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DeFreese A, Camarata S, Sunderhaus L, Holder J, Berg K, Lighterink M, Gifford R. The impact of spectral and temporal processing on speech recognition in children with cochlear implants. Sci Rep 2024; 14:14094. [PMID: 38890428 PMCID: PMC11189542 DOI: 10.1038/s41598-024-63932-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
While the relationships between spectral resolution, temporal resolution, and speech recognition are well defined in adults with cochlear implants (CIs), they are not well defined for prelingually deafened children with CIs, for whom language development is ongoing. This cross-sectional study aimed to better characterize these relationships in a large cohort of prelingually deafened children with CIs (N = 47; mean age = 8.33 years) by comprehensively measuring spectral resolution thresholds (measured via spectral modulation detection), temporal resolution thresholds (measured via sinusoidal amplitude modulation detection), and speech recognition (measured via monosyllabic word recognition, vowel recognition, and sentence recognition in noise via both fixed signal-to-noise ratio (SNR) and adaptively varied SNR). Results indicated that neither spectral or temporal resolution were significantly correlated with speech recognition in quiet or noise for children with CIs. Both age and CI experience had a moderate effect on spectral resolution, with significant effects for spectral modulation detection at a modulation rate of 0.5 cyc/oct, suggesting spectral resolution may improve with maturation. Thus, it is possible we may see an emerging relationship between spectral resolution and speech perception over time for children with CIs. While further investigation into this relationship is warranted, these findings demonstrate the need for new investigations to uncover ways of improving spectral resolution for children with CIs.
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Affiliation(s)
- Andrea DeFreese
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA.
| | - Stephen Camarata
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - Linsey Sunderhaus
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - Jourdan Holder
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - Katelyn Berg
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - Mackenzie Lighterink
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - René Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
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Schauwecker N, Patro A, Holder J, Moberly AC, Perkins E. Simultaneous versus Sequential Cochlear Implantation in Adults: Quantitative and Qualitative Outcomes. Otolaryngol Head Neck Surg 2024. [PMID: 38842041 DOI: 10.1002/ohn.848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/06/2024] [Accepted: 04/14/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To compare speech recognition and quality of life outcomes between bilateral sequentially and simultaneously implanted adult cochlear implant (CI) recipients who initially qualify for a CI in both ears. STUDY DESIGN Retrospective chart review. SETTING Tertiary referral center. METHODS Retrospective chart review identified adults who underwent bilateral CI, either simultaneously or sequentially, at a high-volume center between 2012 and 2022. Sequentially implanted patients were only included if the second ear qualified for CI in quiet (defined as best-aided AzBio quiet testing <60%), at time of initial CI evaluation. RESULTS Of 112 bilateral CI patients who qualified in both ears at initial evaluation, 95 underwent sequential implantation and 17 simultaneous. Age, duration, and etiology of hearing loss, and CI usage were similar between groups. Preoperatively, the sequential group had lower pure-tone average (PTA) in the 1st ear than the simultaneously implanted group (P = <.001) but, no difference in 2nd ear PTA (P = .657). Preoperative speech recognition scores were significantly higher for the sequential group; however, this was not true for postoperative scores. There was no difference in the proportion of patients showing significant CI-only or bilateral performance improvement between the groups. Both groups demonstrated similar benefit in quality of life measures. CONCLUSION Our findings indicate both simultaneous and sequential cochlear implantation are effective in improving hearing performance and quality of life. Thus, bilateral versus simultaneous implantation should be discussed and tailored for each individual patient.
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Affiliation(s)
- Natalie Schauwecker
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ankita Patro
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jourdan Holder
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Aaron C Moberly
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Nyirjesy SC, Lewis JH, Hallak D, Conroy S, Moberly AC, Tamati TN. Evaluating Listening Effort in Unilateral, Bimodal, and Bilateral Cochlear Implant Users. Otolaryngol Head Neck Surg 2024; 170:1147-1157. [PMID: 38104319 DOI: 10.1002/ohn.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/24/2023] [Accepted: 11/24/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Evaluate listening effort (LE) in unilateral, bilateral, and bimodal cochlear implant (CI) users. Establish an easy-to-implement task of LE that could be useful for clinical decision making. STUDY DESIGN Prospective cohort study. SETTING Tertiary neurotology center. METHODS The Sentence Final Word Identification and Recall Task, an established measure of LE, was modified to include challenging listening conditions (multitalker babble, gender, and emotional variation; test), in addition to single-talker sentences (control). Participants listened to lists of sentences in each condition and recalled the last word of each sentence. LE was quantified by percentage of words correctly recalled and was compared across conditions, across CI groups, and within subjects (best aided vs monaural). RESULTS A total of 24 adults between the ages of 37 and 82 years enrolled, including 4 unilateral CI users (CI), 10 bilateral CI users (CICI), and 10 bimodal CI users (CIHA). Task condition impacted LE (P < .001), but hearing configuration and listener group did not (P = .90). Working memory capacity and contralateral hearing contributed to individual performance. CONCLUSION This study adds to the growing body of literature on LE in challenging listening conditions for CI users and demonstrates feasibility of a simple behavioral task that could be implemented clinically to assess LE. This study also highlights the potential benefits of bimodal hearing and individual hearing and cognitive factors in understanding individual differences in performance, which will be evaluated through further research.
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Affiliation(s)
- Sarah C Nyirjesy
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Jessica H Lewis
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio, USA
| | - Diana Hallak
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Sara Conroy
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA
| | - Aaron C Moberly
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Terrin N Tamati
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Lively S, Agrawal S, Stewart M, Dwyer RT, Strobel L, Marcinkevich P, Hetlinger C, Croce J. CROS or hearing aid? Selecting the ideal solution for unilateral CI patients with limited aidable hearing in the contralateral ear. PLoS One 2024; 19:e0293811. [PMID: 38394286 PMCID: PMC10890777 DOI: 10.1371/journal.pone.0293811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/19/2023] [Indexed: 02/25/2024] Open
Abstract
A hearing aid or a contralateral routing of signal device are options for unilateral cochlear implant listeners with limited hearing in the unimplanted ear; however, it is uncertain which device provides greater benefit beyond unilateral listening alone. Eighteen unilateral cochlear implant listeners participated in this prospective, within-participants, repeated measures study. Participants were tested with the cochlear implant alone, cochlear implant + hearing aid, and cochlear implant + contralateral routing of signal device configurations with a one-month take-home period between each in-person visit. Audiograms, speech perception in noise, and lateralization were evaluated. Subjective feedback was obtained via questionnaires. Marked improvement in speech in noise and non-implanted ear lateralization accuracy were observed with the addition of a contralateral hearing aid. There were no significant differences in speech recognition between listening configurations. However, the chronic device use questionnaires and the final device selection showed a clear preference for the hearing aid in spatial awareness and communication domains. Individuals with limited hearing in their unimplanted ears demonstrate significant improvement with the addition of a contralateral device. Subjective questionnaires somewhat contrast with clinic-based outcome measures, highlighting the delicate decision-making process involved in clinically advising one device or another to maximize communication benefits.
