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Okalidou A, Peng ZE, Banioti A, Fourakis M, Kyriafinis G. The Lombard effect in children with cochlear implants: suprasegmental aspects. CLINICAL LINGUISTICS & PHONETICS 2024:1-21. [PMID: 38679889 DOI: 10.1080/02699206.2024.2340096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/02/2024] [Indexed: 05/01/2024]
Abstract
Children with cochlear implants (CI) communicate in noisy environments, such as in classrooms, where multiple talkers and reverberation are present. Speakers compensate for noise via the 'Lombard effect'. The present study examined the Lombard effect on the intensity and duration of stressed vowels in the speech of children with Cochlear Implants (CIs) as compared to children with Normal Hearing (NH), focusing on the effects of speech-shaped noise (SSN) and speech-shaped noise with reverberation (SSN+Reverberation). The sample consisted of 7 children with CIs and 7 children with NH, aged 7-12 years. Regarding intensity, a) children with CIs produced stressed vowels with an overall greater intensity across acoustic conditions as compared to NH peers, b) both groups increased their stressed vowel intensity for all vowels from Quiet to both noise conditions, and c) children with NH further increased their intensity when reverberation was added to SSN, esp. for the vowel/u/. Regarding duration, longer stressed vowels were produced by children with CIs as compared to NH in Quiet and SSN conditions but the effect was retained only for the vowels/i/,/o/and/u/when reverberation was added to noise. The SSN+Reverberation condition induced systematic lengthening in stressed vowels for children with NH. Furthermore, although greater intensity and duration ratios of stressed/unstressed syllables were observed for children with NH as compared to CIs in Quiet condition, they diminished with noise. The differences observed across groups have implications for speaking in classroom noise.
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Affiliation(s)
- Areti Okalidou
- Department of Educational & Social Policy, Graduate Program of Communication Disorders & Sciences, University of Macedonia, Thessaloniki, Greece
| | - Z Ellen Peng
- Functional Hearing Laboratory, Boys Town National Research Hospital, Omaha, Nebraska, USA
| | - Aggeliki Banioti
- Department of Educational & Social Policy, Graduate Program of Communication Disorders & Sciences, University of Macedonia, Thessaloniki, Greece
| | - Marios Fourakis
- Department of Hearing & Speech Sciences, University of Maryland, College Park, Maryland, USA
| | - Georgios Kyriafinis
- 1st University Otolaryngology Clinic of AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Lailach S, Lenz A, Zahnert T, Neudert M. Value of patient-reported outcome measures for evaluating the benefit of speech processor upgrading in patients with cochlear implants. HNO 2024; 72:25-32. [PMID: 37656221 PMCID: PMC10799117 DOI: 10.1007/s00106-023-01342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Patients with a cochlear implant (CI) should be evaluated for a new speech processor every 6 years. The aim of this analysis was to assess the subjective and audiological benefit of upgrades. METHODS Speech understanding and subjective benefit were analyzed in 99 patients with the old and the new speech processor after 4 weeks of wearing. Speech understanding was assessed using the Freiburg monosyllabic test in quiet (FBE) at 65 dB and 80 dB, and the Oldenburg Sentence Test (OLSA) at 65 dB noise with adaptive speech sound level. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to assess subjective hearing impairment, and the Audio Processor Satisfaction Questionnaire (APSQ) was used to assess subjective satisfaction. RESULTS The speech processor upgrade resulted in a significant improvement of speech understanding in quiet at 65 dB (mean difference 8.9 ± 25.9 percentage points, p < 0.001) and 80 dB (mean difference 8.1 ± 29.7 percentage points, p < 0.001) and in noise (mean difference 3.2 ± 10.7 dB signal-to-noise ratio [S/N], p = 0.006). Using the APHAB, a significant improvement (mean difference 0.07 ± 0.16, p < 0.001) in hearing impairment was demonstrated in all listening situations. The APSQ showed significantly higher patient satisfaction with the new speech processor (mean difference 0.42 ± 1.26, p = 0.006). A comparative assessment of the benefit based on subjective and speech audiometric results identified a proportion of patients (35-42%) who subjectively benefited from the upgrade but had no measurable benefit based on speech audiometry. CONCLUSION There was a significant improvement in audiologically measurable and subjectively reflected speech understanding and patient satisfaction after the upgrade. In patients with only a small improvement in audiologically measurable speech understanding, the subjective benefit should also be assessed with validated measurement instruments in order to justify an upgrade to the payers in the health sector.
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Affiliation(s)
- Susen Lailach
- Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Alexander Lenz
- Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Thomas Zahnert
- Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Marcus Neudert
- Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Lailach S, Lenz A, Zahnert T, Neudert M. [Value of patient-reported outcome measures for evaluating the benefit of speech processor upgrading in patients with cochlear implants. German version]. HNO 2023; 71:583-591. [PMID: 37540233 PMCID: PMC10462568 DOI: 10.1007/s00106-023-01341-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Patients with a cochlear implant (CI) should be evaluated for a new speech processor every 6 years. The aim of this analysis was to assess the subjective and audiological benefit of upgrades. METHODS Speech understanding and subjective benefit were analyzed in 99 patients with the old and the new speech processor after 4 weeks of wearing. Speech understanding was assessed using the Freiburg monosyllabic test in quiet (FBE) at 65 dB and 80 dB, and the Oldenburg Sentence Test (OLSA) at 65 dB noise with adaptive speech sound level. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to assess subjective hearing impairment, and the Audio Processor Satisfaction Questionnaire (APSQ) was used to assess subjective satisfaction. RESULTS The speech processor upgrade resulted in a significant improvement of speech understanding in quiet at 65 dB (mean difference 8.9 ± 25.9 percentage points, p < 0.001) and 80 dB (mean difference 8.1 ± 29.7 percentage points, p < 0.001) and in noise (mean difference 3.2 ± 10.7 dB signal-to-noise ratio [S/N], p = 0.006). Using the APHAB, a significant improvement (mean difference 0.07 ± 0.16, p < 0.001) in hearing impairment was demonstrated in all listening situations. The APSQ showed significantly higher patient satisfaction with the new speech processor (mean difference 0.42 ± 1.26, p = 0.006). A comparative assessment of the benefit based on subjective and speech audiometric results identified a proportion of patients (35-42%) who subjectively benefited from the upgrade but had no measurable benefit based on speech audiometry. CONCLUSION There was a significant improvement in audiologically measurable and subjectively reflected speech understanding and patient satisfaction after the upgrade. In patients with only a small improvement in audiologically measurable speech understanding, the subjective benefit should also be assessed with validated measurement instruments in order to justify an upgrade to the payers in the health sector.
