Fine structure processing improves telephone speech perception in cochlear implant users

The effect of internet telephony and a cochlear implant accessory on mobile phone speech comprehension in cochlear implant users

PURPOSE

In individuals with severe hearing loss, mobile phone communication is limited despite treatment with a cochlear implant (CI). The goal of this study is to identify the best communication practice for CI users by comparing speech comprehension of conventional mobile phone (GSM) calls, Voice over Internet Protocol (VoIP) calls, and the application of a wireless phone clip (WPC) accessory.

METHODS

This study included 13 individuals (mean age 47.1  ± 17.3 years) with at least one CI. Frequency response and objective voice quality were tested for each device, transmission mode and the WPC. We measured speech comprehension using a smartphone for a GSM call with and without WPC as well as VoIP-calls with and without WPC at different levels of white background noise.

RESULTS

Frequency responses of the WPC were limited (< 4 kHz); however, speech comprehension in a noisy environment was significantly improved compared to GSM. Speech comprehension was improved by 9-27% utilizing VoIP or WPC compared to GSM. WPC was superior in noisy environments (80 dB SPL broadband noise) compared to GSM. At lower background noise levels (50, 60, 70 dB SPL broadband noise), VoIP resulted in improved speech comprehension with and without WPC. Speech comprehension scores did not correlate with objective voice quality measurements.

CONCLUSION

Speech comprehension was best with VoIP alone; however, accessories such as a WPC provide additional improvement in the presence of background noise. Mobile phone calls utilizing VoIP technology, with or without a WPC accessory, result in superior speech comprehension compared to GSM.

Influence of Telecommunication Modality, Internet Transmission Quality, and Accessories on Speech Perception in Cochlear Implant Users

Background

Telecommunication is limited or even impossible for more than one-thirds of all cochlear implant (CI) users.

Objective

We sought therefore to study the impact of voice quality on speech perception with voice over Internet protocol (VoIP) under real and adverse network conditions.

Methods

Telephone speech perception was assessed in 19 CI users (15-69 years, average 42 years), using the German HSM (Hochmair-Schulz-Moser) sentence test comparing Skype and conventional telephone (public switched telephone networks, PSTN) transmission using a personal computer (PC) and a digital enhanced cordless telecommunications (DECT) telephone dual device. Five different Internet transmission quality modes and four accessories (PC speakers, headphones, 3.5 mm jack audio cable, and induction loop) were compared. As a secondary outcome, the subjective perceived voice quality was assessed using the mean opinion score (MOS).

Results

Speech telephone perception was significantly better (median 91.6%, P<.001) with Skype compared with PSTN (median 42.5%) under optimal conditions. Skype calls under adverse network conditions (data packet loss > 15%) were not superior to conventional telephony. In addition, there were no significant differences between the tested accessories (P>.05) using a PC. Coupling a Skype DECT phone device with an audio cable to the CI, however, resulted in higher speech perception (median 65%) and subjective MOS scores (3.2) than using PSTN (median 7.5%, P<.001).

Conclusions

Skype calls significantly improve speech perception for CI users compared with conventional telephony under real network conditions. Listening accessories do not further improve listening experience. Current Skype DECT telephone devices do not fully offer technical advantages in voice quality.

Technical aids for speech understanding in cochlear implanted adults using cell-phones

OBJECTIVES

The present study sought to assess (1) phone use habits and awareness of listening aids in adult cochlear implant bearers, and (2) objective and subjective benefit of listening aids for cell-phone communication.

MATERIAL AND METHODS

A questionnaire was sent to 17 cochlear (Cochlear(®)) implanted adults to assess phone use and awareness of available listening aids. Speech perception without lip-reading was assessed in silence and in noise using Fournier dissyllabic word lists recorded on an iPhone 5C(®), with and without listening aids. Subjective benefit was assessed according to listening aid system.

RESULTS

Sixty-five percent of adult cochlear implant bearers regularly used a phone with all kinds of correspondent. Eighty-eight percent phoned only in quiet conditions; 53% did not answer unknown callers; 71% never used listening aids. Speech discrimination scores for disyllabic words recorded on the phone were respectively 69%, 63%, 45% and 16% in quiet and 50, 60 and 70dB SPL noise. Speech perception in quiet and noise was improved by listening aids; the Roger system was the most beneficial, followed by the FM system, then the inductive system.

CONCLUSION

Listening aids are effective, but little known by adult cochlear implant bearers.

The Glasgow Benefit Inventory: a systematic review of the use and value of an otorhinolaryngological generic patient-recorded outcome measure

BACKGROUND

The Glasgow Benefit Inventory (GBI) is a validated, generic patient-recorded outcome measure widely used in otolaryngology to report change in quality of life post-intervention.

