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Guastamacchia A, Albera A, Puglisi GE, Nudelman CJ, Soleimanifar S, Astolfi A, Aronoff JM, Bottalico P. Impact of cochlear implants use on voice production and quality. Sci Rep 2024; 14:12787. [PMID: 38834775 DOI: 10.1038/s41598-024-63688-3] [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: 01/26/2024] [Accepted: 05/31/2024] [Indexed: 06/06/2024] Open
Abstract
Cochlear implant users experience difficulties controlling their vocalizations compared to normal hearing peers. However, less is known about their voice quality. The primary aim of the present study was to determine if cochlear implant users' voice quality would be categorized as dysphonic by the Acoustic Voice Quality Index (AVQI) and smoothed cepstral peak prominence (CPPS). A secondary aim was to determine if vocal quality is further impacted when using bilateral implants compared to using only one implant. The final aim was to determine how residual hearing impacts voice quality. Twenty-seven cochlear implant users participated in the present study and were recorded while sustaining a vowel and while reading a standardized passage. These recordings were analyzed to calculate the AVQI and CPPS. The results indicate that CI users' voice quality was detrimentally affected by using their CI, raising to the level of a dysphonic voice. Specifically, when using their CI, mean AVQI scores were 4.0 and mean CPPS values were 11.4 dB, which indicates dysphonia. There were no significant differences in voice quality when comparing participants with bilateral implants to those with one implant. Finally, for participants with residual hearing, as hearing thresholds worsened, the likelihood of a dysphonic voice decreased.
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Affiliation(s)
| | - Andrea Albera
- Department of Surgical Sciences, Universitá degli Studi di Torino, 10100, Turin, Italy
| | | | - Charles J Nudelman
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, 61820, USA
| | - Simin Soleimanifar
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, 61820, USA
| | - Arianna Astolfi
- Department of Energy, Politecnico di Torino, 10129, Turin, Italy
| | - Justin M Aronoff
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, 61820, USA
| | - Pasquale Bottalico
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, 61820, USA.
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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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Landsberger DM, Stupak N, Dahl C, Aronoff JM. Musical Interval Perception With a Cochlear Implant Alone and With a Contralateral Normal Hearing Ear. Trends Hear 2022; 26:23312165221142689. [PMID: 36464788 PMCID: PMC9726843 DOI: 10.1177/23312165221142689] [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: 12/12/2022] Open
Abstract
Music through a cochlear implant (CI) is described as out-of-tune, suggesting that musical intervals are not accurately provided by a CI. One potential reason is that pitch may be insufficiently conveyed to provide reliable intervals. Another potential reason is that the size of intervals is distorted through a CI as they would be when produced by a mistuned piano. To measure intervals through a CI, listeners selected prerecorded vowels with different fundamental frequencies to represent each note in Happy Birthday. Each listener had contralateral normal hearing (NH); repeating the experiment with their NH ear allowed for a within-subject control. Additionally, the effect of listening simultaneously to both a CI and NH ear was measured. The resulting versions of Happy Birthday were analyzed in terms of their contours, interval sizes, magnitudes, consistency, and direction. Intervals with NH ears ranged from perfect to uncorrelated with target intervals. Chosen interval size with the CI was poorer than with the NH ear for all subjects. Across listeners, chosen intervals with the CI ranged from highly correlated to uncorrelated with target intervals. That CI intervals were highly correlated with target intervals for some listeners suggests that accurate intervals can be provided through a CI. For some listeners, chosen intervals were larger than target intervals, suggesting that intervals may be perceived as too small. Overall, intervals with the combination of the NH and CI ears were similar to those with the NH ear alone, suggesting that the addition of a CI has little-to-no effect on interval perception.
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Affiliation(s)
- David M. Landsberger
- Department of Otolaryngology, New York University Grossman School of Medicine, New York, NY, USA,David M. Landsberger, Department of Otolaryngology, New York University Grossman School of Medicine, 550 1st Avenue, STE NBV 5E5, New York, NY 10016, USA.
| | - Natalia Stupak
- Department of Otolaryngology, New York University Grossman School of Medicine, New York, NY, USA
| | - Cori Dahl
- Speech and Hearing Science Department, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Justin M. Aronoff
- Speech and Hearing Science Department, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
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Soleimanifar S, Staisloff HE, Aronoff JM. The effect of simulated insertion depth differences on the vocal pitches of cochlear implant users. JASA EXPRESS LETTERS 2022; 2:044401. [PMID: 36154233 DOI: 10.1121/10.0010243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Cochlear implant (CI) users often produce different vocal pitches when using their left versus right CI. One possible explanation for this is that insertion depth differs across the two CIs. The goal of this study was to investigate the role of electrode insertion depth in the production of vocal pitch. Eleven individuals with bilateral CIs used maps simulating differences in insertion depth. Participants produced a sustained vowel and sang Happy Birthday. Approximately half the participants significantly shifted the pitch of their voice in response to different simulated insertion depths. The results suggest insertion depth differences can alter produced vocal pitch.
