scholarly journals Application of Wireless Contralateral Routing of Signal Technology in Unilateral Cochlear Implant Users with Bilateral Profound Hearing Loss

2019 ◽  
Vol 30 (07) ◽  
pp. 579-589 ◽  
Author(s):  
Hillary A. Snapp ◽  
Michael E. Hoffer ◽  
Anthony Spahr ◽  
Suhrud Rajguru
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Profound Hearing Loss ◽  
Speech In Noise ◽  
Bonferroni Adjustment ◽  
Significant Difference ◽  
Hearing Outcomes

AbstractThe aim of the study was to determine if contralateral routing of signal (CROS) technology results in improved hearing outcomes in unilateral cochlear implant (CI) patients and provides similar gains in speech perception in noise to traditional monaural listeners (MLs).The study is a prospective, within-subject repeated-measures experiment.Adult, English-speaking patients with bilateral severe–profound sensorineural hearing loss using an Advanced Bionics CI (n = 12) in one ear were enrolled for the study.Hearing performance in the monaural listening condition (CI only) was compared with the CROS-aided (unilateral CI + CROS) condition. Participants were tested for speech-in-noise performance using the Bamford-Kowal-Bench Speech-in-Noise™ test materials in the speech front/noise front (0 degrees/0 degrees azimuth), speech front/noise back (0 degrees/180 degrees azimuth), speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth), and speech monaural ear/noise deaf ear (90 degrees/270 degrees azimuth) configurations. Localization error was assessed using three custom stimuli consisting of 1/3 octave narrowband noises centered at 500 and 4000 Hz and a broadband speech stimulus. Localization stimuli were presented at random in the front hemifield by 19 speakers spatially separated by 10 degrees. Outcomes were compared with a previously described group of traditional MLs in the CROS-aided condition (normal hearing ear + CROS).All participants were tested acutely with no adaptation to the CROS device. Statistical analyses were performed using Wilcoxon signed rank tests for nonparametric data and paired sample. Statistical significance was set to p < 0.00625 after Bonferroni adjustment for eight tests.Significant benefit was observed from unaided to the CI + CROS–aided condition for listening in noise across most listening conditions with the greatest benefit observed in the speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth) condition (p < 0.0005). When compared with traditional MLs, no significant difference in decibel gain from the unaided to CROS-aided conditions was observed between participant groups. There was no improvement in localization ability in the CROS-aided condition for either participant group and no significant difference in performance between traditional MLs and unilateral CI listeners.These findings support that unilateral CI users are capable of achieving similar gains in speech perception to that of traditional MLs with wireless CROS. These results indicate that the use of wireless CROS stimulation in unilateral CI recipients provides increased benefit and an additional rehabilitative option for this population when bilateral implantation is not possible. The results suggest that noninvasive CROS solutions can successfully rehabilitate certain monaural listening deficits, provide improved hearing outcomes, and expand the reach of treatment in this population.

The Effect of Conventional and Transparent Surgical Masks on Speech Understanding in Individuals with and without Hearing Loss

2017 ◽  
Vol 28 (01) ◽  
pp. 058-067 ◽  
Author(s):  
Samuel R. Atcherson ◽  
Lisa Lucks Mendel ◽  
Wesley J. Baltimore ◽  
Chhayakanta Patro ◽  
Sungmin Lee ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Impairment ◽  
Visual Input ◽  
Acoustic Properties ◽  
Speech Understanding ◽  
Profound Hearing Loss ◽  
Cross Sectional ◽  
Surgical Masks ◽  
Significant Difference

