Benefit of Higher Maximum Force Output on Listening Effort in Bone-Anchored Hearing System Users: A Pupillometry Study

Abstract

The aim of this study was to compare listening effort, as estimated via pupillary response, during a speech-in-noise test in boneanchored hearing system (BAHS) users wearing three different sound processors. The three processors, Ponto Pro (PP), Ponto 3 (P3), and Ponto 3 SuperPower (P3SP), differ in terms of maximum force output (MFO) and MFO algorithm. The hypothesis was that listeners would allocate lower listening effort with the P3SP than with the PP, as a consequence of a higher MFO and, hence, fewer saturation artifacts in the signal. Design: Pupil dilations were recorded in 21 BAHS users with a conductive or mixed hearing loss, during a speech-in-noise test performed at positive signal-to-noise ratios (SNRs), where the speech and noise levels were individually adjusted to lead to 95% correct intelligibility with the PP. The listeners had to listen to a sentence in noise, retain it for 3 seconds and then repeat it, while an eye-tracking camera recorded their pupil dilation. The three sound processors were tested in random order with a single-blinded experimental design. Two conditions were performed at the same SNR: Condition 1, where the speech level was designed to saturate the PP but not the P3SP, and condition 2, where the overall sound level was decreased relative to condition 1 to reduce saturation artifacts. Results: The P3SP led to higher speech intelligibility than the PP in both conditions, while the performance with the P3 did not differ from the performance with the PP and the P3SP. Pupil dilations were analyzed in terms of both peak pupil dilation (PPD) and overall pupil dilation via growth curve analysis (GCA). In condition 1, a significantly lower PPD, indicating a decrease in listening effort, was obtained with the P3SP relative to the PP. The PPD obtained with the P3 did not differ from the PPD obtained with the other two sound processors. In condition 2, no difference in PPD was observed across the three processors. The GCA revealed that the overall pupil dilation was significantly lower, in both conditions, with both the P3SP and the P3 relative to the PP, and, in condition 1, also with the P3SP relative to the P3. Conclusions: The overall effort to process a moderate to loud speech signal was significantly reduced by using a sound processor with a higher MFO (P3SP and P3), as a consequence of fewer saturation artifacts. These findings suggest that sound processors with a higher MFO may help BAHS users in their everyday listening scenarios, in particular in noisy environments, by improving sound quality and, thus, decreasing the amount of cognitive resources utilized to process incoming speech sounds.

Listening Effort Is Not the Same as Speech Intelligibility Score

“…Window 2 spanned from 0.7 to 2.2 s relative to stimulus offset, reflecting the response preparation phase of the trial. These windows arguably correspond to auditory encoding versus poststimulus linguistic resolution and have been separately analyzed in numerous previous studies that find distinctly different effects in each window (Bianchi et al, 2019;Francis et al, 2018;Piquado et al, 2010;Wendt et al, 2016;Winn, 2016;Winn et al, 2015;Winn & Moore, 2018;Winn & Teece, 2020).…”

Ten years of experience with the Ponto bone‐anchored hearing system—A systematic literature review

“…Within-subject comparisons of different generations of Ponto sound processors were performed in three studies. [12][13][14][15] Comparisons to other brands of sound processors were performed with a within-subject crossover design in four studies [16][17][18][19] and between groups in two studies. 20,21 Comparison to other treatment options was performed for SSD patients and contralateral routing of signals devices with a within-subject design.…”

“…12 the ability to perform lexical decision tasks, the ability to detect nonsense words in context, rapid word learning,27 memory recall by the sentence-final Word Identification and Recall Test (SWIR) test,28 the Abbreviated Profile of Hearing Aid Benefit[13][14][15][16][17]21,26 and the Speech Spatial and Qualities of Hearing scale [13][14][15][16][17]22. …”

Effortful listening despite correct responses: the cost of mental repair in sentence recognition by listeners with cochlear implants

“…These windows arguably correspond to auditory encoding versus post-stimulus linguistic resolution, and have been separately analyzed in numerous previous studies that find distinctly different effects in each window (Piquado et al 2010;Winn et al 2015;Wendt et al 2016;Winn 2016;Winn & Moore 2018;Francis et al 2018;Bianchi et al 2019;Winn & Teece 2020;Winn & Teece 2021). Peelle and Van Engen (2021) comment on the value of close inspection of time windows in this style of analysis when drawing conclusions from the analysis.…”