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Távora-Vieira D, Wedekind A, Ffoulkes E, Voola M, Marino R. Cortical auditory evoked potential in cochlear implant users: An objective method to improve speech perception. PLoS One 2022; 17:e0274643. [PMID: 36206248 PMCID: PMC9543874 DOI: 10.1371/journal.pone.0274643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/31/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate if cortical auditory evoked potential (CAEP) measures can be used to verify the cochlear implant (CI) map and consequently improve CI outcomes in adults with bilateral hearing loss. DESIGN CAEPs were measured in CI recipients using the speech tokens /m/, /g/, /t/ and /s/. If CAEP responses were present for all speech tokens, the participant's map was considered "satisfactory". If CAEP responses were absent, the CI map was considered "unsatisfactory" and therefore adjusted and CAEP measures repeated. This was repeated until auditory potentials were seen in response to all four speech tokens. Speech testing was conducted pre-CI, as well as before and after CAEP-guided map adjustments. RESULTS 108 adult unilateral CI users participated, whose sound processors were previously programmed using subjective methods. 42 CI users elicited a CAEP response to all four speech tokens and therefore no further mapping adjustments were made. 66 subjected lacked a CAEP response to at least one speech token and had their CI map adjusted accordingly. Of those, 31 showed a CAEP response to all four speech tokens, and the average speech score significantly improved after CI map adjustments based on CAEP responses. CONCLUSION CAEP's are an objective tool that can be used to guide and verify CI mapping in adults CI users. Significant improvement in speech scores was observed in participants who had their CI map adjusted based on CAEP responses.
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Affiliation(s)
- Dayse Távora-Vieira
- Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia
- Division of Surgery, Medical School, The University of Western Australia, Perth, Australia
- Faculty of Health Sciences, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
- * E-mail:
| | - Andre Wedekind
- Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia
- Division of Surgery, Medical School, The University of Western Australia, Perth, Australia
| | - Ellen Ffoulkes
- Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia
| | - Marcus Voola
- Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia
- Division of Surgery, Medical School, The University of Western Australia, Perth, Australia
| | - Roberta Marino
- Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia
- Division of Surgery, Medical School, The University of Western Australia, Perth, Australia
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Pieper SH, Hamze N, Brill S, Hochmuth S, Exter M, Polak M, Radeloff A, Buschermöhle M, Dietz M. Considerations for Fitting Cochlear Implants Bimodally and to the Single-Sided Deaf. Trends Hear 2022; 26:23312165221108259. [PMID: 35726211 PMCID: PMC9218456 DOI: 10.1177/23312165221108259] [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: 11/16/2022] Open
Abstract
When listening with a cochlear implant through one ear and acoustically through the other, binaural benefits and spatial hearing abilities are generally poorer than in other bilaterally stimulated configurations. With the working hypothesis that binaural neurons require interaurally matched inputs, we review causes for mismatch, their perceptual consequences, and experimental methods for mismatch measurements. The focus is on the three primary interaural dimensions of latency, frequency, and level. Often, the mismatch is not constant, but rather highly stimulus-dependent. We report on mismatch compensation strategies, taking into consideration the specific needs of the respective patient groups. Practical challenges typically faced by audiologists in the proposed fitting procedure are discussed. While improvement in certain areas (e.g., speaker localization) is definitely achievable, a more comprehensive mismatch compensation is a very ambitious endeavor. Even in the hypothetical ideal fitting case, performance is not expected to exceed that of a good bilateral cochlear implant user.