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Affiliation(s)
- Susen Lailach
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Sächsisches Cochlear Implant Centrum, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
| | - Alexander Lenz
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Sächsisches Cochlear Implant Centrum, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - Thomas Zahnert
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Sächsisches Cochlear Implant Centrum, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - Marcus Neudert
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Sächsisches Cochlear Implant Centrum, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
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Kurz A, Rak K, Hagen R. Improved performance with automatic sound management 3 in the MED-EL SONNET 2 cochlear implant audio processor. PLoS One 2022; 17:e0274446. [PMID: 36108069 PMCID: PMC9477286 DOI: 10.1371/journal.pone.0274446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives The SONNET 2 audio processor features ambient noise reduction (ANR), transient-noise reduction (TNR), and adaptive intelligence (AI). The primary aim of this study was to evaluate if using these features improves speech perception in noise, subjective listening effort, and sound quality. Design In this prospective longitudinal study, twenty adult SONNET users were fitted with the SONNET 2 audio processor, configured either as a default SONNET (no ANR/TNR/AI), with mild ANR/TNR, with strong ANR/TNR, with mild AI, and with strong AI. Speech perception in noise was assessed in speech and stationary noise from the front (S0N0); speech, stationary noise, and transient noise from the front (S0N0T0); and speech from the front in spatially-distributed stationary noise (S0N±45N±135). Listening effort, subjective sound quality, and device/setup preference were assessed. Results In the S0N0 setup, speech perception in noise was significantly better with the SONNET 2 when using ANR/TNR in the mild setup than with the SONNET or the SONNET 2 in the default SONNET configuration. In the S0N±45N±135 setup, speech understanding was significantly better in all four SONNET 2 configurations than with the SONNET or the SONNET 2 in the default SONNET configuration (a 1.26–2.55 dB SRT80 benefit). Subjects tolerated consistently lower signal-to-noise values with the SONNET 2 configurations using ANR/TNR than with the default SONNET configuration in all listening effort categories. All SONNET 2 configurations using ANR/TNR were preferred and better rated in speech in stationary and/or transient noise compared to the default SONNET configuration. Sound quality and pleasantness were better in those SONNET 2 configurations. Subjects strongly preferred the SONNET 2 configurations over the SONNET configuration. Conclusions The new front-end features implemented in the SONNET 2 audio processor objectively improve speech perception in noise. Subjects preferred the SONNET 2, over the SONNET, in the presence of stationary and transient noise.
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Affiliation(s)
- Anja Kurz
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital of Würzburg, Würzburg, Germany
- * E-mail:
| | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital of Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital of Würzburg, Würzburg, Germany
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Hey M, Hersbach AA, Hocke T, Mauger SJ, Böhnke B, Mewes A. Ecological Momentary Assessment to Obtain Signal Processing Technology Preference in Cochlear Implant Users. J Clin Med 2022; 11:jcm11102941. [PMID: 35629065 PMCID: PMC9147494 DOI: 10.3390/jcm11102941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/13/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023] Open
Abstract
Background: To assess the performance of cochlear implant users, speech comprehension benefits are generally measured in controlled sound room environments of the laboratory. For field-based assessment of preference, questionnaires are generally used. Since questionnaires are typically administered at the end of an experimental period, they can be inaccurate due to retrospective recall. An alternative known as ecological momentary assessment (EMA) has begun to be used for clinical research. The objective of this study was to determine the feasibility of using EMA to obtain in-the-moment responses from cochlear implant users describing their technology preference in specific acoustic listening situations. Methods: Over a two-week period, eleven adult cochlear implant users compared two listening programs containing different sound processing technologies during everyday take-home use. Their task was to compare and vote for their preferred program. Results: A total of 205 votes were collected from acoustic environments that were classified into six listening scenes. The analysis yielded different patterns of voting among the subjects. Two subjects had a consistent preference for one sound processing technology across all acoustic scenes, three subjects changed their preference based on the acoustic scene, and six subjects had no conclusive preference for either technology. Conclusion: Results show that EMA is suitable for quantifying real-world self-reported preference, showing inter-subject variability in different listening environments. However, there is uncertainty that patients will not provide sufficient spontaneous feedback. One improvement for future research is a participant forced prompt to improve response rates.
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Affiliation(s)
- Matthias Hey
- Audiology, ENT Clinic, UKSH, 24105 Kiel, Germany; (B.B.); (A.M.)
- Correspondence: ; Tel.: +49-431-500-21857
| | - Adam A. Hersbach
- Research and Development, Cochlear Limited, Melbourne, VIC 3000, Australia;
| | - Thomas Hocke
- Research, Cochlear Deutschland, 30625 Hannover, Germany;
| | | | - Britta Böhnke
- Audiology, ENT Clinic, UKSH, 24105 Kiel, Germany; (B.B.); (A.M.)
| | - Alexander Mewes
- Audiology, ENT Clinic, UKSH, 24105 Kiel, Germany; (B.B.); (A.M.)
