Restoring hearing symmetry with two cochlear implants or one cochlear implant and a contralateral hearing aid

Firszt, Jill B.; Reeder, Ruth M.; Skinner, Margaret W.

doi:10.1682/jrrd.2007.08.0120

Cited by 83 publications

(69 citation statements)

References 88 publications

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“…Researchers have shown that listeners with normal hearing are sensitive to ITDs of 10 to 15µs (Firszt et al, 2008). However, studies have reported relatively poor sensitivity to…”

Section: Interaural Time Differencesmentioning

confidence: 99%

“…Because CI users are more sensitive to ILDs than ITDs, ILDs have been considered the primary cue for sound source localization (Firszt et al, 2008).…”

Section: Interaural Level Differencesmentioning

confidence: 99%

“…It is possible that timing and level differences between the CI+HA explains why binaural advantages have not been observed across all studies or across all subjects with CI+HA (see Ching et al, 2007;Firszt et al, 2008).…”

Section: Interaural Level Differencesmentioning

confidence: 99%

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The Contribution of a Frequency-Compression Hearing Aid to Contralateral Cochlear Implant Performance

Perreau¹,

Bentler²,

Tyler³

2013

J Am Acad Audiol

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Frequency-lowering signal processing in hearing aids has re-emerged as an option to improve audibility of the high frequencies by expanding the input bandwidth.However, few studies have investigated the usefulness of the scheme as a bimodal option for cochlear implant users. In this study, that question was posed. It was hypothesized that, following fitting and a period of adjustment to a frequency-compression hearing aid, sound localization and speech perception would be improved compared to conventional amplification. More specifically, more high-frequency cues would be perceived in the hearing aid ear using frequency compression, thereby providing better sensitivity to interaural level differences when a cochlear implant is used contralaterally.There were two experiments in this study. In the first experiment, the goal was to determine if frequency compression was a better bimodal option than conventional amplification. Performance was assessed on tests of sound localization, speech perception in a background of noise, and using questionnaires. Ten subjects with a cochlear implant plus hearing aid participated in experiment one. In the second experiment, the goal was to determine the impact of frequency compression on speech perception in quiet. Consonant and vowel perception in quiet was assessed using the frequency-compression and conventional hearing aid. Seventeen adult subjects participated in the second experiment.In both experiments, subjects alternated daily between a frequency-compression and conventional hearing aid for two months. The parameters of frequency compression were set individually for each subject and audibility was measured for the frequency compression and conventional hearing aid programs by comparing estimations of the Speech Intelligibility Index (SII) using a modified algorithm (Bentler, R., Cole, B., Wu, Y-H. (2011, March). Deriving an audibility index for frequency-lowered hearing aids.Poster session presented at the meeting of the American Auditory Society, Scottsdale, 2 AZ). In both experiments, the outcome measures were administered following the hearing aid fitting to establish baseline performance and after two months of use.Results revealed no significant difference between the frequency-compression and conventional hearing aid on tests of localization and consonant recognition. Spondee-innoise and vowel perception scores were significantly higher with the conventional hearing aid compared to the frequency-compression hearing aid after two months of use.These results suggest that, for the subjects in this study, frequency compression is not a better bimodal option than conventional amplification. In addition, speech perception may be negatively influenced by frequency compression because formant frequencies are too severely compressed and can no longer be distinguished.

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“…Researchers have shown that listeners with normal hearing are sensitive to ITDs of 10 to 15µs (Firszt et al, 2008). However, studies have reported relatively poor sensitivity to…”

Section: Interaural Time Differencesmentioning

confidence: 99%

“…Because CI users are more sensitive to ILDs than ITDs, ILDs have been considered the primary cue for sound source localization (Firszt et al, 2008).…”

Section: Interaural Level Differencesmentioning

confidence: 99%

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The Contribution of a Frequency-Compression Hearing Aid to Contralateral Cochlear Implant Performance

