Binaural Glimpses at the Cocktail Party?

Predictors of cochlear implant outcomes in pediatric auditory neuropathy: A matched case-control study

OBJECTIVES

Current evidence supports the benefits of cochlear implants (CIs) in children with hearing loss, including those with auditory neuropathy spectrum disorder (ANSD). However, there is limited evidence regarding factors that hold predictive value for intervention outcomes.

DESIGN

This retrospective case-control study consisted of 66 children with CIs, including 22 with ANSD and 44 with sensorineural hearing loss (SNHL) matched on sex, age, age at CI activation, and the length of follow-up with CIs (1:2 ratio). The case and control groups were compared in the results of five open-set speech perception tests, and a Forward Linear Regression Model was used to identify factors that can predict the post-CI outcomes.

RESULTS

There was no significant difference in average scores between the two groups across five outcome measures, ranging from 88.40% to 95.65%. The correlation matrix revealed that younger ages at hearing aid fitting and CI activation positively influenced improvements in speech perception test scores. Furthermore, among the variables incorporated in the regression model, the duration of follow-up with CIs, age at CI activation, and the utilization of two CIs demonstrated prognostic significance for improved post-CI speech perception outcomes.

CONCLUSIONS

Children with ANSD can achieve similar open-set speech perception outcomes as children with SNHL. A longer CI follow-up, a lower age at CI activation, and the use of two CIs are predictive for optimal CI outcome.

Cortical temporal integration can account for limits of temporal perception: investigations in the binaural system

The auditory system has exquisite temporal coding in the periphery which is transformed into a rate-based code in central auditory structures, like auditory cortex. However, the cortex is still able to synchronize, albeit at lower modulation rates, to acoustic fluctuations. The perceptual significance of this cortical synchronization is unknown. We estimated physiological synchronization limits of cortex (in humans with electroencephalography) and brainstem neurons (in chinchillas) to dynamic binaural cues using a novel system-identification technique, along with parallel perceptual measurements. We find that cortex can synchronize to dynamic binaural cues up to approximately 10 Hz, which aligns well with our measured limits of perceiving dynamic spatial information and utilizing dynamic binaural cues for spatial unmasking, i.e. measures of binaural sluggishness. We also find that the tracking limit for frequency modulation (FM) is similar to the limit for spatial tracking, demonstrating that this sluggish tracking is a more general perceptual limit that can be accounted for by cortical temporal integration limits.

Effect of interaural electrode insertion depth difference and independent band selection on sentence recognition in noise and spatial release from masking in simulated bilateral cochlear implant listening

PURPOSE

Inter-aural insertion depth difference (IEDD) in bilateral cochlear implant (BiCI) with continuous interleaved sampling (CIS) processing is known to reduce the recognition of speech in noise and spatial release from masking (SRM). However, the independent channel selection in the 'n-of-m' sound coding strategy might have a different effect on speech recognition and SRM when compared to the effects of IEDD in CIS-based findings. This study aimed to investigate the effect of bilateral 'n-of-m' processing strategy and interaural electrode insertion depth difference on speech recognition in noise and SRM under conditions that simulated bilateral cochlear implant listening.

METHODS

Five young adults with normal hearing sensitivity participated in the study. The target sentences were spatially filtered to originate from 0° and the masker was spatially filtered at 0°, 15°, 37.5°, and 90° using the Oldenburg head-related transfer function database for behind the ear microphone. A 22-channel sine wave vocoder processing based on 'n-of-m' processing was applied to the spatialized target-masker mixture, in each ear. The perceptual experiment involved a test of speech recognition in noise under one co-located condition (target and masker at 0°) and three spatially separated conditions (target at 0°, masker at 15°, 37.5°, or 90° to the right ear).

RESULTS

The results were analyzed using a three-way repeated measure analysis of variance (ANOVA). The effect of interaural insertion depth difference (F (2,8) = 3.145, p = 0.098, ɳ² = 0.007) and spatial separation between target and masker (F (3,12) = 1.239, p = 0.339, ɳ² = 0.004) on speech recognition in noise was not significant.

CONCLUSIONS

Speech recognition in noise and SRM were not affected by IEDD ≤ 3 mm. Bilateral 'n-of-m' processing resulted in reduced speech recognition in noise and SRM.

Improved binaural speech reception thresholds through small symmetrical separation of speech and noise

Speech perception in noise is challenging and is improved by binaural hearing. Since signal processing of assistive hearing devices often modifies or masks the peripheral binaural head-shadow or better-ear effects, central binaural processing should be measured separately. In a prospective study, 10 listeners with normal hearing were tested with the German matrix sentence test in a set-up with two loudspeakers located at opposite angles in the horizontal plane with respect to S₀N₀. The speech reception threshold (SRT) was investigated depending on the separation angle between speech and noise. The lowest (best) SRT was obtained for a separation of target and interfering source from S₀N₀ at an angle of about S_±60°N_∓60°. The derived normative curve was comparable to SRTs predicted by the binaural-speech-intelligibility-model. The systematic separation of signal and noise showed a significant improvement in speech intelligibility for normal-hearing people even for small separation angles. This experimental setting was verified. This study aimed to assess the effect of small sound source separation on binaural hearing and speech perception.