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Affiliation(s)
- Sarah Lively
- Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, United States of America
| | - Smita Agrawal
- Collaborative Research Group, Clinical Research, Advanced Bionics, Valencia, CA, United States of America
| | - Matthew Stewart
- Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, United States of America
| | - Robert T. Dwyer
- Collaborative Research Group, Clinical Research, Advanced Bionics, Valencia, CA, United States of America
| | - Laura Strobel
- Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, United States of America
| | - Paula Marcinkevich
- Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, United States of America
| | - Chris Hetlinger
- Research and Technology Group, Advanced Bionics, Valencia, CA, United States of America
| | - Julia Croce
- Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, United States of America
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Anderson SR, Burg E, Suveg L, Litovsky RY. Review of Binaural Processing With Asymmetrical Hearing Outcomes in Patients With Bilateral Cochlear Implants. Trends Hear 2024; 28:23312165241229880. [PMID: 38545645 PMCID: PMC10976506 DOI: 10.1177/23312165241229880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 01/11/2024] [Accepted: 01/16/2024] [Indexed: 04/01/2024] Open
Abstract
Bilateral cochlear implants (BiCIs) result in several benefits, including improvements in speech understanding in noise and sound source localization. However, the benefit bilateral implants provide among recipients varies considerably across individuals. Here we consider one of the reasons for this variability: difference in hearing function between the two ears, that is, interaural asymmetry. Thus far, investigations of interaural asymmetry have been highly specialized within various research areas. The goal of this review is to integrate these studies in one place, motivating future research in the area of interaural asymmetry. We first consider bottom-up processing, where binaural cues are represented using excitation-inhibition of signals from the left ear and right ear, varying with the location of the sound in space, and represented by the lateral superior olive in the auditory brainstem. We then consider top-down processing via predictive coding, which assumes that perception stems from expectations based on context and prior sensory experience, represented by cascading series of cortical circuits. An internal, perceptual model is maintained and updated in light of incoming sensory input. Together, we hope that this amalgamation of physiological, behavioral, and modeling studies will help bridge gaps in the field of binaural hearing and promote a clearer understanding of the implications of interaural asymmetry for future research on optimal patient interventions.
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Affiliation(s)
- Sean R. Anderson
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Physiology and Biophysics, University of Colorado Anschutz Medical School, Aurora, CO, USA
| | - Emily Burg
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lukas Suveg
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Ruth Y. Litovsky
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA
- Department of Surgery, Division of Otolaryngology, University of Wisconsin-Madison, Madison, WI, USA
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Jahn KN, Koach CE. Hyperacusis Diagnosis and Management in the United States: Clinical Audiology Practice Patterns. Am J Audiol 2023; 32:950-961. [PMID: 37917915 PMCID: PMC11001428 DOI: 10.1044/2023_aja-23-00118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/27/2023] [Accepted: 09/01/2023] [Indexed: 11/04/2023] Open
Abstract
PURPOSE Hyperacusis often leads to debilitating psychosocial consequences, but there is no standard protocol for its diagnosis and management in the United States. In this study, we surveyed U.S. clinical audiologists to understand their education and clinical practices surrounding the evaluation and treatment of hyperacusis. METHOD An online survey was distributed to clinical audiologists across the United States. Survey responses were quantified using descriptive statistics and inductive content analysis. RESULTS Hyperacusis definitions and clinical practice patterns varied widely across the 102 respondents. Respondents cited a lack of education and training as the primary barrier to effective audiological diagnosis and management of hyperacusis, with most respondents reporting ≤ 5 hr of hyperacusis education. Other primary barriers to effective audiological management of hyperacusis included time constraints, reimbursement, poor sensitivity and specificity of available diagnostic tools, and poor efficacy of available treatments and management strategies. Most respondents (82.5%) agreed that audiologists are the primary professionals who are responsible for implementing hyperacusis interventions. However, 63.3% of respondents reported that their clinic does not have a hyperacusis management protocol, and 80.0% routinely recommend treatment that is outside their scope of practice to implement (cognitive behavioral therapy). CONCLUSIONS Clinical audiologists in the United States do not receive uniform education on hyperacusis, and they report multiple barriers to its evidence-based diagnosis and management. Effective hyperacusis management necessitates a multidisciplinary approach. The information obtained via this survey will pave the way toward the refinement of interprofessional education programs and the development of systematic, evidence-based clinical protocols for hyperacusis. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24431188.
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Affiliation(s)
- Kelly N. Jahn
- Department of Speech, Language, and Hearing, The University of Texas at Dallas, Richardson
- Callier Center for Communication Disorders, The University of Texas at Dallas
| | - Chelsea E. Koach
- Department of Speech, Language, and Hearing, The University of Texas at Dallas, Richardson
- Callier Center for Communication Disorders, The University of Texas at Dallas
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Neo WL, Tan BYB, Tan APM, Wee OML, Thong JF. The role for cochlear implants in microtia and congenital aural atresia: A case report and a review of literature. PROCEEDINGS OF SINGAPORE HEALTHCARE 2023. [DOI: 10.1177/20101058231160603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Sensorineural hearing loss resulting from microtia and aural atresia is rare due to different embryologic origins of the external and inner ear. Consequently, cochlear implants are seldom performed in patients with microtia and/or aural atresia. Herein we discuss an 8 year-old boy with congenital aural atresia and microtia who underwent cochlear implant surgery for profound hearing loss with good results. A literature review was performed and discussed. Pre-operative planning with high resolution computed tomography and facial nerve monitoring are crucial in identification and preservation of the facial nerve due to the high rate of aberrant anatomy. Careful incision placement is required particularly if pinna reconstruction is considered. Literature review highlighted various surgical approaches as well as different modalities used for intra-operative facial nerve monitoring. Only one patient had intra-operative complications. Cochlear implant is a viable solution in patients with external ear malformations and severe-profound sensorineural hearing loss. Adequate planning and counselling are essential due to the challenges that may occur in microtia and aural atresia.
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Affiliation(s)
- Wei Li Neo
- Department of Otorhinolaryngology—Head and Neck Surgery, Singapore General Hospital, Singapore
| | - Barrie Yau Boon Tan
- Department of Otorhinolaryngology—Head and Neck Surgery, Singapore General Hospital, Singapore
- Center for Hearing and Ear Implants, Singapore General Hospital, Singapore
| | - Adam Ping Meng Tan
- Center for Hearing and Ear Implants, Singapore General Hospital, Singapore
| | | | - Jiun Fong Thong
- Department of Otorhinolaryngology—Head and Neck Surgery, Singapore General Hospital, Singapore
- Center for Hearing and Ear Implants, Singapore General Hospital, Singapore
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8
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Dourado RPB, Caldas FF, Cardoso CC, Santos DCD, Bahmad F. Benefits of Bimodal Stimulation to Speech Perception in Noise and Silence. Int Arch Otorhinolaryngol 2023; 27:e645-e653. [PMID: 37876694 PMCID: PMC10593532 DOI: 10.1055/s-0043-1761169] [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: 07/25/2022] [Accepted: 09/26/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Understanding all the benefits of bimodality with self-assessment questionnaires on the effect of hearing on quality of life is still necessary. Objective To present whether bimodality still offers hearing benefits to the population who uses acoustic stimulation associated with electrical stimulation. Methods The present study included 13 participants aged between 16 and 80 years old who were users of cochlear implants from Cochlear Corporation and hearing aids. All patients underwent the Hearing in Noise Test, and their visual analog scale score was obtained. Four-tone means were collected, and the participants answered the Speech, Spatial and Hearing Qualities questionnaire. Results Bimodal users had an average sentence recognition rate of 76.0% in silence and 67.6% in fixed noise, and the signal-to-noise ratio in adaptive noise was +2.89dB. In addition, a lower level of difficulty was observed in the test using the visual analog scale. The domain with the highest average was auditory qualities (6.50), followed by spatial hearing (6.26) and hearing for speech (5.81). Individuals with an average between 50 and 70 dB of hearing level showed better sentence recognition in silence and noise. Conclusion Bimodal stimulation showed benefits for users with different degrees of hearing loss; however, individuals who presented greater hearing residue had better performance in speech recognition with noise and in silence in addition to a good perception of hearing quality.