AbstractIt is generally well known that speech perception is often improved with integrated audiovisual input whether in quiet or in noise. In many health-care environments, however, conventional surgical masks block visual access to the mouth and obscure other potential facial cues. In addition, these environments can be noisy. Although these masks may not alter the acoustic properties, the presence of noise in addition to the lack of visual input can have a deleterious effect on speech understanding. A transparent (“see-through”) surgical mask may help to overcome this issue.To compare the effect of noise and various visual input conditions on speech understanding for listeners with normal hearing (NH) and hearing impairment using different surgical masks.Participants were assigned to one of three groups based on hearing sensitivity in this quasi-experimental, cross-sectional study.A total of 31 adults participated in this study: one talker, ten listeners with NH, ten listeners with moderate sensorineural hearing loss, and ten listeners with severe-to-profound hearing loss.Selected lists from the Connected Speech Test were digitally recorded with and without surgical masks and then presented to the listeners at 65 dB HL in five conditions against a background of four-talker babble (+10 dB SNR): without a mask (auditory only), without a mask (auditory and visual), with a transparent mask (auditory only), with a transparent mask (auditory and visual), and with a paper mask (auditory only).A significant difference was found in the spectral analyses of the speech stimuli with and without the masks; however, no more than ∼2 dB root mean square. Listeners with NH performed consistently well across all conditions. Both groups of listeners with hearing impairment benefitted from visual input from the transparent mask. The magnitude of improvement in speech perception in noise was greatest for the severe-to-profound group.Findings confirm improved speech perception performance in noise for listeners with hearing impairment when visual input is provided using a transparent surgical mask. Most importantly, the use of the transparent mask did not negatively affect speech perception performance in noise.

Effect of Different Signal-Processing Options on Speech-in-Noise Recognition for Cochlear Implant Recipients with the Cochlear CP810 Speech Processor

2014 ◽  
Vol 25 (04) ◽  
pp. 367-379 ◽  
Author(s):  
Lisa G. Potts ◽  
Kelly A. Kolb
Keyword(s):  
Cochlear Implant ◽  
Speech Processing ◽  
Repeated Measures ◽  
Noise Cancellation ◽  
Space Environment ◽  
Speech Processor ◽  
Speech In Noise ◽  
Directional Filtering ◽  
Significant Difference ◽  
Db Difference

Background: Difficulty understanding speech in the presence of background noise is a common report among cochlear implant (CI) recipients. Several speech-processing options designed to improve speech recognition, especially in noise, are currently available in the Cochlear Nucleus CP810 speech processor. These include adaptive dynamic range optimization (ADRO), autosensitivity control (ASC), Beam, and Zoom. Purpose: The purpose of this study was to evaluate CI recipients’ speech-in-noise recognition to determine which currently available processing option or options resulted in best performance in a simulated restaurant environment. Research Design: Experimental study with one study group. The independent variable was speech-processing option, and the dependent variable was the reception threshold for sentences score. Study Sample: Thirty-two adult CI recipients. Intervention: Eight processing options were tested: Beam, Beam + ASC, Beam + ADRO, Beam + ASC + ADRO, Zoom, Zoom + ASC, Zoom + ADRO, and Zoom + ASC + ADRO. Data Collection and Analysis: Participants repeated Hearing in Noise Test sentences presented at a 0° azimuth, with R-Space restaurant noise presented from a 360° eight-loudspeaker array at 70 dB sound pressure level. A one-way repeated-measures analysis of variance was used to analyze differences in Beam options, Zoom options, and Beam versus Zoom options. Results: Among the Beam options, Beam + ADRO was significantly poorer than Beam only, Beam + ASC, and Beam + ASC + ADRO. A 1.6-dB difference was observed between the best (Beam only) and poorest (Beam + ADRO) options. Among the Zoom options, Zoom only and Zoom + ADRO were significantly poorer than Zoom + ASC. A 2.2-dB difference was observed between the best (Zoom + ASC) and poorest (Zoom only) options. The comparison between Beam and Zoom options showed one significant difference, with Zoom only significantly poorer than Beam only. No significant difference was found between the other Beam and Zoom options (Beam + ASC vs Zoom + ASC, Beam + ADRO vs Zoom + ADRO, and Beam + ASC + ADRO vs Zoom + ASC + ADRO). The best processing option varied across subjects, with an almost equal number of participants performing best with a Beam option (n = 15) compared with a Zoom option (n = 17). There were no significant demographic or audiological moderating variables for any option. Conclusions: The results showed no significant differences between adaptive directionality (Beam) and fixed directionality (Zoom) when ASC was active in the R-Space environment. This finding suggests that noise-reduction processing is extremely valuable in loud semidiffuse environments in which the effectiveness of directional filtering might be diminished. However, there was no significant difference between the Beam-only and Beam + ASC options, which is most likely related to the additional noise cancellation performed by the Beam option (i.e., two-stage directional filtering and noise cancellation). In addition, the processing options with ADRO resulted in the poorest performances. This could be related to how the CI recipients were programmed or the loud noise level used in this study. The best processing option varied across subjects, but the majority performed best with directional filtering (Beam or Zoom) in combination with ASC. Therefore in a loud semidiffuse environment, the use of either Beam + ASC or Zoom + ASC is recommended.