The effect of an active transcutaneous bone conduction device on spatial release from masking

Objective: The aim was to quantify the effect of the experimental active transcutaneous Bone Conduction Implant (BCI) on spatial release from masking (SRM) in subjects with bilateral or unilateral conductive and mixed hearing loss.Design: Measurements were performed in a sound booth with five loudspeakers at 0°, +/-30° and +/-150° azimuth. Target speech was presented frontally, and interfering speech from either the front (co-located) or surrounding (separated) loudspeakers. SRM was calculated as the difference between the separated and the co-located speech recognition threshold (SRT).Study Sample: Twelve patients (aged 22-76 years) unilaterally implanted with the BCI were included.Results: A positive SRM, reflecting a benefit of spatially separating interferers from target speech, existed for all subjects in unaided condition, and for nine subjects (75%) in aided condition. Aided SRM was lower compared to unaided in nine of the subjects. There was no difference in SRM between patients with bilateral and unilateral hearing loss. In aided situation, SRT improved only for patients with bilateral hearing loss.Conclusions: The BCI fitted unilaterally in patients with bilateral or unilateral conductive/mixed hearing loss seems to reduce SRM. However, data indicates that SRT is improved or maintained for patients with bilateral and unilateral hearing loss, respectively.

The effect of room acoustical parameters on speech reception thresholds and spatial release from masking

In daily life, speech intelligibility is affected by masking caused by interferers and by reverberation. For a frontal target speaker and two interfering sources symmetrically placed to either side, spatial release from masking (SRM) is observed in comparison to frontal interferers. In this case, the auditory system can make use of temporally fluctuating interaural time/phase and level differences promoting binaural unmasking (BU) and better-ear glimpsing (BEG). Reverberation affects the waveforms of the target and maskers, and the interaural differences, depending on the spatial configuration and on the room acoustical properties. In this study, the effect of room acoustics, temporal structure of the interferers, and target-masker positions on speech reception thresholds and SRM was assessed. The results were compared to an optimal better-ear glimpsing strategy to help disentangle energetic masking including effects of BU and BEG as well as informational masking (IM). In anechoic and moderate reverberant conditions, BU and BEG contributed to SRM of fluctuating speech-like maskers, while BU did not contribute in highly reverberant conditions. In highly reverberant rooms a SRM of up to 3 dB was observed for speech maskers, including effects of release from IM based on binaural cues.

Better-ear glimpsing with symmetrically-placed interferers in bilateral cochlear implant users

For a frontal target in spatially symmetrically placed interferers, normal hearing (NH) listeners can use "better-ear glimpsing" to select time-frequency segments with favorable signal-to-noise ratio in either ear. With an ideal monaural better-ear mask (IMBM) processing, some studies showed that NH listeners can reach similar performance as in the natural binaural listening condition, although interaural phase differences at low frequencies can further improve performance. In principle, bilateral cochlear implant (BiCI) listeners could use the same better-ear glimpsing, albeit without exploiting interaural phase differences. Speech reception thresholds of NH and BiCI listeners were measured in three interferers (speech-shaped stationary noise, nonsense speech, or single talker) either co-located with the target, symmetrically placed at ±60°, or independently presented to each ear, with and without IMBM processing. Furthermore, a bilateral noise vocoder based on the BiCI electrodogram was used in the same NH listeners. Headphone presentation and direct stimulation with head-related transfer functions for spatialization were used in NH and BiCI listeners, respectively. Compared to NH listeners, both NH listeners with vocoder and BiCI listeners showed strongly reduced binaural benefit from spatial separation. However, both groups greatly benefited from IMBM processing as part of the stimulation strategy.

Effect of audibility on better-ear glimpsing as a function of frequency in normal-hearing and hearing-impaired listeners

Better-ear glimpsing (BEG) is an auditory phenomenon that helps understanding speech in noise by utilizing interaural level differences (ILDs). The benefit provided by BEG is limited in hearing-impaired (HI) listeners by reduced audibility at high frequencies. Rana and Buchholz [(2016). J. Acoust. Soc. Am. 140(2), 1192-1205] have shown that artificially enhancing ILDs at low and mid frequencies can help HI listeners understanding speech in noise, but the achieved benefit is smaller than in normal-hearing (NH) listeners. To understand how far this difference is explained by differences in audibility, audibility was carefully controlled here in ten NH and ten HI listeners and speech reception thresholds (SRTs) in noise were measured in a spatially separated and co-located condition as a function of frequency and sensation level. Maskers were realized by noise-vocoded speech and signals were spatialized using artificially generated broadband ILDs. The spatial benefit provided by BEG and SRTs improved consistently with increasing sensation level, but was limited in the HI listeners by loudness discomfort. Further, the HI listeners performed similar to NH listeners when differences in audibility were compensated. The results help to understand the hearing aid gain that is required to maximize the spatial benefit provided by ILDs as a function of frequency.

Binaural masking release in symmetric listening conditions with spectro-temporally modulated maskers

Speech reception thresholds (SRTs) decrease as target and maskers are spatially separated (spatial release from masking, SRM). The current study systematically assessed how SRTs and SRM for a frontal target in a spatially symmetric masker configuration depend on spectro-temporal masker properties, the availability of short-time interaural level difference (ILD) and interaural time difference (ITD), and informational masking. Maskers ranged from stationary noise to single, interfering talkers and were modified by head-related transfer functions to provide: (i) different binaural cues (ILD, ITD, or both) and (ii) independent maskers in each ear ("infinite ILD"). Additionally, a condition was tested in which only information from short-time spectro-temporal segments of the ear with a favorable signal-to-noise ratio (better-ear glimpses) was presented. For noise-based maskers, ILD, ITD, and spectral changes related to masker location contributed similarly to SRM, while ILD cues played a larger role if temporal modulation was introduced. For speech maskers, glimpsing and perceived location contributed roughly equally and ITD contributed less. The "infinite ILD" condition might suggest better-ear glimpsing limitations resulting in a maximal SRM of 12 dB for maskers with low or absent informational masking. Comparison to binaural model predictions highlighted the importance of short-time processing and helped to clarify the contribution of the different binaural cues and mechanisms.