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Affiliation(s)
- Rayssa Pacheco Brito Dourado
- Health Sciences Postgraduate Program in Ciências da Saúde, Campus Universitário Darcy Ribeiro, Universidade de Brasília, Brasília, DF, Brazil
| | | | | | - Danielle Cristovão dos Santos
- Faculdade de Ciências da Saúde, Universidade de Brasília, Brasilia, DF, Brazil
- Centro de Reabilitação da Audição e Fala, Instituto Brasiliense de Otorrino, Asa Norte, Brasília, DF, Brazil
| | - Fayez Bahmad
- Health Science School, Universidade de Brasilia, Brasilia, DF, Brazil
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Xu C, Cheng FY, Medina S, Eng E, Gifford R, Smith S. Objective discrimination of bimodal speech using frequency following responses. Hear Res 2023; 437:108853. [PMID: 37441879 DOI: 10.1016/j.heares.2023.108853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/03/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
Bimodal hearing, in which a contralateral hearing aid is combined with a cochlear implant (CI), provides greater speech recognition benefits than using a CI alone. Factors predicting individual bimodal patient success are not fully understood. Previous studies have shown that bimodal benefits may be driven by a patient's ability to extract fundamental frequency (f0) and/or temporal fine structure cues (e.g., F1). Both of these features may be represented in frequency following responses (FFR) to bimodal speech. Thus, the goals of this study were to: 1) parametrically examine neural encoding of f0 and F1 in simulated bimodal speech conditions; 2) examine objective discrimination of FFRs to bimodal speech conditions using machine learning; 3) explore whether FFRs are predictive of perceptual bimodal benefit. Three vowels (/ε/, /i/, and /ʊ/) with identical f0 were manipulated by a vocoder (right ear) and low-pass filters (left ear) to create five bimodal simulations for evoking FFRs: Vocoder-only, Vocoder +125 Hz, Vocoder +250 Hz, Vocoder +500 Hz, and Vocoder +750 Hz. Perceptual performance on the BKB-SIN test was also measured using the same five configurations. Results suggested that neural representation of f0 and F1 FFR components were enhanced with increasing acoustic bandwidth in the simulated "non-implanted" ear. As spectral differences between vowels emerged in the FFRs with increased acoustic bandwidth, FFRs were more accurately classified and discriminated using a machine learning algorithm. Enhancement of f0 and F1 neural encoding with increasing bandwidth were collectively predictive of perceptual bimodal benefit on a speech-in-noise task. Given these results, FFR may be a useful tool to objectively assess individual variability in bimodal hearing.
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Affiliation(s)
- Can Xu
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, 2504A Whitis Ave. (A1100), Austin 78712-0114, TX, USA
| | - Fan-Yin Cheng
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, 2504A Whitis Ave. (A1100), Austin 78712-0114, TX, USA
| | - Sarah Medina
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, 2504A Whitis Ave. (A1100), Austin 78712-0114, TX, USA
| | - Erica Eng
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, 2504A Whitis Ave. (A1100), Austin 78712-0114, TX, USA
| | - René Gifford
- Department of Speech, Language, and Hearing Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Spencer Smith
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, 2504A Whitis Ave. (A1100), Austin 78712-0114, TX, USA.
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Buz E, Dwyer NC, Lai W, Watson DG, Gifford RH. Integration of fundamental frequency and voice-onset-time to voicing categorization: Listeners with normal hearing and bimodal hearing configurations. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:1580. [PMID: 37002096 PMCID: PMC9995168 DOI: 10.1121/10.0017429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 05/18/2023]
Abstract
This study investigates the integration of word-initial fundamental frequency (F0) and voice-onset-time (VOT) in stop voicing categorization for adult listeners with normal hearing (NH) and unilateral cochlear implant (CI) recipients utilizing a bimodal hearing configuration [CI + contralateral hearing aid (HA)]. Categorization was assessed for ten adults with NH and ten adult bimodal listeners, using synthesized consonant stimuli interpolating between /ba/ and /pa/ exemplars with five-step VOT and F0 conditions. All participants demonstrated the expected categorization pattern by reporting /ba/ for shorter VOTs and /pa/ for longer VOTs, with NH listeners showing more use of VOT as a voicing cue than CI listeners in general. When VOT becomes ambiguous between voiced and voiceless stops, NH users make more use of F0 as a cue to voicing than CI listeners, and CI listeners showed greater utilization of initial F0 during voicing identification in their bimodal (CI + HA) condition than in the CI-alone condition. The results demonstrate the adjunctive benefit of acoustic hearing from the non-implanted ear for listening conditions involving spectrotemporally complex stimuli. This finding may lead to the development of a clinically feasible perceptual weighting task that could inform clinicians about bimodal efficacy and the risk-benefit profile associated with bilateral CI recommendation.
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Affiliation(s)
- Esteban Buz
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee 37203, USA
| | - Nichole C Dwyer
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida 33620, USA
| | - Wei Lai
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee 37203, USA
| | - Duane G Watson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee 37203, USA
| | - René H Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37203, USA
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11
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Biever A, Kelsall DC, Lupo JE, Haase GM. Evolution of the candidacy requirements and patient perioperative assessment protocols for cochlear implantation. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:3346. [PMID: 36586869 DOI: 10.1121/10.0016446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
Cochlear implantation as an approved clinical therapy ushered in an exciting era of innovation for the treatment of hearing loss. The U.S. Food and Drug Administration approved the use of cochlear implants as a treatment option for adults with profound sensorineural hearing loss in 1985. The landscape for treating adults and children with significant hearing loss has changed dramatically over the last three decades. The purpose of this paper is to examine the evolving regulatory process and changes to clinical care. A significant emerging trend in cochlear implantation is the consideration of steroids to preserve hearing during and following surgery. This parallels the quest for hearing preservation in noise-induced hearing disorders, especially considering the current interest in biological drug therapies in this population. The future will likely usher in an era of combination therapeutics utilizing drugs and cochlear implantation. For over 30+ years and following regulatory compliance, the Rocky Mountain Ear Center has developed an extensive candidacy and outcome assessment protocol. This systematic approach evaluates both unaided and aided auditory performance during candidacy stages and post-implantation. Adjunctive measures of cognition and quality-of-life augment the auditory assessment in specific populations. Practical insights into lessons learned have directed further clinical research and have resulted in beneficial changes to clinical care.
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Affiliation(s)
- Allison Biever
- Rocky Mountain Ear Center, Englewood, Colorado 80113, USA
| | | | - J Eric Lupo
- Rocky Mountain Ear Center, Englewood, Colorado 80113, USA
| | - Gerald M Haase
- University of Colorado, School of Medicine, Aurora, Colorado 80045, USA
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12
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Yoon YS, Morgan D. Dichotic spectral integration range for consonant recognition in listeners with normal hearing. Front Psychol 2022; 13:1009463. [PMID: 36337493 PMCID: PMC9633255 DOI: 10.3389/fpsyg.2022.1009463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/05/2022] [Indexed: 01/16/2023] Open
Abstract
Dichotic spectral integration range, or DSIR, was measured for consonant recognition with normal-hearing listeners. DSIR is defined as a frequency range needed from 0 to 8,000 Hz band in one ear for consonant recognition when low-frequency information of the same consonant was presented to the opposite ear. DSIR was measured under the three signal processing conditions: (1) unprocessed, (2) target: intensified target spectro-temporal regions by 6 dB responsible for consonant recognition, and (3) target minus conflicting: intensified target regions minus spectro-temporal regions that increase confusion. Each consonant was low-pass filtered with a cutoff frequency of 250, 500, 750, and 1,000 Hz, and then was presented in the left ear or low-frequency (LF) ear. To create dichotic listening, the same consonant was simultaneously presented to the right ear or high-frequency (HF) ear. This was high-pass filtered with an initial cutoff frequency of 7,000 Hz, which was adjusted using an adaptive procedure to find the maximum high-pass cutoff for 99.99% correct consonant recognition. Mean DSIRs spanned from 3,198-8,000 Hz to 4,668-8,000 Hz (i.e., mid-to-high frequencies were unnecessary), depending on low-frequency information in the LF ear. DSIRs narrowed (i.e., required less frequency information) with increasing low-frequency information in the LF ear. However, the mean DSIRs were not significantly affected by the signal processing except at the low-pass cutoff frequency of 250 Hz. The individual consonant analyses revealed that /ta/, /da/, /sa/, and /za/ required the smallest DSIR, while /ka/, /ga/, /fa/, and /va/ required the largest DSIRs. DSIRs also narrowed with increasing low-frequency information for the two signal processing conditions except for 250 vs. 1,000 Hz under the target-conflicting condition. The results suggest that consonant recognition is possible with large amounts of spectral information missing if complementary spectral information is integrated across ears. DSIR is consonant-specific and relatively consistent, regardless of signal processing. The results will help determine the minimum spectral range needed in one ear for consonant recognition if limited low spectral information is available in the opposite ear.