Comparison of Trunk Muscle Activity During Modified Side-Bridge Exercises and Traditional Side Bridge Exercise

2020 ◽  
Vol 29 (7) ◽  
pp. 963-969 ◽  
Author(s):  
Chi-Whan Choi ◽  
Jung-Wan Koo ◽  
Yeon-Gyu Jeong
Keyword(s):  
Analysis Of Variance ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Compressive Load ◽  
University Hospital ◽  
Healthy Men ◽  
Bonferroni Adjustment ◽  
Repeated Measures Analysis ◽  
Significant Difference

Context: The modified side-bridge exercise is designed for some special situations in which it is impossible to tolerate the compressive load on the side supported during the side bridge, such as in the older people with a hip or knee replacement and even in athletes with shoulder pain. Objectives: To examine the effects of 3 modified side-bridge exercises on the spinal stability muscles compared with traditional side-bridge (TSB) exercises for healthy men. Design: The effects of different exercises on the muscle activities of the external oblique (EO), internal oblique (IO), and quadratus lumborum (QL) during TSB exercise, both legs lift on side lying (BLLS), torso lift on a 45° bench while side lying (TLBS), and wall side bridge (WSB) were analyzed with the 1-way repeated-measures analysis of variance. Setting: This study was conducted in a university hospital laboratory. Participants: A total of 20 healthy men were recruited for this study. Interventions: The participants performed TSB, BLLS, TLBS, and WSB in a random order. Main Outcome Measures: Surface electromyography measured the muscle activity of the EO, IO, and QL. A 1-way repeated-measures analysis of variance assessed the statistical significance of the EO, IO, and QL muscle activity. When there was a significant difference, a Bonferroni adjustment was performed. Results: BLLS and TLBS showed similar effects to TSB in the EO, IO, and QL muscle activity, whereas WSB showed significantly less QL muscle activity than TSB (P < .05). Moreover, TLBS was significantly greater in the muscle activity of QL and EO than WSB (P < .05). Conclusion: BLLS and TLBS may be effective rehabilitation techniques to activate EO, IO, and QL in patients who are unable to perform TSB as spine stability exercises.

scholarly journals Recent Results with the MED-EL COMBI 40+ Cochlear Implant and TEMPO+ behind-the-ear Processor

2002 ◽  
Vol 81 (4) ◽  
pp. 229-233 ◽  
Author(s):  
Ilona Anderson ◽  
Viktor Weichbold ◽  
Patrick D'Haese
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Distinct Advantage ◽  
Profound Hearing Loss ◽  
Speech Processor ◽  
German Study ◽  
Viable Treatment

Cochlear implantation is a viable treatment for patients with severe to profound hearing loss. We report the results of speech perception tests (numbers, monosyllables, and sentence tests) achieved with MED-EL's COMBI 40+ (C40+) cochlear implant after 12 months of use. These findings, which were taken from a larger German study, were similar to those of other studies of the C40+ implant. We also compared the differences in speech perception observed with the CIS PRO+ body-worn speech processor and the newer TEMPO+ behind-the-ear speech processor. Although these results were similar with respect to most of the measured parameters, the TEMPO+ processor had a distinct advantage during tests in noise.

