Effectiveness of Directional Microphones in Bilateral/Bimodal Cochlear Implant Users—Impact of Spatial and Temporal Noise Characteristics

Weißgerber, Tobias; Baumann, Uwe

doi:10.1097/mao.0000000000001524

Cited by 21 publications

(50 citation statements)

References 16 publications

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“…Spatial release from masking is thought to be due to a combination of both head shadow and binaural unmasking of speech, depending on the spectral and temporal characteristics of the signal and distracter(s) as well as the spatial location of signal and distracter(s). Research has shown that both bimodal and bilateral CI users derive benefit from spatial release from masking with similar degrees of benefit (e.g., Gifford et al, 2014;Weissgerber et al, 2017).…”

Section: Bimodal Hearing Versus Bilateral Cochlear Implantsmentioning

confidence: 99%

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

Gifford

Dorman

2019

Ear &Amp; Hearing

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Objective: The objectives of this study were to assess the effectiveness of various measures of speech understanding in distinguishing performance differences between adult bimodal and bilateral cochlear implant (CI) recipients and to provide a preliminary evidence-based tool guiding clinical decisions regarding bilateral CI candidacy. Design: This study used a multiple-baseline, cross-sectional design investigating speech recognition performance for 85 experienced adult CI recipients (49 bimodal, 36 bilateral). Speech recognition was assessed in a standard clinical test environment with a single loudspeaker using the minimum speech test battery for adult CI recipients as well as with an R-SPACE™ 8loudspeaker, sound-simulation system. All participants were tested in three listening conditions for each measure including each ear alone as well as in the bilateral/bimodal condition. In addition, we asked each bimodal listener to provide a yes/no answer to the question, "Do you think you need a second CI?" Results: This study yielded three primary findings: 1) there were no significant differences between bimodal and bilateral CI performance or binaural summation on clinical measures of speech recognition, 2) an adaptive speech recognition task in the R-SPACE™ system revealed significant differences in performance and binaural summation between bimodal and bilateral CI users, with bilateral CI users achieving significantly better performance and greater summation, and 3) the patient's answer to the question, "Do you think you need a second CI?" held high sensitivity (100% hit rate) for identifying likely bilateral CI candidates and moderately high specificity (77% correct rejection rate) for correctly identifying listeners best suited with a bimodal hearing configuration. Conclusions: Clinics cannot rely on current clinical measures of speech understanding, with a single loudspeaker, to determine bilateral CI candidacy for adult bimodal listeners nor to accurately document bilateral benefit relative to a previous bimodal hearing configuration. Speech recognition in a complex listening environment, such as R-SPACE™, is a sensitive and appropriate measure for determining bilateral CI candidacy and also likely for documenting bilateral benefit relative to a previous bimodal configuration. In the absence of an available R-SPACE™ system, asking the patient whether or not s/he thinks s/he needs a second CI is a highly sensitive measure which may prove clinically useful.

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Section: Bimodal Hearing Versus Bilateral Cochlear Implantsmentioning

confidence: 99%

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

Gifford

Dorman

2019

Ear &Amp; Hearing

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“…Clinical routine outcomes consist of CI- and HA-aided speech comprehension in quiet and noise. In research studies, performance in audiometric tests shows substantial dependence on the type of speech material, on the nature of noise confounders, and on spatial distribution of speech and noise sources ( 8 – 10 ). Furthermore, during audiometric tests pronunciation is clear, spectro-temporal characteristics and location of the speaker as well as noise type are static and thus predictable, and predictability increases the performance of CI-patients.…”