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Fleming JT, Winn MB. Strategic perceptual weighting of acoustic cues for word stress in listeners with cochlear implants, acoustic hearing, or simulated bimodal hearing. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:1300. [PMID: 36182279 PMCID: PMC9439712 DOI: 10.1121/10.0013890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 05/28/2023]
Abstract
Perception of word stress is an important aspect of recognizing speech, guiding the listener toward candidate words based on the perceived stress pattern. Cochlear implant (CI) signal processing is likely to disrupt some of the available cues for word stress, particularly vowel quality and pitch contour changes. In this study, we used a cue weighting paradigm to investigate differences in stress cue weighting patterns between participants listening with CIs and those with normal hearing (NH). We found that participants with CIs gave less weight to frequency-based pitch and vowel quality cues than NH listeners but compensated by upweighting vowel duration and intensity cues. Nonetheless, CI listeners' stress judgments were also significantly influenced by vowel quality and pitch, and they modulated their usage of these cues depending on the specific word pair in a manner similar to NH participants. In a series of separate online experiments with NH listeners, we simulated aspects of bimodal hearing by combining low-pass filtered speech with a vocoded signal. In these conditions, participants upweighted pitch and vowel quality cues relative to a fully vocoded control condition, suggesting that bimodal listening holds promise for restoring the stress cue weighting patterns exhibited by listeners with NH.
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Affiliation(s)
- Justin T Fleming
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Matthew B Winn
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, Minnesota 55455, USA
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Holder JT, Holcomb MA, Snapp H, Labadie RF, Vroegop J, Rocca C, Elgandy MS, Dunn C, Gifford RH. Guidelines for Best Practice in the Audiological Management of Adults Using Bimodal Hearing Configurations. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e011. [PMID: 36274668 PMCID: PMC9581116 DOI: 10.1097/ono.0000000000000011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Clinics are treating a growing number of patients with greater amounts of residual hearing. These patients often benefit from a bimodal hearing configuration in which acoustic input from a hearing aid on 1 ear is combined with electrical stimulation from a cochlear implant on the other ear. The current guidelines aim to review the literature and provide best practice recommendations for the evaluation and treatment of individuals with bilateral sensorineural hearing loss who may benefit from bimodal hearing configurations. Specifically, the guidelines review: benefits of bimodal listening, preoperative and postoperative cochlear implant evaluation and programming, bimodal hearing aid fitting, contralateral routing of signal considerations, bimodal treatment for tinnitus, and aural rehabilitation recommendations.
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Affiliation(s)
| | | | | | | | | | - Christine Rocca
- Guy’s and St. Thomas’ Hearing Implant Centre, London, United Kingdom
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15
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Racca JM, Jones LL, Dwyer RT, Ferguson M, Sunderhaus L, Hood LJ, Gifford RH. Changes in Acoustic Absorbance Pre- and Post-Cochlear Implantation. Am J Audiol 2022; 31:380-391. [PMID: 35549520 PMCID: PMC9524757 DOI: 10.1044/2022_aja-21-00146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Until recently, there has been little investigation on the effects of cochlear implantation on the transmission of acoustic stimuli through the middle-ear system. Recent studies have shown that cochlear implantation decreases low-frequency acoustic absorbance, consistent with a stiffer middle-ear system postsurgery. The objectives of this study are (a) to investigate the time course of changes in acoustic absorbance post-cochlear implantation in the implanted ear and (b) to compare changes in acoustic absorbance between implanted and nonimplanted ears over time. METHOD Seventeen adult cochlear implant (CI) recipients within 6 months of device activation participated in this study. Wideband acoustic absorbance was measured in both ears at one to six different time points from pre-implantation up to 6-month postactivation. Analyses examined (a) changes in acoustic absorbance as compared to pre-implantation and (b) differences in acoustic absorbance between implanted and nonimplanted ears over time. RESULTS Acoustic absorbance in the implanted ear decreased postsurgery for frequencies lower than 1.5 kHz and persisted through at least 6-month postactivation. We also observed that the spectral range of decreased acoustic absorbance in the implanted ear decreased with longer time postsurgery. Differences in acoustic absorbance between implanted and nonimplanted ears occurred over a broad spectral range at the activation time point and persisted through at least 3-month postactivation, though for a narrower spectral range at the later time point. CONCLUSIONS Cochlear implantation increased middle-ear stiffness as indicated by decreased acoustic absorbance of low-frequency acoustic power. The findings of this study are consistent with those of previous studies and may have important implications toward understanding spatial hearing and programming of acoustic components for CI-combined electric and binaural acoustic stimulation patients.
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Affiliation(s)
- Jordan M. Racca
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN,Department of Radiology, Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN
| | - Laura L. Jones
- Department of Audiology, MedStar Georgetown University Hospital, Washington, DC
| | - Robert T. Dwyer
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN,Advanced Bionics LLC, Valencia, CA
| | - Mary Ferguson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Linsey Sunderhaus
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Linda J. Hood
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - René H. Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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Caswell-Midwinter B, Doney EM, Arjmandi MK, Jahn KN, Herrmann BS, Arenberg JG. The Relationship Between Impedance, Programming and Word Recognition in a Large Clinical Dataset of Cochlear Implant Recipients. Trends Hear 2022; 26:23312165211060983. [PMID: 35018875 PMCID: PMC8761885 DOI: 10.1177/23312165211060983] [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] [Indexed: 11/15/2022] Open
Abstract
Cochlear implant programming typically involves measuring electrode impedance, selecting a speech processing strategy and fitting the dynamic range of electrical stimulation. This study retrospectively analyzed a clinical dataset of adult cochlear implant recipients to understand how these variables relate to speech recognition. Data from 425 implanted post-lingually deafened ears with Advanced Bionics devices were analyzed. A linear mixed-effects model was used to infer how impedance, programming and patient factors were associated with monosyllabic word recognition scores measured in quiet. Additional analyses were conducted on subsets of data to examine the role of speech processing strategy on scores, and the time taken for the scores of unilaterally implanted patients to plateau. Variation in basal impedance was negatively associated with word score, suggesting importance in evaluating the profile of impedance. While there were small, negative bivariate correlations between programming level metrics and word scores, these relationships were not clearly supported by the model that accounted for other factors. Age at implantation was negatively associated with word score, and duration of implant experience was positively associated with word score, which could help to inform candidature and guide expectations. Electrode array type was also associated with word score. Word scores measured with traditional continuous interleaved sampling and current steering speech processing strategies were similar. The word scores of unilaterally implanted patients largely plateaued within 6-months of activation. However, there was individual variation which was not related to initially measured impedance and programming levels.