OBJECTIVES OF REVIEW

To date, no systematic review has made (i) a quality assessment of reporting of Glasgow Benefit Inventory outcomes; (ii) a comparison between Glasgow Benefit Inventory outcomes for different interventions and objectives; (iii) an evaluation of subscales in describing the area of benefit; (iv) commented on its value in clinical practice and research.

TYPE OF REVIEW

Systematic review.

SEARCH STRATEGY

'Glasgow Benefit Inventory' and 'GBI' were used as keywords to search for published, unpublished and ongoing trials in PubMed, EMBASE, CINAHL and Google in addition to an ISI citation search for the original validating Glasgow Benefit Inventory paper between 1996 and January 2015.

EVALUATION METHOD

Papers were assessed for study type and quality graded by a predesigned scale, by two authors independently. Papers with sufficient quality Glasgow Benefit Inventory data were identified for statistical comparisons. Papers with <50% follow-up were excluded.

RESULTS

A total of 118 eligible papers were identified for inclusion. A national audit paper (n = 4325) showed that the Glasgow Benefit Inventory gave a range of scores across the specialty, being greater for surgical intervention than medical intervention or 'reassurance'. Fourteen papers compared one form of surgery versus another form of surgery. In all but one study, there was no difference between the Glasgow Benefit Inventory scores (or of any other outcome). The most likely reason was lack of power. Two papers took an epidemiological approach and used the Glasgow Benefit Inventory scores to predict benefit. One was for tonsillectomy where duration of sore throat episodes and days with fever were identified on multivariate analysis to predict benefit albeit the precision was low. However, the traditional factor of number of episodes of sore throat was not predictive. The other was surgery for chronic rhinosinusitis where those with polyps on univariate analysis had greater benefit than those without. Forty-three papers had a response rate of >50% and gave sufficient Glasgow Benefit Inventory total and subscales for meta-analysis. For five of the 11 operation categories (vestibular schwannoma, tonsillectomy, cochlear implant, middle ear implant and stapes surgery) that were most likely to have a single clear clinical objective, score data had low-to-moderate heterogeneity. The value in the Glasgow Benefit Inventory having both positive and negative scores was shown by an overall negative score for the management of vestibular schwannoma. The other six operations gave considerable heterogeneity with rhinoplasty and septoplasty giving the greatest percentages (98% and 99%) most likely because of the considerable variations in patient selection. The data from these operations should not be used for comparative purposes. Five papers also reported the number of patients that had no or negative benefit, a potentially a more clinically useful outcome to report. Glasgow Benefit Inventory subscores for tonsillectomy were significantly different from ear surgery suggesting different areas of benefit

CONCLUSIONS

The Glasgow Benefit Inventory has been shown to differentiate the benefit between surgical and medical otolaryngology interventions as well as 'reassurance'. Reporting benefit as percentages with negative, no and positive benefit would enable better comparisons between different interventions with varying objectives and pathology. This could also allow easier evaluation of factors that predict benefit. Meta-analysis data are now available for comparison purposes for vestibular schwannoma, tonsillectomy, cochlear implant, middle ear implant and stapes surgery. Fuller report of the Glasgow Benefit Inventory outcomes for non-surgical otolaryngology interventions is encouraged.

Using the HISQUI29 to assess the sound quality levels of Spanish adults with unilateral cochlear implants and no contralateral hearing

To evaluate cochlear implant (CI) users' self-reported level of sound quality and quality of life (QoL). Sound quality was self-evaluated using the hearing implant sound quality index (HISQUI29). HISQUI29 scores were further examined in three subsets. QoL was self-evaluated using the glasgow benefit inventory (GBI). GBI scores were further examined in three subsets. Possible correlations between the HISQUI29 and GBI were explored. Additional possible correlations between these scores and subjects' pure tone averages, speech perception scores, age at implantation, duration of hearing loss, duration of CI use, gender, and implant type were explored. Subjects derived a "moderate" sound quality level from their CI. Television, radio, and telephone tasks were easier in quiet than in background noise. 89 % of subjects reported their QoL benefited from having a CI. Mean total HISQUI29 score significantly correlated with all subcategories of the GBI. Age at implantation inversely correlated with the total HISQUI29 score and with television and radio understanding. Sentence in noise scores significantly correlated with all sound perception scores. Women had a better mean score in music perception and in telephone use than did men. CI users' self-reported levels of sound quality significantly correlated with their QoL. Cochlear implantation had a beneficial impact on subjects' QoL. Understanding speech is easier in quiet than in noise. Music perception remains a challenge for many CI users. The HISQUI29 and the GBI can provide useful information about the everyday effects of future treatment modalities, rehabilitation strategies, and technical developments.