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Müller V, Krause J, Klünter HD, Streicher B, Lang-Roth R. Speech perception in noise and sound localization using different microphone modes in pediatric bilateral cochlear implant users. Int J Pediatr Otorhinolaryngol 2022; 156:111117. [PMID: 35366421 DOI: 10.1016/j.ijporl.2022.111117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/25/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of the study was to investigate if a directional microphone mode improves speech perception in noise and sound localization in experienced pediatric bilateral cochlear implant users. METHODS 15 bilaterally implanted children were included in the analysis. Speech perception in 4 noise conditions (S0N0, S0N90, S0N-90, S0N180) and sound localization were measured when using the OPUS 2 audio processor (omnidirectional mode) and the SONNET audio processor (omnidirectional and natural mode). RESULTS Speech perception in all 4 noise conditions was better with the SONNET natural mode than with the omnidirectional mode of either SONNET or OPUS 2. The root-mean-square error of the sound localization test was smaller with the natural mode of SONNET than with the omnidirectional mode of either SONNET or OPUS 2. The performance of the audio processors in the omnidirectional mode did not differ significantly except in the S0N0 condition of the speech perception test. CONCLUSION The natural microphone mode of the SONNET audio processor improved speech perception in noise and sound localization in bilaterally implanted children.
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Affiliation(s)
- Verena Müller
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic of Otorhinolaryngology, Head and Neck Surgery, Cochlear Implant Centre, Germany.
| | - Jasmin Krause
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic of Otorhinolaryngology, Head and Neck Surgery, Cochlear Implant Centre, Germany
| | - Heinz Dieter Klünter
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic of Otorhinolaryngology, Head and Neck Surgery, Cochlear Implant Centre, Germany
| | - Barbara Streicher
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic of Otorhinolaryngology, Head and Neck Surgery, Cochlear Implant Centre, Germany
| | - Ruth Lang-Roth
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic of Otorhinolaryngology, Head and Neck Surgery, Cochlear Implant Centre, Germany
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Obrycka A, Lorens A, Walkowiak A, Wlodarczyk E, Dziendziel B, Skarzynski PH, Skarzynski H. The COVID-19 pandemic and upgrades of CI speech processors for children: part II-hearing outcomes. Eur Arch Otorhinolaryngol 2022; 279:4815-4823. [PMID: 35286441 PMCID: PMC8919915 DOI: 10.1007/s00405-022-07324-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
Purpose To gauge the benefits to children of upgrading speech processors during the COVID-19 pandemic. Methods The study involved 297 children, aged from 7.3 to 18.0 years, whose processors were upgraded to either Nucleus 7 or Kanso 2, or to Sonnet 2 or Rondo 3. To document the benefits of the upgrades, a speech-in-noise discrimination test and Patient Reported Outcome Measures (PROMs) were used. Results There was a significant benefit from the newer processors in terms of speech discrimination in noise. Patient Reported Outcome Measures (PROMs) indicated less hearing disability, a higher level of functioning in everyday life situations, and more satisfaction with the new speech processor in social situations. Conclusion There is a measurable improvement in performance when the devices are upgraded to the new technology.
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Affiliation(s)
- Anita Obrycka
- Institute of Physiology and Pathology of Hearing, ul. Mokra 17, 05-830, Kajetany, Nadarzyn, Poland.
| | - Artur Lorens
- Institute of Physiology and Pathology of Hearing, ul. Mokra 17, 05-830, Kajetany, Nadarzyn, Poland
| | - Adam Walkowiak
- Institute of Physiology and Pathology of Hearing, ul. Mokra 17, 05-830, Kajetany, Nadarzyn, Poland
| | - Elzbieta Wlodarczyk
- Institute of Physiology and Pathology of Hearing, ul. Mokra 17, 05-830, Kajetany, Nadarzyn, Poland
| | - Beata Dziendziel
- Institute of Physiology and Pathology of Hearing, ul. Mokra 17, 05-830, Kajetany, Nadarzyn, Poland
| | - Piotr Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, ul. Mokra 17, 05-830, Kajetany, Nadarzyn, Poland.,Heart Failure and Cardiac Rehabilitation, Department of the Medical, University of Warsaw, Warsaw, Poland.,Institute of Sensory Organs, Kajetany, Poland
| | - Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, ul. Mokra 17, 05-830, Kajetany, Nadarzyn, Poland
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Findlen UM, Benedict J, Agrawal S. Clinical Practice Patterns of Fitting Advanced Device Features in Children With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:797-815. [PMID: 35015974 DOI: 10.1044/2021_jslhr-21-00168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to identify common clinical practice patterns for providing advanced noise management features in children with cochlear implants (CIs) and evaluate trends in consideration of clinician experience and comfort with CI manufacturer-specific technology. METHOD A mixed-model survey including quantitative and qualitative questions regarding providing advanced noise management features in the pediatric CI population was collected electronically via research electronic data capture. Survey questions spanned approach/philosophy toward provision of features, age of provision, and demographics of respondents. Descriptive statistics were completed to define common clinical practice patterns and demographic information. RESULTS A total of 160 pediatric audiologists from 35 U.S. States and five Canadian provinces completed the survey. Most audiologists (73.8%) reported enabling automatic directional microphones, and a vast majority (91%) reported enabling advanced noise processing features such as automatic noise cancellers, wind noise cancellers, and impulse noise cancellers in recipients' main programs. Audiologists ranked features in terms of importance for a school-age child with the top three ranked as automatic noise reduction, automatic directional microphones, and concha-level microphones. Importance of child-specific factors varied depending upon the specific feature of interest. CONCLUSIONS Variability exists among providers in enabling advanced noise management features for pediatric CI recipients. Multiple factors, including patient characteristics, provider characteristics, and limited evidence-based guidance, could account for much of the variation. Overall, there is a trend toward automaticity for noise management. Additional studies are warranted to provide the evidence base for confidently programming advanced features for children using CIs.
