Binaural hearing helps normal-hearing listeners localize sound sources and understand speech in noise. However, it is not fully understood how far this is the case for bilateral cochlear implant (CI) users. To determine the potential benefits of bilateral over unilateral CIs, speech comprehension thresholds (SCTs) were measured in seven Japanese bilateral CI recipients using Helen test sentences (translated into Japanese) in a two-talker speech interferer presented from the front (co-located with the target speech), ipsilateral to the first-implanted ear (at +90° or −90°), and spatially symmetric at ±90°. Spatial release from masking was calculated as the difference between co-located and spatially separated SCTs. Localization was assessed in the horizontal plane by presenting either male or female speech or both simultaneously. All measurements were performed bilaterally and unilaterally (with the first implanted ear) inside a loudspeaker array. Both SCTs and spatial release from masking were improved with bilateral CIs, demonstrating mean bilateral benefits of 7.5 dB in spatially asymmetric and 3 dB in spatially symmetric speech mixture. Localization performance varied strongly between subjects but was clearly improved with bilateral over unilateral CIs with the mean localization error reduced by 27°. Surprisingly, adding a second talker had only a negligible effect on localization.

Tests for transient evoked otoacoustic emissions and speech-evoked auditory brainstem responses provide unique and functionally independent information about the integrity and sensitivity of the auditory system. Therefore, combining both tests will provide a more sensitive clinical battery with which to identify the location of different disorders (e.g. language-based learning impairments and hearing impairments).

Better-ear glimpsing (BEG) is an auditory phenomenon that helps understanding speech in noise by utilizing interaural level differences (ILDs). The benefit provided by BEG is limited in hearing-impaired (HI) listeners by reduced audibility at high frequencies. Rana and Buchholz [(2016). J. Acoust. Soc. Am. 140(2), 1192-1205] have shown that artificially enhancing ILDs at low and mid frequencies can help HI listeners understanding speech in noise, but the achieved benefit is smaller than in normal-hearing (NH) listeners. To understand how far this difference is explained by differences in audibility, audibility was carefully controlled here in ten NH and ten HI listeners and speech reception thresholds (SRTs) in noise were measured in a spatially separated and co-located condition as a function of frequency and sensation level. Maskers were realized by noise-vocoded speech and signals were spatialized using artificially generated broadband ILDs. The spatial benefit provided by BEG and SRTs improved consistently with increasing sensation level, but was limited in the HI listeners by loudness discomfort. Further, the HI listeners performed similar to NH listeners when differences in audibility were compensated. The results help to understand the hearing aid gain that is required to maximize the spatial benefit provided by ILDs as a function of frequency.