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Affiliation(s)
- Simin Soleimanifar
- Speech and Hearing Science Department, University of Illinois at Urbana-Champaign, 901 South 6th Street, Champaign, Illinois 61801, USA , ,
| | - Hannah E Staisloff
- Speech and Hearing Science Department, University of Illinois at Urbana-Champaign, 901 South 6th Street, Champaign, Illinois 61801, USA , ,
| | - Justin M Aronoff
- Speech and Hearing Science Department, University of Illinois at Urbana-Champaign, 901 South 6th Street, Champaign, Illinois 61801, USA , ,
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Kirchner A, Loucks TM, Abbs E, Shi K, Yu JW, Aronoff JM. Influence of bilateral cochlear implants on vocal control. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 147:2423. [PMID: 32359322 PMCID: PMC7173977 DOI: 10.1121/10.0001099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Receiving a cochlear implant (CI) can improve fundamental frequency (F0) control for deaf individuals, resulting in increased vocal pitch control. However, it is unclear whether using bilateral CIs, which often result in mismatched pitch perception between ears, will counter this benefit. To investigate this, 23 bilateral CI users were asked to produce a sustained vocalization using one CI, the other CI, both CIs, or neither. Additionally, a set of eight normal hearing participants completed the sustained vocalization task as a control group. The results indicated that F0 control is worse with both CIs compared to using the ear that yields the lowest vocal variability. The results also indicated that there was a large range of F0 variability even for the relatively stable portion of the vocalization, spanning from 6 to 46 cents. These results suggest that bilateral CIs can detrimentally affect vocal control.
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Affiliation(s)
- Abbigail Kirchner
- Department of Speech and Hearing Science, The University of Illinois at Urbana Champaign, 901 South 6th Street, Champaign, Illinois 61820, USA
- Electronic mail:
| | - Torrey M. Loucks
- Department of Communication Sciences and Disorders, University of Alberta, 116 St. and 85 Avenue, Edmonton, Alberta T6G 2R3, Canada
| | - Elizabeth Abbs
- Department of Speech and Hearing Science, The University of Illinois at Urbana Champaign, 901 South 6th Street, Champaign, Illinois 61820, USA
| | - Kevin Shi
- Department of Otolaryngology, The University of Illinois at Chicago, 1740 West Taylor Street, Chicago, Illinois 60612, USA
| | - Jeff W. Yu
- Department of Otolaryngology, The University of Illinois at Chicago, 1740 West Taylor Street, Chicago, Illinois 60612, USA
| | - Justin M. Aronoff
- Department of Speech and Hearing Science, The University of Illinois at Urbana Champaign, 901 South 6th Street, Champaign, Illinois 61820, USA
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Dillon MT, Buss E, Rooth MA, King ER, Pillsbury HC, Brown KD. Low-Frequency Pitch Perception in Cochlear Implant Recipients With Normal Hearing in the Contralateral Ear. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:2860-2871. [PMID: 31306588 DOI: 10.1044/2019_jslhr-h-18-0409] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Three experiments were carried out to evaluate the low-frequency pitch perception of adults with unilateral hearing loss who received a cochlear implant (CI). Method Participants were recruited from a cohort of CI users with unilateral hearing loss and normal hearing in the contralateral ear. First, low-frequency pitch perception was assessed for the 5 most apical electrodes at 1, 3, 6, and 12 months after CI activation using an adaptive pitch-matching task. Participants listened with a coding strategy that presents low-frequency temporal fine structure (TFS) and compared the pitch to that of an acoustic target presented to the normal hearing ear. Next, participants listened with an envelope-only, continuous interleaved sampling strategy. Pitch perception was compared between coding strategies to assess the influence of TFS cues on low-frequency pitch perception. Finally, participants completed a vocal pitch-matching task to corroborate the results obtained with the adaptive pitch-matching task. Results Pitch matches roughly corresponded to electrode center frequencies (CFs) in the CI map. Adaptive pitch matches exceeded the CF for the most apical electrode, an effect that was larger for continuous interleaved sampling than TFS. Vocal pitch matches were variable but correlated with the CF of the 3 most apical electrodes. There was no evidence that pitch matches changed between the 1- and 12-month intervals. Conclusions Relatively accurate and asymptotic pitch perception was observed at the 1-month interval, indicating either very rapid acclimatization or the provision of familiar place and rate cues. Early availability of appropriate pitch cues could have played a role in the early improvements in localization and masked speech recognition previously observed in this cohort. Supplemental Material https://doi.org/10.23641/asha.8862389.
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Affiliation(s)
- Margaret T Dillon
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Emily Buss
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Meredith A Rooth
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - English R King
- Department of Audiology, UNC Healthcare, Chapel Hill, NC
| | - Harold C Pillsbury
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Kevin D Brown
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
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