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Affiliation(s)
- Ursula M Findlen
- Division of Clinical Therapies, Audiology Department, Nationwide Children's Hospital, Columbus, OH
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus
| | - Jason Benedict
- Division of Clinical Therapies, Audiology Department, Nationwide Children's Hospital, Columbus, OH
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus
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Pinheiro MMC, Mancini PC, Soares AD, Ribas Â, Lima DP, Cavadas M, Banhara MR, Carvalho SADS, Buzo BC. Comparison of Speech Recognition in Cochlear Implant Users with Different Speech Processors. J Am Acad Audiol 2021; 32:469-476. [PMID: 34847587 DOI: 10.1055/s-0041-1735252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Speech recognition in noisy environments is a challenge for both cochlear implant (CI) users and device manufacturers. CI manufacturers have been investing in technological innovations for processors and researching strategies to improve signal processing and signal design for better aesthetic acceptance and everyday use. PURPOSE This study aimed to compare speech recognition in CI users using off-the-ear (OTE) and behind-the-ear (BTE) processors. DESIGN A cross-sectional study was conducted with 51 CI recipients, all users of the BTE Nucleus 5 (CP810) sound processor. Speech perception performances were compared in quiet and noisy conditions using the BTE sound processor Nucleus 5 (N5) and OTE sound processor Kanso. Each participant was tested with the Brazilian-Portuguese version of the hearing in noise test using each sound processor in a randomized order. Three test conditions were analyzed with both sound processors: (i) speech level fixed at 65 decibel sound pressure level in a quiet, (ii) speech and noise at fixed levels, and (iii) adaptive speech levels with a fixed noise level. To determine the relative performance of OTE with respect to BTE, paired comparison analyses were performed. RESULTS The paired t-tests showed no significant difference between the N5 and Kanso in quiet conditions. In all noise conditions, the performance of the OTE (Kanso) sound processor was superior to that of the BTE (N5), regardless of the order in which they were used. With the speech and noise at fixed levels, a significant mean 8.1 percentage point difference was seen between Kanso (78.10%) and N5 (70.7%) in the sentence scores. CONCLUSION CI users had a lower signal-to-noise ratio and a higher percentage of sentence recognition with the OTE processor than with the BTE processor.
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Affiliation(s)
| | - Patricia Cotta Mancini
- Department of Speech-Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alexandra Dezani Soares
- Centro do Deficiente Auditivo - Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ângela Ribas
- Centro de Implante Coclear do Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil
| | - Danielle Penna Lima
- Centro de Implantes Cocleares do Hospital do Coração de Natal, Natal, Brazil
| | - Marcia Cavadas
- Department of Speech-Language Pathology and Audiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Equipe Sonora, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcos Roberto Banhara
- Centro Especializado de Reabilitação IV do Hospital Santo Antônio/Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil
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Goffi-Gomez MVS, Muniz L, Wiemes G, Onuki LC, Calonga L, Osterne FJ, Kós MI, Caldas FF, Cardoso C, Cagnacci B. Contribution of noise reduction pre-processing and microphone directionality strategies in the speech recognition in noise in adult cochlear implant users. Eur Arch Otorhinolaryngol 2020; 278:2823-2828. [PMID: 32948894 DOI: 10.1007/s00405-020-06372-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/10/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Refinement currently offered in new sound processors may improve noise listening capability reducing constant background noise and enhancing listening in challenging signal-to-noise conditions. This study aimed to identify whether the new version of speech processor preprocessing strategy contributes to speech recognition in background noise compared to the previous generation processor. METHODS This was a multicentric prospective cross-sectional study. Post-lingually deaf adult patients, with at least 1 year of device use and speech recognition scores above 60% on HINT sentences in quiet were invited. Speech recognition performance in quiet and in noise with sound processors with previous and recent technologies was assessed under four conditions with speech coming from the front: (a) quiet (b) fixed noise coming from the front, (c) fixed noise coming from the back, and (d) adaptive noise ratios with noise coming from the front. RESULTS Forty-seven cochlear implant users were included. No significant difference was found in quiet condition. Performance with the new processor was statistically better than the previous sound processor in all three noisy conditions (p < 0.05). With fixed noise coming from the back condition, speech recognition was 62.9% with the previous technology and 73.5% on the new one (p < 0.05). The mean speech recognition in noise was also statistically higher, with 5.8 dB and 7.1 dB for the newer and older technologies (p < 0.05), respectively. CONCLUSION New technology has shown to provide benefits regarding speech recognition in noise. In addition, the new background noise reduction technology, has shown to be effective and improves speech recognition in situations of more intense noise coming from behind.
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Affiliation(s)
| | | | - Gislaine Wiemes
- Instituto Paranaense de Otorrinolaringologia, Hospital IPO, Curitiba, Brazil
| | | | | | | | - Maria Isabel Kós
- Hospital Universitário Clementino Fraga Filho, UFRJ, Janeiro, Brazil
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Busch T, Vermeulen A, Langereis M, Vanpoucke F, van Wieringen A. Cochlear Implant Data Logs Predict Children’s Receptive Vocabulary. Ear Hear 2020; 41:733-746. [DOI: 10.1097/aud.0000000000000818] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bayri M, Çiprut A. The effects of behind-the-ear and off-the-ear sound processors on speech understanding performance in cochlear implant users. Auris Nasus Larynx 2020; 47:950-957. [PMID: 32591169 DOI: 10.1016/j.anl.2020.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The first aim of this study was to compare speech understanding performance in adult cochlear implant users using behind-the-ear and off-the-ear sound processors in quiet and noise. Second, the impact of sound processor microphone location on speech understanding performance was compared. METHODS Participants were tested with both types of sound processors in the free field with warble tones, and speech discrimination scores in quiet were obtained. Turkish Matrix Test was used to measure speech understanding in noise with five different loudspeaker settings. Twenty-seven participants of cochlear implants between 16 and 67 years-of-age using behind-the-ear or off-the-ear sound processors were included in the study. The results obtained with two types of sound processors were compared. RESULTS Aided free field thresholds were significantly better for the behind-the-ear vs. off-the-ear sound processor. The mean difference was 3.3 dB HL. There was no significant difference in speech discrimination scores in quite between the two processors (p > 0.05). Statistically significant differences were not seen for speech intelligibility in five spatial settings in the Turkish Matrix Test (p > 0.05). CONCLUSION Although both types of sound processors had different microphone locations, the outcomes were found to be consistent with previous results in adult users off-the-ear sound processors, demonstrating equivalent speech understanding in quiet and noise.