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Affiliation(s)
- Benjamin Caswell-Midwinter
- Department of Otolaryngology - Head and Neck Surgery, 1811Harvard Medical School, Boston, MA, USA.,Eaton-Peabody Laboratories, Boston, MA, USA.,Massachusetts Eye and Ear, 1866Audiology Division, Boston, MA, USA
| | | | - Meisam K Arjmandi
- Department of Otolaryngology - Head and Neck Surgery, 1811Harvard Medical School, Boston, MA, USA.,Eaton-Peabody Laboratories, Boston, MA, USA.,Massachusetts Eye and Ear, 1866Audiology Division, Boston, MA, USA
| | - Kelly N Jahn
- Department of Otolaryngology - Head and Neck Surgery, 1811Harvard Medical School, Boston, MA, USA.,Eaton-Peabody Laboratories, Boston, MA, USA
| | - Barbara S Herrmann
- Department of Otolaryngology - Head and Neck Surgery, 1811Harvard Medical School, Boston, MA, USA.,Massachusetts Eye and Ear, 1866Audiology Division, Boston, MA, USA
| | - Julie G Arenberg
- Department of Otolaryngology - Head and Neck Surgery, 1811Harvard Medical School, Boston, MA, USA.,Eaton-Peabody Laboratories, Boston, MA, USA.,Massachusetts Eye and Ear, 1866Audiology Division, Boston, MA, USA
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Tawdrous MM, D'Onofrio KL, Gifford R, Picou EM. Emotional Responses to Non-Speech Sounds for Hearing-aid and Bimodal Cochlear-Implant Listeners. Trends Hear 2022; 26:23312165221083091. [PMID: 35435773 PMCID: PMC9019384 DOI: 10.1177/23312165221083091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/19/2021] [Accepted: 02/06/2022] [Indexed: 02/03/2023] Open
Abstract
The purpose of this project was to evaluate differences between groups and device configurations for emotional responses to non-speech sounds. Three groups of adults participated: 1) listeners with normal hearing with no history of device use, 2) hearing aid candidates with or without hearing aid experience, and 3) bimodal cochlear-implant listeners with at least 6 months of implant use. Participants (n = 18 in each group) rated valence and arousal of pleasant, neutral, and unpleasant non-speech sounds. Listeners with normal hearing rated sounds without hearing devices. Hearing aid candidates rated sounds while using one or two hearing aids. Bimodal cochlear-implant listeners rated sounds while using a hearing aid alone, a cochlear implant alone, or the hearing aid and cochlear implant simultaneously. Analysis revealed significant differences between groups in ratings of pleasant and unpleasant stimuli; ratings from hearing aid candidates and bimodal cochlear-implant listeners were less extreme (less pleasant and less unpleasant) than were ratings from listeners with normal hearing. Hearing aid candidates' ratings were similar with one and two hearing aids. Bimodal cochlear-implant listeners' ratings of valence were higher (more pleasant) in the configuration without a hearing aid (implant only) than in the two configurations with a hearing aid (alone or with an implant). These data support the need for further investigation into hearing device optimization to improve emotional responses to non-speech sounds for adults with hearing loss.
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Affiliation(s)
- Marina M. Tawdrous
- School of Communication Sciences and Disorders, Western University, 1151 Richmond St, London, ON, N6A 3K7
| | - Kristen L. D'Onofrio
- Department of Hearing and Speech Sciences, Graduate School, Vanderbilt University, 1215 21st Ave South, Room 8310, Nashville, TN, 37232
- Department of Hearing and Speech Sciences, School of Medicine, Vanderbilt University Medical
Center, 1215 21st Ave South, Room 8310, Nashville, TN, 37232
| | - René Gifford
- Department of Hearing and Speech Sciences, Graduate School, Vanderbilt University, 1215 21st Ave South, Room 8310, Nashville, TN, 37232
- Department of Hearing and Speech Sciences, School of Medicine, Vanderbilt University Medical
Center, 1215 21st Ave South, Room 8310, Nashville, TN, 37232
| | - Erin M. Picou
- Department of Hearing and Speech Sciences, Graduate School, Vanderbilt University, 1215 21st Ave South, Room 8310, Nashville, TN, 37232
- Department of Hearing and Speech Sciences, School of Medicine, Vanderbilt University Medical
Center, 1215 21st Ave South, Room 8310, Nashville, TN, 37232
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18
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Bilateral Cochlear Implants or Bimodal Hearing for Children with Bilateral Sensorineural Hearing Loss. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021; 8:385-394. [PMID: 33815965 DOI: 10.1007/s40136-020-00314-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose of review This review describes speech perception and language outcomes for children using bimodal hearing (cochlear implant (CI) plus contralateral hearing aid) as compared to children with bilateral CIs and contrasts said findings with the adult literature. There is a lack of clinical evidence driving recommendations for bimodal versus bilateral CI candidacy and as such, clinicians are often unsure about when to recommend a second CI for children with residual acoustic hearing. Thus the goal of this review is to identify scientific information that may influence clinical decision making for pediatric CI candidates with residual acoustic hearing. Recent findings Bilateral CIs are considered standard of care for children with bilateral severe-to-profound sensorineural hearing loss. For children with aidable acoustic hearing-even in just the low frequencies-an early period of bimodal stimulation has been associated with significantly better speech perception, vocabulary, and language development. HA audibility, however, is generally poorer than that offered by a CI resulting in interaural asymmetry in speech perception, head shadow, as well as brainstem and cortical activity and development. Thus there is a need to optimize "two-eared" hearing while maximizing a child's potential with respect to hearing, speech, and language while ensuring that we limit asymmetrically driven auditory neuroplasticity. A recent large study of bimodal and bilateral CI users suggested that a period of bimodal stimulation was only beneficial for children with a better-ear pure tone average (PTA) ≤ 73 dB HL. This 73-dB-HL cutoff applied even to children who ultimately received bilateral CIs. Summary Though we do not yet have definitive guidelines for determining bimodal versus bilateral CI candidacy, there is increasing evidence that 1) bilateral CIs yield superior outcomes for children with bilateral severe-to-profound hearing loss and, 2) an early period of bimodal stimulation is beneficial for speech perception and language development, but only for children with better-ear PTA ≤ 73 dB HL. For children with residual acoustic hearing, even in just the low-frequency range, rapid sequential bilateral cochlear implantation following a trial period with bimodal stimulation will yield best outcomes for auditory, language, and academic development. Of course, there is also an increasing prevalence of cochlear implantation with acoustic hearing preservation allowing for combined electric and acoustic stimulation even following bilateral implantation.
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King K, Dillon MT, O'Connell BP, Brown KD, Park LR. Spatial Release From Masking in Bimodal and Bilateral Pediatric Cochlear Implant Recipients. Am J Audiol 2021; 30:67-75. [PMID: 33259722 DOI: 10.1044/2020_aja-20-00051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Traditional clinical measures of cochlear implant (CI) recipient performance may not fully evaluate the benefit of bimodal listening (hearing aid contralateral to a CI). The clinical assessment of spatial release from masking (SRM) may be a sensitive measure of the benefit of listening with bimodal stimulation. This study compared the SRM of pediatric bimodal and bilateral CI listeners using a clinically feasible method, and investigated variables that may contribute to speech recognition performance with spatially separated maskers. Method Forty pediatric bimodal (N = 20) and bilateral CI (N = 20) participants were assessed in their best aided listening condition on sentence recognition in a four-talker masker. Testing was completed with target and masker colocated at 0° azimuth, and with the masker directed at 90° to either ear. SRM was calculated as the difference in performance between the colocated and each 90° condition. A two-way mixed-methods analysis of variance was used to compare performance between groups in the three masker conditions. Multiple regression analyses were conducted to investigate potential predictors for SRM asymmetry including hearing history, unaided thresholds, word recognition, duration of device use, and acoustic bandwidth. Results Both groups demonstrated SRM, with significantly better recognition in each 90° condition as compared to the colocated condition. The groups did not differ significantly in SRM. The multiple regression analyses did not reveal any significant predictors of SRM asymmetry. Conclusions Bimodal and bilateral CI listeners demonstrated similar amounts of SRM. While no specific variables predicted SRM asymmetry in bimodal listeners, pediatric bimodal and bilateral CI recipients should expect similar amounts of SRM regardless of the side of the masker. SRM asymmetry in pediatric bimodal listeners may signal a need for consideration of a second CI.
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Affiliation(s)
- Kaylene King
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Margaret T. Dillon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Brendan P. O'Connell
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Kevin D. Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Lisa R. Park
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
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20
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Zhang H, Zhang J, Peng G, Ding H, Zhang Y. Bimodal Benefits Revealed by Categorical Perception of Lexical Tones in Mandarin-Speaking Kindergarteners With a Cochlear Implant and a Contralateral Hearing Aid. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:4238-4251. [PMID: 33186505 DOI: 10.1044/2020_jslhr-20-00224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Pitch reception poses challenges for individuals with cochlear implants (CIs), and adding a hearing aid (HA) in the nonimplanted ear is potentially beneficial. The current study used fine-scale synthetic speech stimuli to investigate the bimodal benefit for lexical tone categorization in Mandarin-speaking kindergarteners using a CI and an HA in opposite ears. Method The data were collected from 16 participants who were required to complete two classical tasks for speech categorical perception (CP) with CI + HA device condition and CI alone condition. Linear mixed-effects models were constructed to evaluate the identification and discrimination scores across different device conditions. Results The bimodal kindergarteners showed CP for the continuum varying from Mandarin Tone 1 and Tone 2. Moreover, the additional acoustic information from the contralateral HA contributes to improved lexical tone categorization, with a steeper slope, a higher discrimination score of between-category stimuli pair, and an improved peakedness score (i.e., an increased benefit magnitude for discriminations of between-category over within-category pairs) for the CI + HA condition than the CI alone condition. The bimodal kindergarteners with better residual hearing thresholds at 250 Hz level in the nonimplanted ear could perceive lexical tones more categorically. Conclusion The enhanced CP results with bimodal listening provide clear evidence for the clinical practice to fit a contralateral HA in the nonimplanted ear in kindergarteners with unilateral CIs with direct benefits from the low-frequency acoustic hearing.