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Affiliation(s)
- Sabrina H Pieper
- Department of Medical Physics and Acoustic, University of Oldenburg, Oldenburg, Germany.,Cluster of Excellence Hearing4all, University of Oldenburg, Oldenburg, Germany
| | - Noura Hamze
- MED-EL Medical Electronics GmbH, Innsbruck, Austria
| | - Stefan Brill
- MED-EL Medical Electronics Germany GmbH, Starnberg, Germany
| | - Sabine Hochmuth
- Division of Otorhinolaryngology, University of Oldenburg, Oldenburg, Germany
| | - Mats Exter
- Cluster of Excellence Hearing4all, University of Oldenburg, Oldenburg, Germany.,Hörzentrum Oldenburg gGmbH, Oldenburg, Germany
| | - Marek Polak
- MED-EL Medical Electronics GmbH, Innsbruck, Austria
| | - Andreas Radeloff
- Cluster of Excellence Hearing4all, University of Oldenburg, Oldenburg, Germany.,Division of Otorhinolaryngology, University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | | | - Mathias Dietz
- Department of Medical Physics and Acoustic, University of Oldenburg, Oldenburg, Germany.,Cluster of Excellence Hearing4all, University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
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Wagner L, Geiling L, Hauth C, Hocke T, Plontke S, Rahne T. Improved binaural speech reception thresholds through small symmetrical separation of speech and noise. PLoS One 2020; 15:e0236469. [PMID: 32756594 PMCID: PMC7406049 DOI: 10.1371/journal.pone.0236469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 07/07/2020] [Indexed: 12/02/2022] Open
Abstract
Speech perception in noise is challenging and is improved by binaural hearing. Since signal processing of assistive hearing devices often modifies or masks the peripheral binaural head-shadow or better-ear effects, central binaural processing should be measured separately. In a prospective study, 10 listeners with normal hearing were tested with the German matrix sentence test in a set-up with two loudspeakers located at opposite angles in the horizontal plane with respect to S0N0. The speech reception threshold (SRT) was investigated depending on the separation angle between speech and noise. The lowest (best) SRT was obtained for a separation of target and interfering source from S0N0 at an angle of about S±60°N∓60°. The derived normative curve was comparable to SRTs predicted by the binaural-speech-intelligibility-model. The systematic separation of signal and noise showed a significant improvement in speech intelligibility for normal-hearing people even for small separation angles. This experimental setting was verified. This study aimed to assess the effect of small sound source separation on binaural hearing and speech perception.
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Affiliation(s)
- Luise Wagner
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
- * E-mail:
| | - Lukas Geiling
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - Christopher Hauth
- Department of Medical Physics and Cluster of Excellence Hearing4All, Carl von Ossietzky University, Oldenburg, Germany
| | - Thomas Hocke
- Cochlear Deutschland GmbH & Co. KG, Hannover, Germany
| | - Stefan Plontke
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - Torsten Rahne
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
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Van Eeckhoutte M, Wouters J, Francart T. Objective Binaural Loudness Balancing Based on 40-Hz Auditory Steady-State Responses. Part I: Normal Hearing. Trends Hear 2019; 22:2331216518805352. [PMID: 30334493 PMCID: PMC6196616 DOI: 10.1177/2331216518805352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Psychophysical procedures are used to balance loudness across the ears. However, they can be difficult and require active cooperation. We investigated whether 40-Hz auditory steady-state response (ASSR) amplitudes can be used to objectively estimate the balanced loudness across the ears for a group of young, normal-hearing participants. The 40-Hz ASSRs were recorded using monaural stimuli with carrier frequencies of 500, 1000, or 2000 Hz over a range of levels between 40 and 80 dB SPL. Behavioral loudness balancing was performed for at least one reference level of the left ear. ASSR amplitude growth functions were listener dependent, but median across-ear ratios in ASSR amplitudes were close to 1. The differences between the ASSR-predicted balanced levels and the behaviorally found balanced levels were smaller than 5 dB in 59% of cases and smaller than 10 dB in 85% of cases. The differences between the ASSR-predicted balanced levels and the reference levels were smaller than 5 dB in 54% of cases and smaller than 10 dB in 87% of cases. No clear hemispheric lateralization was found for 40-Hz ASSRs, with the exception of responses evoked by stimulus levels of 40 to 60 dB SPL at 2000 Hz.
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Affiliation(s)
| | - Jan Wouters
- 1 ExpORL, Department of Neurosciences, KU Leuven, Belgium
| | - Tom Francart
- 1 ExpORL, Department of Neurosciences, KU Leuven, Belgium
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