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Affiliation(s)
- Merve Bayri
- Marmara University School of Medicine, Audiology Department, Address: Fevzi Çakmak Mah. Mimar Sinan Cd. No:10, Pendik, Istanbul 34899, Turkey; Cochlear Turkey, Address: Çubuklu Mah Boğaziçi Cad. Boğaziçi Plaza, 6/1, Beykoz, Istanbul 34805, Turkey.
| | - Ayça Çiprut
- Marmara University School of Medicine, Audiology Department, Address: Fevzi Çakmak Mah. Mimar Sinan Cd. No:10, Pendik, Istanbul 34899, Turkey
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Data logging variables and speech perception in prelingually deafened pediatric cochlear implant users. Int J Pediatr Otorhinolaryngol 2020; 133:110003. [PMID: 32203760 DOI: 10.1016/j.ijporl.2020.110003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To investigate the relationship among objectively gathered data logging measurements, patient-related variables, and speech recognition performance of pediatric CI users. METHODS AND MATERIALS Thirty-two prelingually implanted children who have the ability to perform word discrimination test were included in this study. To reveal the relationship between speech perception abilities and auditory exposure, seven data logging variables were analyzed: "on-air," "off-air," "coil-off," "speech," "speech in noise," "music" and "noise. In addition, implantation age (months) and CI usage duration (months) were taken into account. Finally, it was investigated the differences between unilateral, sequential bilateral, and simultaneous bilateral CI users in terms of all study variables. RESULTS The average on-air time ranged between 10.52 and 12.30 in the groups. In the case of sequential implantation, smaller on-air and higher coil off values were observed with the second CI. In the case of simultaneous bilateral implantation, data logging measurements were almost the same in both implants. WRS was significantly correlated (p < 0.05) with on-air time (r = 0.62), coil-off count (r = -0.48), chronological age (r = 0.48), and CI duration (r = 0.44). Multiple linear regression model was fit to predict the WRS, with on-air time, CI duration, and chronological age as predictors. CONCLUSIONS The critical importance of early intervention and long-term use of CI is well-established in the literature and is also corroborated by our findings. However, the key findings of the present study are that consistent CI use and the quality of daily listening environment also exerted a major and positive effect on the speech recognition performance of pediatric CI users. Therefore, during the monitoring of pediatric CI recipients, it is important to know the device usage data in order to detect problems in the early stages after CI.
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Speech Perception Outcomes for Adult Cochlear Implant Recipients Using a Lateral Wall or Perimodiolar Array. Otol Neurotol 2020; 40:608-616. [PMID: 31083082 DOI: 10.1097/mao.0000000000002189] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To assess the speech perception outcomes of adult CI recipients with significant preimplant low frequency hearing, examining differences between perimodiolar and lateral wall electrode placement in order to provide clinical guidance for clinicians and surgeons. METHODS A prospective cohort study was undertaken identifying all adults who received a thin straight electrode array (TSEA) at the Royal Victorian Eye & Ear Hospital (RVEEH) from 2010 to 2015 and who had a preimplant low frequency pure tone median ≤70 dB HL (n = 63). A retrospective review was completed of the RVEEH database to identify a comparison group who had been implanted with a perimodiolar electrode array, comprising adults implanted between 2004 and 2011 (PM Group) with preimplant hearing equivalent to the TSEA group (n = 70). The TSEA Group were further divided into subgroups in which n = 19 used EAS (TSEA-EAS) and n = 44 who used electric-only hearing (TSEA-Standard). RESULTS There was no significant difference in median speech perception outcomes between the TSEA and PM Groups (TSEA 61.7%, PM 67.3%, p = 0.954). A significant difference was found between the TSEA-EAS and TSEA-Standard subgroups for median speech perception outcome (TSEA-EAS median 73.5%, TSEA-Standard median 58.3%, p = 0.043). CONCLUSIONS Significant speech perception benefit following cochlear implantation was achieved with both the perimodiolar and lateral wall electrode arrays and no significant difference was found between outcomes with those array types in this population of adults with functional low frequency hearing pre-implant. Those that received a TSEA, had preserved hearing, and utilised an EAS sound processor performed better than their peers with a TSEA and electric-only hearing.
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15
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Franco-Vidal V, Parietti-Winkler C, Guevara N, Truy E, Loundon N, Bailleux S, Ardoint M, Saaï S, Hoen M, Laplante-Lévesque A, Mosnier I, Bordure P, Vincent C. The Oticon Medical Neuro Zti cochlear implant and the Neuro 2 sound processor: multicentric evaluation of outcomes in adults and children. Int J Audiol 2019; 59:153-160. [PMID: 31584300 DOI: 10.1080/14992027.2019.1671616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: This study evaluated the outcomes of the Oticon Medical Neuro Zti cochlear implant and the Neuro 2 sound processor.Design: Neuro One users were upgraded to Neuro 2. Monosyllabic word identification was evaluated in adults with Neuro One after ≥5 months, with Neuro 2 at upgrade, and with Neuro 2 after 3 months. Self-reported listening ability, satisfaction, and usability were measured in adults and children.Study sample: Participants were 44 adults and 26 children.Results: Speech identification scores in quiet and noise were 58% and 45% with Neuro One and 67% and 55% with Neuro 2 after 3 months, respectively. Hearing impairment duration and number of active electrodes significantly predicted speech identification in noise with Neuro 2. Significantly higher questionnaire ratings were obtained for Neuro 2 than Neuro One regarding listening ability in complex listening situations, comfort and music, as well as nine aspects of satisfaction and usability.Conclusion: This study demonstrates the clinical superiority of the Neuro 2 sound processor over Neuro One in terms of speech identification in quiet and in noise and reported patient benefit and satisfaction. Given the study design, sources of improvement may include factors unrelated to the sound processor itself.