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Affiliation(s)
- Hao Zhang
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
- Research Centre for Language, Cognition, and Neuroscience, Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University
| | - Jing Zhang
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Gang Peng
- Research Centre for Language, Cognition, and Neuroscience, Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University
| | - Hongwei Ding
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Yang Zhang
- Department of Speech-Language-Hearing Sciences and Center for Neurobehavioral Development, University of Minnesota, Minneapolis
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21
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Kessler DM, Ananthakrishnan S, Smith SB, D'Onofrio K, Gifford RH. Frequency Following Response and Speech Recognition Benefit for Combining a Cochlear Implant and Contralateral Hearing Aid. Trends Hear 2020; 24:2331216520902001. [PMID: 32003296 PMCID: PMC7257083 DOI: 10.1177/2331216520902001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Multiple studies have shown significant speech recognition benefit when acoustic hearing is combined with a cochlear implant (CI) for a bimodal hearing configuration. However, this benefit varies greatly between individuals. There are few clinical measures correlated with bimodal benefit and those correlations are driven by extreme values prohibiting data-driven, clinical counseling. This study evaluated the relationship between neural representation of fundamental frequency (F0) and temporal fine structure via the frequency following response (FFR) in the nonimplanted ear as well as spectral and temporal resolution of the nonimplanted ear and bimodal benefit for speech recognition in quiet and noise. Participants included 14 unilateral CI users who wore a hearing aid (HA) in the nonimplanted ear. Testing included speech recognition in quiet and in noise with the HA-alone, CI-alone, and in the bimodal condition (i.e., CI + HA), measures of spectral and temporal resolution in the nonimplanted ear, and FFR recording for a 170-ms/da/stimulus in the nonimplanted ear. Even after controlling for four-frequency pure-tone average, there was a significant correlation (r = .83) between FFR F0 amplitude in the nonimplanted ear and bimodal benefit. Other measures of auditory function of the nonimplanted ear were not significantly correlated with bimodal benefit. The FFR holds potential as an objective tool that may allow data-driven counseling regarding expected benefit from the nonimplanted ear. It is possible that this information may eventually be used for clinical decision-making, particularly in difficult-to-test populations such as young children, regarding effectiveness of bimodal hearing versus bilateral CI candidacy.
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Affiliation(s)
- David M Kessler
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Spencer B Smith
- Department of Communication Sciences and Disorders, The University of Texas at Austin, TX, USA
| | - Kristen D'Onofrio
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - René H Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA
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D'Onofrio K, Richards V, Gifford R. Spatial Release From Informational and Energetic Masking in Bimodal and Bilateral Cochlear Implant Users. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3816-3833. [PMID: 33049147 PMCID: PMC8582905 DOI: 10.1044/2020_jslhr-20-00044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/27/2020] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
Purpose Spatially separating speech and background noise improves speech understanding in normal-hearing listeners, an effect referred to as spatial release from masking (SRM). In cochlear implant (CI) users, SRM has often been demonstrated using asymmetric noise configurations, which maximize benefit from head shadow and the potential availability of binaural cues. In contrast, SRM in symmetrical configurations has been minimal to absent in CI users. We examined the interaction between two types of maskers (informational and energetic) and SRM in bimodal and bilateral CI users. We hypothesized that SRM would be absent or "negative" using symmetrically separated noise maskers. Second, we hypothesized that bimodal listeners would exhibit greater release from informational masking due to access to acoustic information in the non-CI ear. Method Participants included 10 bimodal and 10 bilateral CI users. Speech understanding in noise was tested in 24 conditions: 3 spatial configurations (S0N0, S0N45&315, S0N90&270) × 2 masker types (speech, signal-correlated noise) × 2 listening configurations (best-aided, CI-alone) × 2 talker gender conditions (different-gender, same-gender). Results In support of our first hypothesis, both groups exhibited negative SRM with increasing spatial separation. In opposition to our second hypothesis, both groups exhibited similar magnitudes of release from informational masking. The magnitude of release was greater for bimodal listeners, though this difference failed to reach statistical significance. Conclusions Both bimodal and bilateral CI recipients exhibited negative SRM. This finding is consistent with CI signal processing limitations, the audiologic factors associated with SRM, and known effects of behind-the-ear microphone technology. Though release from informational masking was not significantly different across groups, the magnitude of release was greater for bimodal listeners. This suggests that bimodal listeners may be at least marginally more susceptible to informational masking than bilateral CI users, though further research is warranted.
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Affiliation(s)
- Kristen D'Onofrio
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | | | - René Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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23
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Abstract
OBJECTIVE To assess the benefits of bimodal listening (i.e., addition of contralateral hearing aid) for cochlear implant (CI) users on real-world tasks involving high-talker variability speech materials, environmental sounds, and self-reported quality of life (quality of hearing) in listeners' own best-aided conditions. STUDY DESIGN Cross-sectional study between groups. SETTING Outpatient hearing clinic. PATIENTS Fifty experienced adult CI users divided into groups based on normal daily listening conditions (i.e., best-aided conditions): unilateral CI (CI), unilateral CI with contralateral HA (bimodal listening; CIHA), or bilateral CI (CICI). INTERVENTION Task-specific measures of speech recognition with low (Harvard Standard Sentences) and high (Perceptually Robust English Sentence Test Open-set corpus) talker variability, environmental sound recognition (Familiar Environmental Sounds Test-Identification), and hearing-related quality of life (Nijmegen Cochlear Implant Questionnaire). MAIN OUTCOME MEASURES Test group differences among CI, CIHA, and CICI conditions. RESULTS No group effect was observed for speech recognition with low or high-talker variability, or hearing-related quality of life. Bimodal listeners demonstrated a benefit in environmental sound recognition compared with unilateral CI listeners, with a trend of greater benefit than the bilateral CI group. There was also a visual trend for benefit on high-talker variability speech recognition. CONCLUSIONS Findings provide evidence that bimodal listeners demonstrate stronger environmental sound recognition compared with unilateral CI listeners, and support the idea that there are additional advantages to bimodal listening after implantation other than speech recognition measures, which are at risk of being lost if considering bilateral implantation.
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Sturm JJ, Kuhlmey M, Alexiades G, Hoffman R, Kim AH. Comparison of Speech Performance in Bimodal versus Bilateral Cochlear Implant Users. Laryngoscope 2020; 131:E1322-E1327. [PMID: 32876332 DOI: 10.1002/lary.29062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/24/2020] [Accepted: 08/10/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To assess whether listening with two cochlear implants (bilateral) offers significant benefits in terms of speech perception over listening with one cochlear implant and one hearing aid (bimodal). METHODS Retrospective review of bilateral cochlear implant recipients (24 pediatric and 26 adult). Bimodal listening was compared to bilateral listening in terms of speech perception performance at 1-year post second implant under three listening conditions: 50 dBHL, 35 dBHL, and 50 dBHL+5 SNR. Changes in speech performance from bimodal (before second implant) to bilateral (after second implant) listening were determined within subjects and compared to a separate control group of bimodal users matched for age of first implantation who never received a second implant (10 pediatric and 20 adult). RESULTS In the pediatric group, compared to bimodal listening prior to a second implant, speech perception scores with bilateral implants increased significantly when measured at 50 dBHL, 35 dBHL, and 50 dBHL+5 SNR. By contrast, pediatric bimodal controls who never received a second implant failed to demonstrate similar improvement over 1 year's time. In the adult group, compared to bimodal listening prior to a second implant, speech perception scores with bilateral implants increased when measured at 50 dBHL, but were not significantly different at 35 dBHL and 50 dBHL + 5 SNR. Adult bimodal controls who never received a second implant failed to demonstrate significant improvement in all conditions over 1 year's time. CONCLUSION Bilateral listening with two cochlear implants improved speech perception performance relative to bimodal listening in the pediatric population. Improvement in the adult population was not as significant. LEVEL OF EVIDENCE 4, Retrospective Chart Review. Laryngoscope, 131:E1322-E1327, 2021.
