Directional Microphone Contralateral Routing of Signals in Cochlear Implant Users: A Within-Subjects Comparison

Wimmer, Wilhelm; Kompis, Martin; Stieger, Christof; Caversaccio, Marco; Weder, Stefan

doi:10.1097/aud.0000000000000412

Cited by 26 publications

(37 citation statements)

References 18 publications

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“…The recent literature on a CROS (contralateral routing of signals) aid for patients with a single cochlear implant (CI) paints, on the one hand, a cautiously optimistic picture of value [e.g., Arora et al, 2013;Wimmer et al, 2017] and, on the other hand, a quite negative picture of value. Guevara et al [2015] suggest that "the drawbacks (of the CROS) system do not presently allow it to be an effective alternative to bilateral cochlear implants."…”

confidence: 99%

“…Audiol Neurotol 2018;23:270-276 DOI: 10.1159/000493844 If, indeed, bilateral CIs would be the better option, it is not clear which of the several possible advantages provided by bilateral CIs are the ones that make them the better option. In contrast to CI-CROS, bilateral CIs allow a modest level of sound source localization on the horizontal plane [e.g., Grantham et al, 2007;Wimmer et al, 2017]. Bilateral CIs also allow summation and a small amount of squelch [e.g., Buss et al, 2008] -phenomena thought to be important for improving speech understanding in noise.…”

confidence: 99%

“…Previous authors, while commenting on the relative lack of value of a CI-CROS system relative to bilateral CIs, have allowed the possibility that, with the addition of different, or improved, signal-processing algorithms, CI-CROS systems could be more valuable [e.g., Grewal et al, 2015;Wimmer et al, 2017]. To assess the value of one such algorithm, we tested listeners fit with unilateral CIs, bilateral CIs and a CI-CROS system in our restaurant test environment with and without the implementation of the Phonak UltraZoom beamformer [Hehrmann et al, 2012;Büchner et al, 2014].…”

confidence: 99%

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The Value of Unilateral CIs, CI-CROS and Bilateral CIs, with and without Beamformer Microphones, for Speech Understanding in a Simulation of a Restaurant Environment

2018

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Objective: Our primary aim was to determine, in a simulation of a crowded restaurant, the value to speech understanding of (i) a unilateral cochlear implant (CI), (ii) a CI plus CROS (contralateral routing of signals) aid system and (iii) bilateral CIs when tested with and without beamforming microphones. Design: The listeners were 7 CI listeners who had used bilateral CIs for an average of 9 years. The listeners were tested with three device configurations (bilateral CI, unilateral CI + CROS, and unilateral CI), two signal processing conditions (without and with beamformers) and with speech either from +90°, –90°, or from the front. Speech understanding scores for the TIMIT sentences were obtained in the 8-loudspeaker R-SPACE^TM test environment – an environment which simulates listening in a crowded restaurant. Results: In the unilateral condition, speech understanding, relative to speech directed to the CI ear, fell by 17% when speech was from the front and fell 28% when speech was to the side opposite the CI. These deficits were overcome with both CI-CROS and bilateral CIs, and scores for the two devices did not differ significantly for any location of speech input. Beamformer microphones improved speech understanding for speech from the front and depressed speech understanding for speech from the sides for all device configurations. Patients with bilateral CIs and beamformers achieved slightly, but significantly, higher scores for speech from the front than patients with CI-CROS and beamformers. Conclusions: CI-CROS is a valuable addition to the hardware options available to patients fit with a single CI. For patients fit with bilateral CIs, bilateral beamformers are a valuable addition in the condition of speech coming from in front of the listener. The small differences in performance in the CI-CROS and bilateral CI conditions suggest that patient preference for bilateral CIs is based largely on factors other than speech understanding in noise.

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confidence: 99%

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The Value of Unilateral CIs, CI-CROS and Bilateral CIs, with and without Beamformer Microphones, for Speech Understanding in a Simulation of a Restaurant Environment

2018

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“…In horizontal sound localization experiments, the most common definition classifies responses crossing the interaural axis as FBCs [3]- [6], [8], [9]. This definition, which defines the FBC Rate, is sufficient for experiments that only require a coarse angular resolution of the test setup or feedback method [7], [10], [11]. However, such setups limit the measurement resolution for sound localization accuracy.…”

Section: Sound Source (A)mentioning

confidence: 99%

“…In total, 36 stimuli per subject were played, 3 stimuli per loudspeaker. The order of the stimuli with respect to the loudspeaker was randomized [10]. The loudspeakers were hidden behind a sound transparent curtain, no prior knowledge about possible stimuli directions was provided to the subjects.…”

Section: B Static Sound Source Localization Testmentioning

confidence: 99%

A Front-Back Confusion Metric in Horizontal Sound Localization: The FBC Score

Fischer

Caversaccio

Wimmer

2020

Preprint

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In sound localization experiments, currently used metrics for front-back confusion (FBC) analysis weight the occurring FBCs equally, regardless of their deviation from the cone of confusion. To overcome this limitation, we introduce the FBC Score. A sound localization experiment in the horizontal plane with 12 bilaterally implanted cochlear implants (CI) users and 12 normal hearing subjects was performed to validate the method with real clinical data. The overall FBC Rate of the CI users was twice as high as the FBC Score. For the control group, the FBC Rate was 4 times higher than the FBC Score. The results indicate that the FBC Rate is inflated by FBCs that show a considerable deviation from the corresponding value on the cone of confusion.

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Benefits of a contralateral routing of signal device for unilateral Naída CI cochlear implant recipients

Mosnier

Lahlou

Flament

et al. 2019

Eur Arch Otorhinolaryngol

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Directional Microphone Contralateral Routing of Signals in Cochlear Implant Users: A Within-Subjects Comparison

Abstract: In bilateral deafened patients, bilateral implantation is the most preferable form of treatment. However, patients with one implant only could benefit from an additional directional microphone CROS device.

Cited by 26 publications

References 18 publications

The Value of Unilateral CIs, CI-CROS and Bilateral CIs, with and without Beamformer Microphones, for Speech Understanding in a Simulation of a Restaurant Environment

The Value of Unilateral CIs, CI-CROS and Bilateral CIs, with and without Beamformer Microphones, for Speech Understanding in a Simulation of a Restaurant Environment

A Front-Back Confusion Metric in Horizontal Sound Localization: The FBC Score

Benefits of a contralateral routing of signal device for unilateral Naída CI cochlear implant recipients

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