scholarly journals The Effects of Manufacturer’s Prefit and Real-Ear Fitting on the Predicted Speech Perception of Children with Severe to Profound Hearing Loss

2019 ◽  
Vol 30 (05) ◽  
pp. 346-356 ◽  
Author(s):  
Tian Kar Quar ◽  
Cila Umat ◽  
Yong Yee Chew
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
High Input ◽  
Profound Hearing Loss ◽  
High Frequency Region ◽  
Cross Sectional ◽  
Significant Difference

AbstractThe use of probe microphone measures in hearing aid verification is often neglected or not fully used by practitioners. Some practitioners rely on simulated gain and output provided by manufacturer's fitting software to verify hearing aids.This study aims to evaluate the effectiveness of manufacturer’s prefit procedure in matching the prescribed real-ear targets. It also aims to study its correlated impact on the predicted speech perception in children with severe and profound hearing loss.This cross-sectional experiment was carried out by measuring the output of hearing aids based on prefit versus real-ear at low-, moderate-, and high-input levels. The predicted speech perception for different hearing aid fittings was determined based on the Speech Intelligibility Index (SII).Sixteen children (28 ears) aged between 4 and 7 yr, with severe to profound sensorineural hearing loss took part in the study.Two different types of hearing aids (Phonak and Unitron) were programmed based on their respective manufacturers’ Desired Sensation Levels (DSL) v5 Child procedure. The hearing aids were then verified using coupler-based measurements and individual real-ear-to-coupler differences. The prefit outputs were compared with the DSL v5 Child–prescribed outputs at low-, moderate-, and high-input levels. The hearing aids were then adjusted to closely match the prescribed output. The SIIs were calculated for the fittings before and after adjustment.Sixty four percent of fittings that were based on the prefit procedure achieved the optimal fit-to-targets, with less than 5-dB RMS deviations from the DSL v5 Child targets. After adjusting the hearing aids to attempt to meet the DSL v5 Child targets, 75% of the ears tested achieved the optimal fit-to-targets. On average, hearing aid outputs generated by the manufacturer’s prefit procedure had good and reasonable agreement with the DSL v5 Child–prescribed outputs at low- and mid-frequencies. Nonetheless, at 4000 Hz, the hearing aid output mostly fell below the DSL v5 Child–prescribed outputs. This was still the case even after the hearing aid was adjusted to attempt to match with the targets. At low input level, some prefit outputs were found to be higher than the prescribed outputs. The deviations of prefit outputs from the prescribed outputs were dependent on the type of hearing aid and input levels. There was no significant difference between the SII calculated for fittings based on the prefit and adjusted fit.Prefit procedure tends to produce outputs that were below the DSL v5 Child–prescribed outputs, with the largest mean difference at 4000 Hz. Even though the hearing aid gains were adjusted to attempt to match with the targets, the outputs were still below the targets. The limitations of hearing aids to match the DSL v5 Child targets at high-frequency region have resulted in no improvement in the children’s predicted speech perception.

scholarly journals Speech Perception Outcomes in Older Children Who Use Multichannel Cochlear Implants: Older is Not Always Poorer

2002 ◽  
Vol 111 (5_suppl) ◽  
pp. 97-101 ◽  
Author(s):  
Richard C. Dowell ◽  
Elizabeth Winton ◽  
Shani J. Dettman ◽  
Elizabeth J. Barker ◽  
Katie Hill ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Linear Regression Analysis ◽  
Informed Choice ◽  
Multiple Linear Regression Analysis ◽  
Older Children ◽  
Profound Hearing Loss ◽  
Open Set ◽  
The Mean