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Affiliation(s)
- Valérie Franco-Vidal
- Ear, Nose, and Throat Department, Bordeaux University Hospital, Bordeaux, France
| | | | - Nicolas Guevara
- Université Côte D'Azur, Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Eric Truy
- Otorhinolaryngology, Phoniatry, and Head and Neck Surgery Department, Lyon University Hospital, Lyon, France
| | - Natalie Loundon
- Ear, Nose, and Throat Department, Necker University Hospital for Sick Children, Paris, France
| | - Sonanda Bailleux
- Ear, Nose, and Throat Department, Nice-Lenval University Hospital, Nice, France
| | | | - Sonia Saaï
- Clinical Research, Oticon Medical, Vallauris, France
| | - Michel Hoen
- Clinical Research, Oticon Medical, Vallauris, France
| | - Ariane Laplante-Lévesque
- Clinical Research, Oticon Medical, Smørum, Denmark.,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Isabelle Mosnier
- Ear, Nose, and Throat Department, Pitié-Salpêtrière University Hospital, Paris, France
| | - Philippe Bordure
- Ear, Nose, and Throat Department, Nantes University Hospital, Nantes, France
| | - Christophe Vincent
- Otology and Oto-Neurology Department, Lille University Hospital, Lille, France
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Rauch AK, Metzner T, Aschendorff A, Arndt S, Speck I, Laszig R, Beck RL. [Speech processor upgrade increases speech comprehension in patients with cochlear implants]. HNO 2019; 67:778-785. [PMID: 31468082 DOI: 10.1007/s00106-019-00734-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hearing rehabilitation of patients with severe hearing loss by cochlear implant (CI) enhances their opportunities for communication immensely with regard to their normal-hearing social environment. The degree of participation depends decisively on speech discrimination. This study examines whether speech discrimination can be improved by equipping patients with next-generation speech processors (SP). METHODS The changes in speech discrimination of 420 CI patients upon receiving a newer SP from 2003-2012 were retrospectively analyzed. Audiometry comprised the Freiburg number and monosyllable tests and the Oldenburg sentence test in quiet and noise, with a presentation volume of 70 dB. RESULTS In all audiometric tests, the newer SP showed a significant improvement compared to the preceding SP. This improvement was attainable for the majority of patients and was independent of age. CONCLUSION Upgrade of the SP results in improved speech discrimination. This holds true for several test settings. We therefore recommend earlier upgrades and that the costs for new SP be met.
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Affiliation(s)
- A-K Rauch
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - T Metzner
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - A Aschendorff
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - S Arndt
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - I Speck
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - R Laszig
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - R L Beck
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
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Warren CD, Nel E, Boyd PJ. Controlled comparative clinical trial of hearing benefit outcomes for users of the Cochlear™ Nucleus ® 7 Sound Processor with mobile connectivity. Cochlear Implants Int 2019; 20:116-126. [PMID: 30714500 DOI: 10.1080/14670100.2019.1572984] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To assess subjective benefits and objective speech recognition performance following a take-home trial with the new Cochlear™ Nucleus® 7 Sound Processor (SP), in experienced users of compatible cochlear implants from Cochlear Limited. METHODS A total of 37 adult participants were fitted with the Nucleus 7 SP and used the device for up to one year. Baseline speech recognition was assessed at the initial fitting session, using each participant's own SP, and Client Oriented Scale of Improvement (COSI) goals were identified. Speech recognition was measured after 3 months of device use and outcomes of the COSI and a non-validated Processor Comparison Questionnaire (PCQ) were collected. After 11 months, a subset of subjects were tested on speech recognition delivered via direct wireless streaming from an Apple® smartphone to the SP and compatible hearing aid on the opposite side (if worn). RESULTS The COSI and PCQ instruments both indicated significant improvement in perceived subjective benefits in comparison to the participants' previous SPs. Direct streaming via an Apple mobile phone showed improvements when compared with the acoustic alone condition. Standard speech recognition in quiet and noise was equivalent to that obtained using a previous generation SP which uses the same basic processing as the Nucleus 7 Sound Processor. CONCLUSIONS The incremental refinements provided by the Nucleus 7 Sound Processor provide real-world benefits in key areas such as upgraded wireless connectivity. The COSI proved to be an effective tool for individualized assessment of specific benefits that may not be addressed by more standardized instruments.
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Affiliation(s)
| | - Esti Nel
- a Cochlear Ltd , Sydney , Australia
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18
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Maglione AG, Cartocci G, Modica E, Rossi D, Colosimo A, Di Flumeri G, Brizi A, Venuti I, Zinfollino M, Malerba P, Quaranta N, Babiloni F. Evaluation of different cochlear implants in unilateral hearing patients during word listening tasks: A brain connectivity study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2017:2470-2473. [PMID: 29060399 DOI: 10.1109/embc.2017.8037357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Advanced methodologies used for the biomedical signal interpretation allow using cerebral signals to assess important cognitive functions in humans. In the present study, as parameter of cerebral effort, has been employed the isolated effective coherence, in order to estimate the effective connectivity and network organization. The hypothesis was that the lower the number of inter-connections engaged, the lower the cerebral effort induced by the experimental condition. In the present research this index has been applied to test the reaction to the use of different cochlear implant processors (Freedom, CP810 and CP910 - Cochlear Ltd), with the aim to identify the most performing device during a word in noise recognition task. Results support the capability of identifying the device eliciting less brain area connections. In particular, the CP910 was the processor inducing the lower number of inter-connections among the tested ones. This investigation appeared to be worthy, since representing a tool to identify devices that would make available user's cognitive resources for additional tasks, a matter susceptible of generalization to various fields of application. The employment of the cerebral signals therefore open the way to the evaluation of the impact of different sensors and prosthetic devices, also using connectivity measures.
