Wind noise in hearing aids: I. Effect of wide dynamic range compression and modulation-based noise reduction

Comparing Audiological Outcomes of Conventional and AI-Upgraded Cochlear Implant Speech Processors

In current age of technology, artificial intelligence is used in the medical field to improve the quality and accuracy in patient care and achieve better clientele satisfaction. The use of artificial intelligence in the field of hearing rehabilitation and cochlear implantation has an immense scope and it enhances the accuracy in placement of electrode array, forecasting site of surgical location and optimization of speech processing. This study aims to compare the audiological outcomes of conventional versus artificial intelligence technology enabled cochlear implant speech processors. Additionally, it compares the individual performance and satisfaction level with use of both types of speech processors. All children who underwent upgradation of their cochlear implant speech processors at a tertiary care cochlear implant centre with artificial intelligence enabled speech processors were included in the study. The comparison of audiological outcomes of conventional versus artificial intelligence integrated speech processors were assessed by using Aided Audiometry, Categories of Auditory Perception Score and Speech Intelligibility Rating scale. Children using the basic model cochlear implant speech processor which was provided at the time of implantation are referred as conventional cochlear implant speech processor user. Their speech processors were subsequently upgraded with current generation artificial intelligence integrated speech processors which is referred here as artificial intelligence upgraded cochlear implant speech processor. During the study, a total of thirty-four (34) patients underwent upgradation of cochlear implant speech processors. The mean categories of auditory perception score were 11.58 and 11.94 using conventional and artificial intelligence upgraded speech processor respectively. The mean speech intelligibility rating score was 4.5 and 4.6 respectively. The audiological outcomes of conventional speech processors are comparable with those using artificial intelligence enabled speech processors. However, the clientele satisfaction in respect to quality of sound, ease of listening in difficult listening environment, smart connectivity options for both phone and television is available and better with the artificial intelligence enabled cochlear implant speech processor. This also has the advantages of auto switching of programming with change in ambient noise, better signal to noise ratio and better 360* hearing.

Comparison of Speech Recognition in Cochlear Implant Users with Different Speech Processors

BACKGROUND

Speech recognition in noisy environments is a challenge for both cochlear implant (CI) users and device manufacturers. CI manufacturers have been investing in technological innovations for processors and researching strategies to improve signal processing and signal design for better aesthetic acceptance and everyday use.

PURPOSE

This study aimed to compare speech recognition in CI users using off-the-ear (OTE) and behind-the-ear (BTE) processors.

DESIGN

A cross-sectional study was conducted with 51 CI recipients, all users of the BTE Nucleus 5 (CP810) sound processor. Speech perception performances were compared in quiet and noisy conditions using the BTE sound processor Nucleus 5 (N5) and OTE sound processor Kanso. Each participant was tested with the Brazilian-Portuguese version of the hearing in noise test using each sound processor in a randomized order. Three test conditions were analyzed with both sound processors: (i) speech level fixed at 65 decibel sound pressure level in a quiet, (ii) speech and noise at fixed levels, and (iii) adaptive speech levels with a fixed noise level. To determine the relative performance of OTE with respect to BTE, paired comparison analyses were performed.

RESULTS

The paired t-tests showed no significant difference between the N5 and Kanso in quiet conditions. In all noise conditions, the performance of the OTE (Kanso) sound processor was superior to that of the BTE (N5), regardless of the order in which they were used. With the speech and noise at fixed levels, a significant mean 8.1 percentage point difference was seen between Kanso (78.10%) and N5 (70.7%) in the sentence scores.

CONCLUSION

CI users had a lower signal-to-noise ratio and a higher percentage of sentence recognition with the OTE processor than with the BTE processor.

