Cochlear Implants and Remote Microphone Technology

Abstract

Advances in cochlear implant (CI) technology have allowed for impressive outcomes for implant recipients. In fact, many CI recipients achieve ceiling-level scores (i.e., near 100%) on sentence-recognition tests in quiet used in clinical settings. It is, however, well known that CI users often continue to experience difficulty with speech understanding in noisy and reverberant environments (e.g., classroom, restaurant, etc.). Recent research has indicated that performance in these difficult situations may be improved through the use of wireless remote microphone technology. In this article, a review will be provided of several studies that have explored the use of wireless remote microphones for CI users. Specifically, this review will focus on studies that have addressed both induction neckloop and directly coupled radiofrequency (RF) systems, fixed receiver gain settings, audio mixing ratio, adaptive frequency-modulated (FM) systems, cochlear implant signal processing, and digital RF systems. The effect of each of these items on a CI recipient's performance will be discussed. Additionally, clinical tips to optimize hearing assistance technology benefit for CI users will be provided as well as a protocol for fitting and verifying the appropriateness of wireless remote microphone technology for CI users and for optimizing user benefit.Learning Outcomes: As a result of this activity, the participant will be able to (1) list at least three programmable parameters within a cochlear implant (CI) sound processor that influence a CI user's performance with remote microphone technology; (2) list at least three factors associated with remote microphone wireless radiofrequency receivers that influence a CI user's performance with remote microphone

On the Effect of High Stimulation Rates on Temporal Loudness Integration in Cochlear Implant Users

“…The longest investigated pulse trains had thus a duration of 300 ms. The maximum duration was chosen as this is approximately the duration of a syllable, and also because it is commonly used as pulse train duration in clinical fittings (Wolfe & Schafer, 2014). Table 2 offers an overview of all tested rate × duration conditions and their corresponding number of pulses.…”

Loudness Balancing Optimization for Better Speech Intelligibility, Music Perception, and Spectral Temporal Resolution in Cochlear Implant Users

“…However, their frequency significantly reduces over time to once every 1 to 3 years or as per the patient's specific needs. The main purpose of fine-tuning is to restore normal loudness perception for speech in addition to environmental sounds and to adjust stimulation levels for this purpose (3). Therefore, the most comfortable level (MCL), or, in other words, the upper stimulation level and threshold level (THR) of each electrode, should be evaluated and readjusted if needed to optimize speech–sound recognition.…”

“…Therefore, LB is one of the most critical aspects of CI fitting to optimize sound quality and speech recognition. LB involves the successive presentation of a stimulus to two or more electrodes, ensuring equal loudness across the electrode array (3). Most commonly, two or more electrodes are stimulated at or near (e.g., 80% of MCL) the MCLs, and the user reports whether the stimuli are equally loud or whether one electrode possesses a louder percept.…”

Electroacoustic verification of frequency modulation systems in cochlear implant users

“…1 In this time frame, the device manufacturers invested in new technologies in order to provide maximum effectiveness and accessibility to users, such as new signal processing strategies and directional microphone technologies, in an attempt to improve speech perception in noise. 2 , 3 , 4 , 5 The frequency modulation (FM) system is a device that enables speech perception in noise by reducing the harmful effects of reverberation and the distance between the speaker and the listener. 6 , 7 The FM system is currently considered the most effective approach to improve speech recognition in noise in cochlear implant users.…”