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Todorov MJ, Galvin KL. Benefits of upgrading to the Nucleus ® 6 sound processor for a wider clinical population. Cochlear Implants Int 2018; 19:210-215. [PMID: 29566583 DOI: 10.1080/14670100.2018.1452584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To determine whether a large clinical group of cochlear implant (CI) recipients demonstrated a difference in sentence recognition in noise when using their pre-upgrade sound processor compared to when using the Nucleus 6 processor, and to examine the impact of the following factors: implant type, sound processor type, age, or onset of hearing loss. METHODS A file review of 154 CI recipients (aged 7-92 years old) who requested an upgrade to the Nucleus 6 sound processor at the Cochlear Care Centre Melbourne was conducted. 105 recipients had complete data collected according to the protocol. A repeated measures, single subject design was used. Performance of CI recipients was compared with their pre-upgrade sound processor versus the Nucleus 6 processor using the Australian Sentence Test in Noise. RESULTS Group performance of CI recipients improved by 4.7 dB with the Nucleus 6 compared with the pre-upgrade sound processor. The benefit was not affected by pre-upgrade sound processor type or implant type (including older implant types and sound processors), age or onset of hearing loss (pre-lingual versus post-lingual). CONCLUSION This study confirmed that a clinical group of CI recipients obtained a significant benefit when upgrading to the Nucleus 6 sound processor.
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Affiliation(s)
- Michelle J Todorov
- a Department of Audiology and Speech Pathology , The University of Melbourne , Melbourne , Australia
| | - Karyn L Galvin
- a Department of Audiology and Speech Pathology , The University of Melbourne , Melbourne , Australia
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20
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Cristofari E, Cuda D, Martini A, Forli F, Zanetti D, Di Lisi D, Marsella P, Marchioni D, Vincenti V, Aimoni C, Paludetti G, Barezzani MG, Leone CA, Quaranta N, Bianchedi M, Presutti L, Della Volpe A, Redaelli de Zinis LO, Cantore I, Frau GN, Orzan E, Galletti F, Vitale S, Raso F, Negri M, Trabalzini F, Livi W, Piccioni LO, Ricci G, Malerba P. A Multicenter Clinical Evaluation of Data Logging in Cochlear Implant Recipients Using Automated Scene Classification Technologies. Audiol Neurootol 2017; 22:226-235. [DOI: 10.1159/000484078] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 10/10/2017] [Indexed: 11/19/2022] Open
Abstract
Currently, there are no studies assessing everyday use of cochlear implant (CI) processors by recipients by means of objective tools. The Nucleus 6 sound processor features a data logging system capable of real-time recording of CI use in different acoustic environments and under various categories of loudness levels. In this study, we report data logged for the different scenes and different loudness levels of 1,366 CI patients, as recorded by SCAN. Monitoring device use in cochlear implant recipients of all ages provides important information about the listening conditions encountered in recipients' daily lives that may support counseling and assist in the further management of their device settings. The findings for this large cohort of active CI users confirm differences between age groups concerning device use and exposure to various noise environments, especially between the youngest and oldest age groups, while similar levels of loudness were observed.
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21
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Neben N, Buechner A, Schuessler M, Lenarz T. Outcome evaluation on cochlear implant users with residual hearing. Cochlear Implants Int 2017; 19:88-99. [PMID: 29214896 DOI: 10.1080/14670100.2017.1390852] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The performance outcome with Freedom™ Hybrid™ versus the CP900 series sound processor with Hybrid Hearing was investigated. In addition, a preliminary evaluation was conducted to consider the feasibility of upgrading experienced electric-only cochlear implant (CI) users who had substantial residual hearing to Hybrid Hearing. METHODS This study was a single-centre prospective, non-inferiority design with repeated measures conducted at Hannover Medical School (MHH). The randomized AABB cross-over design to compensate for learning effects included two test groups. Group 1 compared two systems for Hybrid Hearing (Freedom Hybrid sound processor versus CP900 series sound processor) and Group 2 compared CP900 series sound processor (electric-only) versus the CP900 with Hybrid Hearing in experienced CI users who had confirmed residual low-frequency hearing. Groups 1 and 2 were composed of different participants. RESULTS Group 1 (n = 24) performance on speech perception tests was equivalent or superior with the CP900 series sound processor showing a statistically significant mean improvement of 1.87 dB in background noise (P < 0.001). The mean speech understanding in quiet showed a better performance by 5% (P = 0.064) for participants tested with the CP900. The patient-reported outcome questionnaire confirmed the beneficial performance with the CP900 series sound processor with Hybrid Hearing. The feasibility portion of the study (Group 2, n = 14) showed an average benefit of 0.54 dB in background noise when using the CP900 with Hybrid Hearing function versus electric-only stimulation. CONCLUSIONS The outcome presents sufficient evidence to show the effectiveness of the CP900 series sound processor with Hybrid Hearing over the Freedom Hybrid for participants with substantial residual hearing. Positive outcomes were observed for improved speech understanding and subjective hearing performance. Further, a trend was demonstrated in the data towards better performance with CP900 with Hybrid Hearing versus electric-only stimulation. Hybrid Hearing users showed a clinically relevant and statistically a significant benefit from the current CP900 series sound processor generation supporting its recommendation, on a case-by-case basis, to current electric-only users. More research is needed to confirm these findings.
