralateral acoustic hearing thresholds between 125 Hz and 8 kHz with a hearing aid were also acquired. To examine the relationship between the research variables, correlation coefficients were generated. Furthermore, the Mann-Whitney U test was used to compare unilateral and bimodal users.Results: There was a statistically significant correlation between LE and spectral ripple discrimination (r = 0.56; p = 0.011), 125 Hz (r = 0.51; p = 0.020), 250 Hz (r = 0.48; p = 0.030), 500 Hz (r = 0.45; p = 0.045), 1,000 Hz (r = 0.51; p = 0.023), 2000 Hz (r = 0.48; p = 0.031), and 4,000 Hz (r = 0.48; p = 0.031), whereas no statistically significant correlations were observed between temporal modulation transfer function in four frequencies and LE. There was no statistically significant difference between unilateral and bimodal CI recipients ( p > 0.05). Conclusion: As a result of the improved signal-to-noise ratio in the auditory environment, CI users with better spectral resolutions and acoustic hearing have a reduced LE. On the other hand, temporal auditory processing, as measured by temporal modulation detection, does not contribute to the LE.

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“…인공와우 반대편 귀에 보청기를 착용하는 바이모달은 저주파 수의 음향 단서를 보완할 수 있다는 장점이 있으나 (Crew et al, 2015;Dorman et al, 2015), 이형기기의 착용으로 양 귀 간 소 리의 부조화 및 간섭이 발생할 수 있다 (Blamey et al, 2000;Reiss et al, 2014;Tan et al, 2017). 바이모달 적합은 사용자 의 착용 효과 향상에 영향을 미칠 수 있는 중요한 요인 중 하나 이며 (Warren & Dunbar, 2018), 바이모달 혜택 증진을 위해서 는 인공와우 매핑뿐만 아니라 반대편 귀의 보청기적합과 관리 또 한 필요하다 (Park & Oh, 2021;Siburt & Holmes, 2015). 이 와 관련하여 최근 몇몇 연구에서는 바이모달 보청기적합의 절차 와 방법, 양 귀 간 음량 균형 맞추기, 보청기 주파수 범위의 설정 등과 관련된 고려 사항을 보고한 바 있다 (Veugen et al, 2016;Vroegop et al, 2018).…”

Section: Introductionunclassified

Case Reports of Hearing Aid Fitting in Bimodal Cochlear Implant Adults

Choi¹,

Oh²

2023

Audiol Speech Res

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The purpose of this case study is to investigate the bimodal benefits and clinical applications of bimodal hearing aid fitting. Bimodal hearing aid fitting was conducted with four bimodal cochlear implant adults. In order to evaluate bimodal benefits, speech recognition tests in quiet and noise conditions and “Speech, Spatial and Qualities of Hearing Scale (SSQ)” questionnaire were performed before and 1 month after bimodal hearing aid fitting. Four cases showed critical improvements in speech recognition tests and SSQ questionnaire scores. Four bimodal users showed improvement in speech perception and SSQ questionnaire after bimodal fitting. Clinical application of bimodal hearing aid fitting will be necessary to improve bimodal benefits and maintain good audibility of the contralateral ear of bimodal users.

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Bimodal Hearing in Individuals with Severe-to-Profound Hearing Loss: Benefits, Challenges, and Management

Cited by 13 publications

References 47 publications

Changes in Speech-Related Brain Activity During Adaptation to Electro-Acoustic Hearing

Changes in Speech-Related Brain Activity During Adaptation to Electro-Acoustic Hearing

Listening Effort in Prelingual Cochlear Implant Recipients: Effects of Spectral and Temporal Auditory Processing and Contralateral Acoustic Hearing

Case Reports of Hearing Aid Fitting in Bimodal Cochlear Implant Adults

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