Wind Noise Management in Hearing Aids

Many hearing aid users are negatively impacted by wind noise when spending time outdoors. Turbulent airflow around hearing aid microphones caused by the obstruction of wind can result in noise that is not only perceived as annoying but may also mask desirable sounds in the listening environment, such as speech. To mitigate the adverse effects of wind noise, hearing aid developers have introduced several technological solutions to reduce the amount of wind noise at the hearing aid output. Some solutions are based on mechanical modifications; more recently, sophisticated signal processing algorithms have also been introduced. By offering solutions to the wind noise problem, these signal processing algorithms can promote more optimal use of hearing aids during outdoor activities. This article reviews how wind noise is generated in hearing aids, outlines the technological challenges in wind noise management, and summarizes the technological solutions that have been proposed and/or implemented in modern hearing aids.

Investigating the prevalence and impact of device-related problems associated with hearing aid use

Objective: To explore the prevalence of device-related problems associated with hearing aid use, participants' help-seeking behaviours for these problems, and factors associated with hearing aid problems.Design: A prospective convenience cohort design surveying 413 adult hearing aid users (34-97 years of age) recruited from seven clinics across Australia.Results: Almost all participants (98%) indicated that they were experiencing at least one of the hearing aid problems included on the survey. The number of hearing aid related problems reported by participants ranged from 0 to 25 (of a possible 26), with a mean of 10 problems (SD = 5). The three most reported problems were related to difficulty hearing in noisy environments, hearing in windy environments, and understanding certain voices. Participants had reported less than half (46.33%) of the total problems identified to their clinic (range = 0-100%, mean = 43.40, SD = 13.92). Participants who reported experiencing a greater number of hearing aid problems also reported lower levels of hearing aid benefit, and satisfaction with their hearing aids.Conclusions: The majority of hearing aid owners experience problems with their hearing aids. Addressing these problems would likely contribute to improved hearing aid outcomes.

Wind noise within and across behind-the-ear and miniature behind-the-ear hearing aids

Previous studies investigated wind noise with Behind-The-Ear (BTE) hearing aids, but not the more common mini-BTE style of device, which typically has a smaller shell and microphones located more deeply behind the pinna. The current study investigated wind-noise levels across one BTE and two mini-BTE devices, and between the front and rear omni-directional microphones within devices. Levels were measured at two wind speeds (3 and 6 m/s) and 36 wind azimuths (10° increments). The pattern of wind-noise level versus azimuth was similar across mini-BTE devices, and differed for the BTE device. However, mean levels were markedly different across mini-BTE devices, and could be higher, lower, or similar to those of the BTE device. For within-device level differences, the pattern and mean across azimuth were similar across mini-BTE devices, and differed for the BTE device. Wind noise had the potential to slightly or severely reduce speech intelligibility at 3 or 6 m/s, respectively, across all devices.

Clinical evaluation of the Nucleus 6 cochlear implant system: performance improvements with SmartSound iQ

Objective:

This paper provides a detailed description of the Nucleus 6 system, and clinically evaluates user performance compared to the previous Nucleus 5 system in cochlear implant recipients. Additionally, it clinically evaluates a range of Nucleus 6 and Nucleus 5 programs to determine the performance benefits provided by new input processing technologies available in SmartSound iQ.

Design

Speech understanding tests were used to clinically validate the default Nucleus 6 program, by comparing performance outcomes against up to five custom Nucleus 5 or Nucleus 6 programs in a range of listening environments. Clinical comparisons between programs were conducted across the following listening environments; quiet, speech weighted noise (co-located and spatially separated noise), and 4-talker babble (co-located and spatially separated noise).

Study sample

Twenty-one adult cochlear implant recipients participated.

Results

Significant speech understanding benefits were found with the default Nucleus 6 program compared to the participants’ preferred program using their Nucleus 5 processor and compared to a range of custom Nucleus 6 programs. All participants successfully accepted and upgraded to the new default Nucleus 6 SmartSound iQ program.

Conclusion

This study demonstrates the acceptance and clinical benefits of the Nucleus 6 cochlear implant system and SmartSound iQ.