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Affiliation(s)
- Nicole Neben
- a Cochlear Deutschland GmbH & Co. KG , Karl-Wiechert-Allee 76A, Hannover 30625 , Germany
| | - Andreas Buechner
- b German Hearing Centre at Hannover Medical School , Karl-Wiechert-Allee 3, Hannover 30625 , Germany
| | - Mark Schuessler
- b German Hearing Centre at Hannover Medical School , Karl-Wiechert-Allee 3, Hannover 30625 , Germany
| | - Thomas Lenarz
- c Department of Otorhinolaryngology , Hannover Medical School , Carl-Neuberg-Str. 1, Hannover 30625 , Germany
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Evaluation of speech reception threshold in noise in young Cochlear™ Nucleus ® system 6 implant recipients using two different digital remote microphone technologies and a speech enhancement sound processing algorithm. Int J Pediatr Otorhinolaryngol 2017; 103:71-75. [PMID: 29224769 DOI: 10.1016/j.ijporl.2017.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/26/2017] [Accepted: 10/03/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Children affected by hearing loss can experience difficulties in challenging and noisy environments even when deafness is corrected by Cochlear implant (CI) devices. These patients have a selective attention deficit in multiple listening conditions. At present, the most effective ways to improve the performance of speech recognition in noise consists of providing CI processors with noise reduction algorithms and of providing patients with bilateral CIs. The aim of this study was to compare speech performances in noise, across increasing noise levels, in CI recipients using two kinds of wireless remote-microphone radio systems that use digital radio frequency transmission: the Roger Inspiro accessory and the Cochlear Wireless Mini Microphone accessory. METHODS Eleven Nucleus Cochlear CP910 CI young user subjects were studied. The signal/noise ratio, at a speech reception threshold (SRT) value of 50%, was measured in different conditions for each patient: with CI only, with the Roger or with the MiniMic accessory. The effect of the application of the SNR-noise reduction algorithm in each of these conditions was also assessed. The tests were performed with the subject positioned in front of the main speaker, at a distance of 2.5 m. Another two speakers were positioned at 3.50 m. The main speaker at 65 dB issued disyllabic words. Babble noise signal was delivered through the other speakers, with variable intensity. RESULTS The use of both wireless remote microphones improved the SRT results. Both systems improved gain of speech performances. The gain was higher with the Mini Mic system (SRT = -4.76) than the Roger system (SRT = -3.01). The addition of the NR algorithm did not statistically further improve the results. CONCLUSION There is significant improvement in speech recognition results with both wireless digital remote microphone accessories, in particular with the Mini Mic system when used with the CP910 processor. The use of a remote microphone accessory surpasses the benefit of application of NR algorithm.
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Purdy SC, Welch D, Giles E, Morgan CLA, Tenhagen R, Kuruvilla-Mathew A. Impact of cognition and noise reduction on speech perception in adults with unilateral cochlear implants. Cochlear Implants Int 2017; 18:162-170. [PMID: 28335695 DOI: 10.1080/14670100.2017.1299393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the impact of cognition and noise reduction (NR) technology in cochlear implants (CIs) on speech perception and listening effort. METHODS Thirteen adults fitted with unilateral CIs (Nucleus® 6, CP900) participated in this study. Participants performed: (I) cognitive tests of working memory and processing speed, (II) speech perception in noise tests, and (III) an auditory-visual dual-task paradigm to quantify listening effort, as a part of the three-phase experimental study. Both the participant and the tester, performing the outcome measures, were blinded to the NR settings (ON/OFF) of the CI for phases II and III. RESULTS Speech intelligibility significantly improved with the NR activated, but was independent of individual differences in cognitive abilities. Listening effort did not significantly change with NR setting; however, there was a trend for participants with good working memory to have better speech perception scores with NR activated during the effortful listening task (dual-task paradigm). CONCLUSION Future studies are warranted to explore the interaction between cognition and CI NR algorithms during an effortful listening task.
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Affiliation(s)
- Suzanne Carolyn Purdy
- a Speech Science, Faculty of Science , University of Auckland , Auckland , New Zealand.,b Eisdell Moore Centre, Hearing and Balance Research , New Zealand
| | - David Welch
- b Eisdell Moore Centre, Hearing and Balance Research , New Zealand.,c Audiology, Faculty of Medical & Health Sciences , University of Auckland , Auckland , New Zealand
| | - Ellen Giles
- b Eisdell Moore Centre, Hearing and Balance Research , New Zealand.,c Audiology, Faculty of Medical & Health Sciences , University of Auckland , Auckland , New Zealand
| | | | - Renique Tenhagen
- a Speech Science, Faculty of Science , University of Auckland , Auckland , New Zealand
| | - Abin Kuruvilla-Mathew
- a Speech Science, Faculty of Science , University of Auckland , Auckland , New Zealand.,b Eisdell Moore Centre, Hearing and Balance Research , New Zealand
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Hey M, Hocke T, Mauger S, Müller-Deile J. A clinical assessment of cochlear implant recipient performance: implications for individualized map settings in specific environments. Eur Arch Otorhinolaryngol 2016; 273:4011-4020. [PMID: 27276990 PMCID: PMC5052294 DOI: 10.1007/s00405-016-4130-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 05/31/2016] [Indexed: 11/28/2022]
Abstract
Individual speech intelligibility was measured in quiet and noise for cochlear Implant recipients upgrading from the Freedom to the CP900 series sound processor. The postlingually deafened participants (n = 23) used either Nucleus CI24RE or CI512 cochlear implant, and currently wore a Freedom sound processor. A significant group mean improvement in speech intelligibility was found in quiet (Freiburg monosyllabic words at 50 dBSPL) and in noise (adaptive Oldenburger sentences in noise) for the two CP900 series SmartSound programs compared to the Freedom program. Further analysis was carried out on individual’s speech intelligibility outcomes in quiet and in noise. Results showed a significant improvement or decrement for some recipients when upgrading to the new programs. To further increase speech intelligibility outcomes when upgrading, an enhanced upgrade procedure is proposed that includes additional testing with different signal-processing schemes. Implications of this research are that future automated scene analysis and switching technologies could provide additional performance improvements by introducing individualized scene-dependent settings.
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Affiliation(s)
- Matthias Hey
- Department of Otorhinolaryngology, Head and Neck Surgery, Audiology, Christian-Albrechts-University, Kiel, Germany.
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