Section: Introductionmentioning

confidence: 99%

Patient Benefit Following Bimodal CI-provision: Self-reported Abilities vs. Hearing Status

et al. 2018

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Objectives: Patient-reported outcomes gain importance for the assessment of auditory abilities in cochlear implant users and for the evaluation of auditory rehabilitation. Aims of the study were to explore the interrelation of self-reported improvements in auditory ability with improvements in speech comprehension and to identify factors other than audiological improvement that affect self-reported auditory ability.Study Design: Explorative prospective analysis using a within-subjects 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 (bimodal hearing).Intervention: Cochlear implantation.Main Outcome Measures: Self-reported auditory ability/disability assessed by the comparative version of the Speech, Spatial and Qualities of Hearing Scale (SSQ-B), and monosyllable as well as sentence comprehension in quiet and within speech modulated noise from different directions assessed pre- as well as 3 and 6 months post-implantation.Results: Data of 17 individuals were analyzed. At the endpoint of the study, improvement of self-reported auditory ability was significant. Regarding audiometric measures, significant improvement was seen for CI-aided pure tone thresholds, for monaural CI-assisted and bimodal sentence comprehension in quiet and in speech-modulated noise that was presented from the same source or at the side of the HA-ear. Correlations between self-reported and audiometric improvements remained weak, with the exception of the improvement seen for monaural CI-aided sentence comprehension in quiet and self-perceived improvement of sound quality. Considerable correlations existed between self-reported improvements and current level of depression and anxiety, and with general self-efficaciousness. Regression analyses substantiated a positive influence of self-efficaciousness on self-reported improvement in speech comprehension and between the improvement of monaural CI-aided sentence comprehension in quiet and perceived sound quality as well as a negative influence of anxiety on self-reported improvement in spatial hearing. Self-reported improvements were significantly better in the subgroup with intensive as compared to regular rehabilitation.Conclusions: Self-reported auditory ability/disability represents an important measure for the success of bimodal CI-provision. It is influenced by personal and mental health factors that may improve CI-rehabilitation results if addressed during rehabilitation.

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“…Speech perception in noise in free-field conditions was assessed with Oldenburg Sentence Test in Multi-Source Noise Field (OLSA MSNF) condition [6,26]. Speech signal was presented from front (0°) with a distance of 1.75 m to the listening position.…”

Section: Methodsmentioning

confidence: 99%

“…The order of test lists was randomized. Further details and normative data for the setup are given in [26].…”

Section: Methodsmentioning

confidence: 99%

Speech perception in noise: Impact of directional microphones in users of combined electric-acoustic stimulation

2019

Self Cite

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Objectives Combined electric-acoustic stimulation (EAS) is a well-accepted therapeutic treatment for cochlear implant (CI) users with residual hearing in the low frequencies but severe to profound hearing loss in the high frequencies. The recently introduced SONNETeas audio processor offers different microphone directionality (MD) settings and wind noise reduction (WNR) as front-end processing. The aim of this study was to compare speech perception in quiet and noise between two EAS audio processors DUET 2 and SONNETeas, to assess the impact of MD and WNR on speech perception in EAS users in the absence of wind. Furthermore, subjective rating of hearing performance was registered. Method Speech perception and subjective rating with SONNETeas or DUET 2 audio processor were assessed in 10 experienced EAS users. Speech perception was measured in quiet and in a diffuse noise setup (MSNF). The SONNETeas processor was tested with three MD settings omnidirectional/natural/adaptive and with different intensities of WNR. Subjective rating of auditory benefit and sound quality was rated using two questionnaires. Results There was no significant difference between DUET 2 and SONNETeas processor using the omnidirectional microphone in quiet and in noise. There was a significant improvement in SRT with MD settings natural (2.2 dB) and adaptive (3.6 dB). No detrimental effect of the WNR algorithm on speech perception was found in the absence of wind. Sound quality was rated as “moderate” for both audio processors. Conclusions The different MD settings of the SONNETeas can provide EAS users with better speech perception compared to an omnidirectional microphone. Concerning speech perception in quiet and quality of life, the performance of the DUET 2 and SONNETeas audio processors was comparable.

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Effectiveness of Directional Microphones in Bilateral/Bimodal Cochlear Implant Users—Impact of Spatial and Temporal Noise Characteristics

Abstract: The absence of the glimpsing effect in CI users was reaffirmed in the present study. Although very effective in single noise source conditions, the beneficial impact of beamforming algorithms in multiple noise source conditions is poor.

Cited by 21 publications

References 16 publications

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

Patient Benefit Following Bimodal CI-provision: Self-reported Abilities vs. Hearing Status

Speech perception in noise: Impact of directional microphones in users of combined electric-acoustic stimulation

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