Speech perception outcomes for early-deafened children who undergo implantation as teenagers or young adults are generally reported to be poorer than results for young children. It is important to provide appropriate expectations when counseling adolescents and their families to help them make an informed choice regarding cochlear implant surgery. The considerable variation of results in this group makes this process more difficult. This study considered a number of factors in a group of 25 children who underwent implantation in Melbourne between the ages of 8 and 18 years. Each subject completed open-set speech perception testing with Bamford-Kowal-Bench sentences before and after implantation and preoperative language testing with the Peabody Picture Vocabulary Test. Data were collected regarding the type of hearing loss, age at implantation, age at hearing aid fitting, audiometric details, and preoperative and postoperative communication mode. Results were submitted to a stepwise multiple linear regression analysis with postoperative open-set sentence scores as the dependent variables. The analysis suggested that 3 factors have a significant predictive value for speech perception after implantation: preoperative open-set sentence score, duration of profound hearing loss, and equivalent language age. These 3 factors accounted for 66% of the variance in this group. The results of this study suggest that children who have useful speech perception before implantation, and higher age-equivalent scores on language measures, would be expected to do well with a cochlear implant. Consistent with other studies, a shorter duration of profound hearing loss is also advantageous. The mean sentence score for this group, 47%, was not significantly different from the mean result across all children in the Melbourne program.

scholarly journals The effect of a coding strategy that removes temporally masked pulses on speech perception by cochlear implant users

2020 ◽  
Author(s):  
Wiebke Lamping ◽  
Tobias Goehring ◽  
Jeremy Marozeau ◽  
Robert P. Carlyon
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Speech Intelligibility ◽  
Average Power ◽  
Decision Criterion ◽  
Speech In Noise ◽  
Current Pulses ◽  
Temporal Integrator ◽  
Significant Difference ◽  
Temporal Masking

Speech recognition in noisy environments remains a challenge for cochlear implant (CI) recipients. Unwanted charge interactions between current pulses in the same and across different electrode channels are likely to impair performance. Here we investigate the effect of reducing the number of current pulses on speech perception. This was achieved by implementing a psychoacoustic temporal-masking model where current pulses in each channel were passed through a temporal integrator to identify and remove pulses that were less likely to be perceived by the recipient. The decision criterion of the temporal integrator was varied to control the percentage of pulses removed in each condition. In experiment 1, speech in quiet was processed with a standard Continuous Interleaved Sampling (CIS) strategy and with 25, 50 and 75% of pulses removed. In experiment 2, performance was measured for speech in noise with the CIS reference and with 50 and 75% of pulses removed. Speech intelligibility in quiet revealed no significant difference between reference and test conditions. For speech in noise, results showed a significant improvement of 2.4 dB when removing 50% of pulses. Performance both in quiet and in noise was not significantly different between the reference and when 75% of pulses were removed. Further, by reducing the overall amount of current pulses by 25, 50, and 75% but accounting for the increase in charge necessary to compensate for the decrease in loudness, estimated average power savings of 21.15, 40.95, and 63.45%, respectively, could be possible for this set of listeners. In conclusion, removing temporally masked pulses may improve speech perception in noise and result in substantial power savings.

scholarly journals Melodic Contour Training and Its Effect on Speech in Noise, Consonant Discrimination, and Prosody Perception for Cochlear Implant Recipients

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Chi Yhun Lo ◽  
Catherine M. McMahon ◽  
Valerie Looi ◽  
William F. Thompson
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Training Program ◽  
Auditory Training ◽  
Speech Prosody ◽  
Speech In Noise ◽  
Melodic Contour ◽  
Significant Difference ◽  
Potential Benefits ◽  
Noisy Conditions

Cochlear implant (CI) recipients generally have good perception of speech in quiet environments but difficulty perceiving speech in noisy conditions, reduced sensitivity to speech prosody, and difficulty appreciating music. Auditory training has been proposed as a method of improving speech perception for CI recipients, and recent efforts have focussed on the potential benefits of music-based training. This study evaluated two melodic contour training programs and their relative efficacy as measured on a number of speech perception tasks. These melodic contours were simple 5-note sequences formed into 9 contour patterns, such as “rising” or “rising-falling.” One training program controlled difficulty by manipulating interval sizes, the other by note durations. Sixteen adult CI recipients (aged 26–86 years) and twelve normal hearing (NH) adult listeners (aged 21–42 years) were tested on a speech perception battery at baseline and then after 6 weeks of melodic contour training. Results indicated that there were some benefits for speech perception tasks for CI recipients after melodic contour training. Specifically, consonant perception in quiet and question/statement prosody was improved. In comparison, NH listeners performed at ceiling for these tasks. There was no significant difference between the posttraining results for either training program, suggesting that both conferred benefits for training CI recipients to better perceive speech.

