Speech Perception for Adult Cochlear Implant Recipients in a Realistic Background Noise: Effectiveness of Preprocessing Strategies and External Options for Improving Speech Recognition in Noise

Abstract

Background Although cochlear implant patients are achieving increasingly higher levels of performance, speech perception in noise continues to be problematic. The newest generations of implant speech processors are equipped with preprocessing and/or external accessories that are purported to improve listening in noise. Most speech perception measures in the clinical setting, however, do not provide a close approximation to real-world listening environments. Purpose To assess speech perception for adult cochlear implant recipients in the presence of a realistic restaurant simulation generated by an eight-loudspeaker (R-SPACE™) array in order to determine whether commercially available preprocessing strategies and/or external accessories yield improved sentence recognition in noise. Research Design Single-subject, repeated-measures design with two groups of participants: Advanced Bionics and Cochlear Corporation recipients. Study Sample Thirty-four subjects, ranging in age from 18 to 90 yr (mean 54.5 yr), participated in this prospective study. Fourteen subjects were Advanced Bionics recipients, and 20 subjects were Cochlear Corporation recipients. Intervention Speech reception thresholds (SRTs) in semidiffuse restaurant noise originating from an eight-loudspeaker array were assessed with the subjects’ preferred listening programs as well as with the addition of either Beam™ preprocessing (Cochlear Corporation) or the T-Mic® accessory option (Advanced Bionics). Data Collection and Analysis In Experiment 1, adaptive SRTs with the Hearing in Noise Test sentences were obtained for all 34 subjects. For Cochlear Corporation recipients, SRTs were obtained with their preferred everyday listening program as well as with the addition of Focus preprocessing. For Advanced Bionics recipients, SRTs were obtained with the integrated behind-the-ear (BTE) mic as well as with the T-Mic. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of the preprocessing strategy or external accessory in reducing the SRT in noise. In addition, a standard t-test was run to evaluate effectiveness across manufacturer for improving the SRT in noise. In Experiment 2, 16 of the 20 Cochlear Corporation subjects were reassessed obtaining an SRT in noise using the manufacturer-suggested “Everyday,” “Noise,” and “Focus” preprocessing strategies. A repeated-measures ANOVA was employed to assess the effects of preprocessing. Results The primary findings were (i) both Noise and Focus preprocessing strategies (Cochlear Corporation) significantly improved the SRT in noise as compared to Everyday preprocessing, (ii) the T-Mic accessory option (Advanced Bionics) significantly improved the SRT as compared to the BTE mic, and (iii) Focus preprocessing and the T-Mic resulted in similar degrees of improvement that were not found to be significantly different from one another. Conclusion Options available in current cochlear implant sound processors are able to significantly improve speech understanding i...

Satisfação dos usuários do implante coclear com perda auditiva pós-lingual

“…Manrique et al (2006) suggests that the limitation beyond being associated with the technology of the implants and with the functional state of the hearing pathway, also guards the relation with the innate limitations of the hearing system before the adverse situation and especially by the speech of binaural stimulation that has a patient implanted in one ear only 19 . Despite the possibility to achieve higher levels of speech comprehension, researches reveal that the users of the CI continue to present considerable difficulty in speech comprehension with noise in the background 11,20,21 . By evaluating the users satisfaction of the CI in different situations, Castro et al (2005) 22 proved that the satisfaction in noisy environments presents a smaller punctuation that the other aspects.…”

Contribution of formant frequency information to vowel perception in steady-state noise by cochlear implant users

“…CI devices can provide recipients with substantial amounts of open-set word recognition in quiet, albeit with large amounts of individual differences (Mahmoud and Ruckenstein, 2014). Most CI recipients complain about difficulty understanding speech in noise at signal-to-noise ratios (SNRs) that would have little impact on speech understanding in listeners with normal hearing (Gifford and Revit, 2010). Present day devices are equipped with directional microphones and signal processing algorithms that can result in improved speech perception in difficult listening environments (Geibler et al, 2015;Mauger et al, 2014).…”

“…Present day devices are equipped with directional microphones and signal processing algorithms that can result in improved speech perception in difficult listening environments (Geibler et al, 2015;Mauger et al, 2014). However, the improvements in speech perception offered by these advances remain poorer than what listeners with normal hearing would achieve under similar listening conditions, especially when signal and noise are co-located in space (Gifford and Revit, 2010). To advance noise reduction algorithms further, it may be helpful to consider the effect of noise on the acoustic cues employed by CI users to understand speech.…”

Voice gender and the segregation of competing talkers: Perceptual learning in cochlear implant simulations

“…In general, CI users' speech perception performance and the quality of CI technology have improved (Gifford and Revit, 2010). Despite the remarkable progress CI users have shown in understanding speech in quiet, there remains a great deal of variability in their performance, especially in adverse listening situations.…”