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Affiliation(s)
- Joshua J Sturm
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, New York, U.S.A.,Department of Otolaryngology- Head and Neck Surgery, Weill Cornell Medicine, New York, New York, U.S.A
| | - Megan Kuhlmey
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, New York, U.S.A
| | - George Alexiades
- Department of Otolaryngology- Head and Neck Surgery, Weill Cornell Medicine, New York, New York, U.S.A
| | - Ronald Hoffman
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary, New York, New York, U.S.A
| | - Ana H Kim
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, New York, U.S.A
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25
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Varadarajan VV, Sydlowski SA, Li MM, Anne S, Adunka OF. Evolving Criteria for Adult and Pediatric Cochlear Implantation. EAR, NOSE & THROAT JOURNAL 2020; 100:31-37. [PMID: 32804575 DOI: 10.1177/0145561320947258] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult and children. There remains a significant underutilization of cochlear implant technology in the United States, and recognition of the potential benefits of cochlear implantation for non-traditional indications is critical for encouraging the evolution of candidacy criteria. Adult cochlear implantation candidacy has progressed from patients with bilateral profound sensorineural hearing loss (SNHL) to include patients with greater degrees of residual hearing, single-sided deafness and asymmetric hearing, and atypical etiologies of hearing loss (eg, vestibular schwannoma, Ménière's disease, and otosclerosis). Indications for pediatric cochlear implantation have similarly evolved from children with bilateral severe to profound SNHL to implanting children at a younger age, including those with residual hearing, asymmetric hearing loss, inner ear malformations, as well as cochlear nerve deficiency. In this editorial, the literature investigating cochlear implantation for nontraditional indications is reviewed with an aim to use the best available evidence to encourage the evolution of candidacy criteria.
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Affiliation(s)
- Varun V Varadarajan
- Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA
| | | | - Michael M Li
- Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA
| | - Samantha Anne
- Head and Neck Institute, 443553Cleveland Clinic, Cleveland, OH, USA
| | - Oliver F Adunka
- Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA
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26
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Turton L, Souza P, Thibodeau L, Hickson L, Gifford R, Bird J, Stropahl M, Gailey L, Fulton B, Scarinci N, Ekberg K, Timmer B. Guidelines for Best Practice in the Audiological Management of Adults with Severe and Profound Hearing Loss. Semin Hear 2020; 41:141-246. [PMID: 33364673 PMCID: PMC7744249 DOI: 10.1055/s-0040-1714744] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Individuals with severe to profound hearing loss are likely to present with complex listening needs that require evidence-based solutions. This document is intended to inform the practice of hearing care professionals who are involved in the audiological management of adults with a severe to profound degree of hearing loss and will highlight the special considerations and practices required to optimize outcomes for these individuals.
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Affiliation(s)
- Laura Turton
- Department of Audiology, South Warwickshire NHS Foundation Trust, Warwick, United Kingdom
| | - Pamela Souza
- Communication Sciences and Disorders and Knowles Hearing Center, Northwestern University, Evanston, Illinois
| | - Linda Thibodeau
- University of Texas at Dallas, Callier Center for Communication Disorders, Dallas, Texas
| | - Louise Hickson
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - René Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Judith Bird
- Cambridge University Hospital NHS Foundation Trust, United Kingdom
| | - Maren Stropahl
- Department of Science and Technology, Sonova AG, Stäfa, Switzerland
| | | | | | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Katie Ekberg
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Barbra Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
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27
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Zhang H, Zhang J, Ding H, Zhang Y. Bimodal Benefits for Lexical Tone Recognition: An Investigation on Mandarin-speaking Preschoolers with a Cochlear Implant and a Contralateral Hearing Aid. Brain Sci 2020; 10:brainsci10040238. [PMID: 32316466 PMCID: PMC7226140 DOI: 10.3390/brainsci10040238] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 04/08/2020] [Accepted: 04/15/2020] [Indexed: 11/16/2022] Open
Abstract
Pitch perception is known to be difficult for individuals with cochlear implant (CI), and adding a hearing aid (HA) in the non-implanted ear is potentially beneficial. The current study aimed to investigate the bimodal benefit for lexical tone recognition in Mandarin-speaking preschoolers using a CI and an HA in opposite ears. The child participants were required to complete tone identification in quiet and in noise with CI + HA in comparison with CI alone. While the bimodal listeners showed confusion between Tone 2 and Tone 3 in recognition, the additional acoustic information from the contralateral HA alleviated confusion between these two tones in quiet. Moreover, significant improvement was demonstrated in the CI + HA condition over the CI alone condition in noise. The bimodal benefit for individual subjects could be predicted by the low-frequency hearing threshold of the non-implanted ear and the duration of bimodal use. The findings support the clinical practice to fit a contralateral HA in the non-implanted ear for the potential benefit in Mandarin tone recognition in CI children. The limitations call for further studies on auditory plasticity on an individual basis to gain insights on the contributing factors to the bimodal benefit or its absence.
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Affiliation(s)
- Hao Zhang
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai 200240, China; (H.Z.); (J.Z.)
| | - Jing Zhang
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai 200240, China; (H.Z.); (J.Z.)
| | - Hongwei Ding
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai 200240, China; (H.Z.); (J.Z.)
- Correspondence: (H.D.); (Y.Z.); Tel.: +1-612-624-7878 (Y.Z.)
| | - Yang Zhang
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, MN 55455, USA
- Correspondence: (H.D.); (Y.Z.); Tel.: +1-612-624-7878 (Y.Z.)
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28
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Yüksel M, Çiprut A. Music and psychoacoustic perception abilities in cochlear implant users with auditory neuropathy spectrum disorder. Int J Pediatr Otorhinolaryngol 2020; 131:109865. [PMID: 31945735 DOI: 10.1016/j.ijporl.2020.109865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 01/05/2020] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Auditory neuropathy spectrum disorder (ANSD) is a condition wherein the pre-neural or cochlear outer hair cell activity is intact, but the neural activity in the auditory nerve is disrupted. Cochlear implant (CI) can be beneficial for subjects with ANSD; however, little is known about the music perception and psychoacoustic abilities of CI users with ANSD. Music perception in CI users is a multidimensional and complex ability requiring the contribution of both auditory and nonauditory abilities. Even though auditory abilities lay the foundation, the contribution of patient-related variables such as ANSD may affect the music perception. This study aimed to evaluate the psychoacoustic and music perception abilities of CI recipients with ANSD. STUDY DESIGN Twelve CI users with ANSD and twelve age- and gendermatched CI users with sensorineural hearing loss (SNHL) were evaluated. Music perception abilities were measured using the Turkish version of the Clinical Assessment of Music Perception (T-CAMP) test. Psychoacoustic abilities were measured using the spectral ripple discrimination (SRD) and temporal modulation transfer function (TMTF) tests. In addition, the age of diagnosis and implantation was recorded. RESULTS Pitch direction discrimination (PDD), timbre recognition, SRD, and TMTF performance of CI users with ANSD were concordant with those reported in previous studies, and differences between ANSD and SNHL groups were not statistically significant. However, the ANSD group performed poorly compared with SNHL group in melody recognition subtest of T-CAMP, and the difference was statistically significant. CONCLUSION CI can prove beneficial for patients with ANSD with respect to their music and psychoacoustic abilities, similar to patients with SNHL, except for melody recognition. Recognition of melodies requires both auditory and non-auditory abilities, and ANSD may have an extensive but subtle effect in the life of CI users.