scholarly journals Effect of “Spatially Separated Speech in Noise Training” on speech perception in noise in children with bimodal fitting

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Younes Lotfi ◽  
Mahdieh Hasanalifard ◽  
Abdollah Moossavi ◽  
Enayatollah Bakhshi ◽  
Mohammad Ajalloueyan
Keyword(s):  
Speech Perception ◽  
Intervention Group ◽  
Auditory Training ◽  
Control Group ◽  
Interventional Study ◽  
Post Intervention ◽  
Speech Perception In Noise ◽  
Speech In Noise ◽  
Significant Difference ◽  
Recognition Ability

Abstract Background The objective of this study was to evaluate the effect of “Spatially separated speech in noise” auditory training on the ability of speech perception in noise among bimodal fitting users. The assumption was that the rehabilitation can enhance spatial hearing and hence speech in noise perception. This study was an interventional study, with a pre/post-design. Speech recognition ability was assessed with the specific tests. After performing the rehabilitation stages in the intervention group, the speech tests were again implemented, and by comparing the pre- and post-intervention data, the effect of auditory training on the speech abilities was assessed. Twenty-four children of 8–12 years who had undergone cochlear implantation and continuously used bimodal fitting were investigated in two groups of control and intervention. Results The results showed a significant difference between the groups in different speech tests after the intervention, which indicated that the intervention group have improved more than the control group. Conclusion It can be concluded that “Spatially separated speech in noise” auditory training can improve the speech perception in noise in bimodal fitting users. In general, this rehabilitation method is useful for enhancing the speech in noise perception ability.

scholarly journals The Effects of Round Window Membrane Injury and the Use of a Model Electrode Application on Hearing in Rats

2021 ◽  
pp. 014556132199018
Author(s):  
Murat Koc ◽  
Abdullah Dalgic ◽  
Mehmet Ziya Ozuer
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Round Window ◽  
Mechanical Trauma ◽  
Round Window Membrane ◽  
Albino Rats ◽  
Topical Steroids ◽  
Distortion Product ◽  
Significant Difference ◽  
Group 3

Objective: To investigate the effects of the mechanical trauma to the round window, a model electrode inserted into the scala tympani on the cochlear reserve, and the efficacy of topical steroids in preventing hearing loss. Materials and Methods: 21 male Wistar Albino rats were equally categorized into three groups. In all groups an initial mechanical injury to round window was created. Only subsequent dexamethasone injection was administrated into the cochlea in the subjects of group 2 while a multichannel cochlear implant guide inserted into the cochlea prior to dexamethasone administration for group 3. Distortion product otoacoustic emissions (DPOAEs) were obtained prior to and immediately after the surgical injury, eventually on postoperative seventh day (d 7). Mean signal/noise ratios (S/Ns) obtained at 2000, 3000, and 4000 Hz were calculated. Data sets were compared with non-parametric statistical tests. Results: The early intraoperative mean S/Ns were significantly less than preoperative measurements for group 1 and 2; however, preoperative and postoperative d 7 average S/Ns did not differ. There was statistically significant difference between preoperative, intraoperative and postoperative d 7 average S/Ns for group 3. Conclusion: We observed that hearing was restored approximately to the preoperative levels following early postoperative repair. However, an electrode insertion into the cochlea via round window subsequent to mechanical trauma seems to cause a progressive hearing loss. Therefore, a special care must be taken to avoid the injury to the round window membrane in the course of the placement of a cochlear implant electrode and surgery for the chronic otitis media.

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