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Affiliation(s)
- Mustafa Yüksel
- Marmara University, Institute of Health Sciences, Audiology and Speech Disorders Program, İstanbul, Turkey.
| | - Ayça Çiprut
- Marmara University Faculty of Medicine, Audiology Department, İstanbul, Turkey
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29
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From Bimodal Hearing to Sequential Bilateral Cochlear Implantation in Children—A Within-Subject Comparison. Otol Neurotol 2020; 41:767-774. [DOI: 10.1097/mao.0000000000002644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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D'Onofrio KL, Caldwell M, Limb C, Smith S, Kessler DM, Gifford RH. Musical Emotion Perception in Bimodal Patients: Relative Weighting of Musical Mode and Tempo Cues. Front Neurosci 2020; 14:114. [PMID: 32174809 PMCID: PMC7054459 DOI: 10.3389/fnins.2020.00114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 01/29/2020] [Indexed: 11/13/2022] Open
Abstract
Several cues are used to convey musical emotion, the two primary being musical mode and musical tempo. Specifically, major and minor modes tend to be associated with positive and negative valence, respectively, and songs at fast tempi have been associated with more positive valence compared to songs at slow tempi (Balkwill and Thompson, 1999; Webster and Weir, 2005). In Experiment I, we examined the relative weighting of musical tempo and musical mode among adult cochlear implant (CI) users combining electric and contralateral acoustic stimulation, or "bimodal" hearing. Our primary hypothesis was that bimodal listeners would utilize both tempo and mode cues in their musical emotion judgments in a manner similar to normal-hearing listeners. Our secondary hypothesis was that low-frequency (LF) spectral resolution in the non-implanted ear, as quantified via psychophysical tuning curves (PTCs) at 262 and 440 Hz, would be significantly correlated with degree of bimodal benefit for musical emotion perception. In Experiment II, we investigated across-channel spectral resolution using a spectral modulation detection (SMD) task and neural representation of temporal fine structure via the frequency following response (FFR) for a 170-ms /da/ stimulus. Results indicate that CI-alone performance was driven almost exclusively by tempo cues, whereas bimodal listening demonstrated use of both tempo and mode. Additionally, bimodal benefit for musical emotion perception may be correlated with spectral resolution in the non-implanted ear via SMD, as well as neural representation of F0 amplitude via FFR - though further study with a larger sample size is warranted. Thus, contralateral acoustic hearing can offer significant benefit for musical emotion perception, and the degree of benefit may be dependent upon spectral resolution of the non-implanted ear.
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Affiliation(s)
- Kristen L D'Onofrio
- Cochlear Implant Research Laboratory, Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States
| | | | - Charles Limb
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Spencer Smith
- Department of Communication Sciences and Disorders, The University of Texas at Austin, Austin, TX, United States
| | - David M Kessler
- Cochlear Implant Research Laboratory, Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States
| | - René H Gifford
- Cochlear Implant Research Laboratory, Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States
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31
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Ciorba A, Guidi MP, Skarżyński PH, Bianchini C, Rosignoli M, Mazzoli M, Pelucchi S, Hatzopoulos S. Rehabilitation of Severe to Profound Sensorineural Hearing Loss in Adults: Audiological Outcomes. EAR, NOSE & THROAT JOURNAL 2019; 100:215S-219S. [PMID: 31838921 DOI: 10.1177/0145561319892461] [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: 11/16/2022] Open
Abstract
The aim of this article is to describe the audiological patterns of 71 adult patients presenting severe to profound sensorineural hearing loss, who were rehabilitated by cochlear implants (CIs) and hearing aids. This is a retrospective study in a university setting, where the clinical records of 71 adult patients were reviewed and processed. Speech intelligibility was evaluated at one aided ear (CI) or at both aided ears (double CI or a combination of CI and hearing aid [HA]). Patients with a bilateral CI or with a bimodal hearing setup (CI and HA) performed better than those with a single CI; data from the phonetic matrices test showed that there was a statistically significant difference among patients aided by a single CI versus binaural setup (double CI or CI + HA). In particular, patients aided by a bilateral CI, or by a CI and HA, showed an improvement in the functional results of the speech tests, compared to patients using a single CI. Binaural hearing (either with a bilateral CI or bimodal) allows an improvement in the functional results at the speech tests, compared to the use of a CI only.
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Affiliation(s)
- Andrea Ciorba
- ENT and Audiology Clinic, University of Ferrara, Ferrara, Italy
| | | | - Piotr H Skarżyński
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Warsaw, Poland.,Institute of Sensory Organs, Kajetany, Poland
| | | | | | - Manuela Mazzoli
- ENT and Audiology Clinic, University of Ferrara, Ferrara, Italy
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32
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Au A, Dowell RC. Evidence-Based Recommendation for Bilateral Cochlear Implantation in Adults. Am J Audiol 2019; 28:775-782. [PMID: 32271119 DOI: 10.1044/2019_aja-heal18-18-0183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Most adult cochlear implant (CI) users in developed countries benefit from the use of a hearing aid in conjunction with their implant device (bimodal hearing). Benefits have also been documented for the use of bilateral CIs for speech perception in quiet, localization, and speech perception in noise. This study attempted to quantify speech perception results for bimodal and bilateral CIs in adults and provide a guide for those considering a 2nd CI. Method Speech perception outcomes were reviewed for 1,394 adults with acquired hearing loss who received a CI at the Melbourne Cochlear Implant Clinic between 2000 and 2015. Results Bimodal and bilateral users significantly outperformed unilateral CI users on consonant-vowel-consonant word recognition in quiet. For the bilateral group, word recognition scores with the 1st CI were predictive of 2nd CI word scores. The analysis suggested that bimodal users who were gaining less than 19% benefit from the nonimplanted ear were likely to perform better with a 2nd implant. Conclusions CI users who score less than 19% on consonant-vowel-consonant words in the nonimplanted ear have a good chance of benefiting from a 2nd implant. Consideration of many other factors including age, hearing goals, medical factors, and the risk to residual hearing also needs to play a part in recommending a 2nd CI.
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Affiliation(s)
- Agnes Au
- The HEARing Cooperative Research Center, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Victoria, Australia
| | - Richard C. Dowell
- The HEARing Cooperative Research Center, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Victoria, Australia
- Cochlear Implant Clinic, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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Yüksel M, Meredith MA, Rubinstein JT. Effects of Low Frequency Residual Hearing on Music Perception and Psychoacoustic Abilities in Pediatric Cochlear Implant Recipients. Front Neurosci 2019; 13:924. [PMID: 31551687 PMCID: PMC6733978 DOI: 10.3389/fnins.2019.00924] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/19/2019] [Indexed: 12/02/2022] Open
Abstract
Studies have demonstrated the benefits of low frequency residual hearing in music perception and for psychoacoustic abilities of adult cochlear implant (CI) users, but less is known about these effects in the pediatric group. Understanding the contribution of combined electric and acoustic stimulation in this group can help to gain a better perspective on decisions regarding bilateral implantation. We evaluated the performance of six unilaterally implanted children between 9 and 13 years of age with contralateral residual hearing using the Clinical Assessment of Music Perception (CAMP), spectral ripple discrimination (SRD), and temporal modulation transfer function (TMTF) tests and compared findings with previous research. Our study sample performed similarly to normal hearing subjects in pitch direction discrimination (0.81 semitones) and performed well above typical CI users in melody recognition (43.37%). The performance difference was less in timbre recognition (48.61%), SRD (1.47 ripple/octave), and TMTF for four modulation frequencies. These findings suggest that the combination of low frequency acoustic hearing with the broader frequency range of electric hearing can help to increase clinical CI benefit in pediatric users and decisions regarding second-side implantation should consider these factors.
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Affiliation(s)
- Mustafa Yüksel
- Audiology and Speech Disorders Program, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Margaret A Meredith
- Childhood Communication Center, Seattle Children's Hospital, Seattle, WA, United States
| | - Jay T Rubinstein
- Virginia Merrill Bloedel Hearing Research Center, Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, WA, United States
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