Perreau¹,

Bentler²,

Tyler³

2013

J Am Acad Audiol

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“…When the nonimplanted ear does not provide any benefit despite acoustic amplification, bilateral cochlear implantation is the alternative suggestion (Tyler et al 2003;van Hoesel & Tyler 2003). Many studies have shown the benefits of bimodal rehabilitation (Ching et al 2004;Firszt et al 2008;Potts et al 2009;Sucher & McDermott 2009) or bilateral cochlear implantation Schleich et al 2004;Long et al 2006;Litovsky et al 2009;Loizou et al 2009;van Schoonhoven et al 2013) as compared with monaural listening with only one cochlear implant (CI). However, what the best solution would be between bimodal rehabilitation and bilateral cochlear implantation for each particular patient remains a difficult clinical decision.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Multicenter Study Comparing Speech Perception Outcomes for Bilateral Implantation and Bimodal Rehabilitation

et al. 2015

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OBJECTIVES: To compare speech perception outcomes between bilateral implantation (cochlear implants [CIs]) and bimodal rehabilitation (one CI on one side plus one hearing aid [HA] on the other side) and to explore the clinical factors that may cause asymmetric performances in speech intelligibility between the two ears in case of bilateral implantation. DESIGN: Retrospective data from 2247 patients implanted since 2003 in 15 international centers were collected. Intelligibility scores, measured in quiet and in noise, were converted into percentile ranks to remove differences between centers. The influence of the listening mode among three independent groups, one CI alone (n = 1572), bimodal listening (CI/HA, n = 589), and bilateral CIs (CI/CI, n = 86), was compared in an analysis taking into account the influence of other factors such as duration of profound hearing loss, age, etiology, and duration of CI experience. No within-subject comparison (i.e., monitoring outcome modifications in CI/HA subjects becoming CI/CI) was possible from this dataset. Further analyses were conducted on the CI/CI subgroup to investigate a number of factors, such as implantation side, duration of hearing loss, amount of residual hearing, and use of HAs that may explain asymmetric performances of this subgroup. RESULTS: Intelligibility ranked scores in quiet and in noise were significantly greater with both CI/CI and CI/HA than with a CI-alone group, and improvement with CI/CI (+11% and +16% in quiet and in noise, respectively) was significantly better than with CI/HA (+6% and +9% in quiet and in noise, respectively). From the CI/HA group, only subjects with ranked preoperative aided speech scores >60% performed as well as CI/CI participants. Furthermore, CI/CI subjects displayed significantly lower preoperative aided speech scores on average compared with that displayed by CI/HA subjects. Routine clinical data available from the present database did not explain the asymmetrical results of bilateral implantation. CONCLUSIONS: This retrospective study, based on basic speech audiometry (no lateralization cues), indicates that, on average, a second CI is likely to provide slightly better postoperative speech outcome than an additional HA for people with very low preoperative performance. These results may be taken into consideration to refine surgical indications for CIs. Design: Retrospective data from 2247 patients implanted since 2003 in 15 international centers were collected. Intelligibility scores, measured in quiet and in noise, were converted into percentile ranks to remove differences between centers. The influence of the listening mode among three independent groups, one CI alone (n = 1572), bimodal listening (CI/HA, n = 589), and bilateral CIs (CI/CI, n = 86), was compared in an analysis taking into account the influence of other factors such as duration of profound hearing loss, age, etiology, and duration of CI experience. No within-subject comparison (i.e., monitoring outcome modifications in CI/HA subjects bec...

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“…Hybrid and EAS are names derived by the manufacturer, Cochlear and MED-EL, respectively. Individuals using these multiple hearing modalities compared with use of a CI alone may demonstrate measurable improvements in speech perception both in quiet and in noise (Ching, Incerti, & Hill, 2004;Ching, van Wanrooy, & Dillon, 2007;Dettman et al, 2004;Firszt, Reeder, & Skinner, 2008;Flynn & Schmidtke, 2004;Gantz & Turner, 2003;Gstoettner et al, 2004;Most, Gaon-Sivan, Shpak, & Luntz, 2012;Mowry et al, 2012;Potts, Skinner, Litovsky, Strube, & Kuk, 2009;Straatman, Rietveld, Beijen, Mylanus, & Mens, 2010;Tuner et al, 2008a;Turner, Reiss, & Gantz, 2008b), sound localization (Ching et al, 2004(Ching et al, , 2007Firszt, et al, 2008;Flynn & Schmidtke, 2004;Potts et al, 2009), music perception (Bartov & Most, 2014;Flynn & Schmidtke, 2004;Mowry et al, 2012;Turner et al, 2008b), and voice recognition (Flynn & Schmidtke, 2004), as well as subjective benefits of access to binaural hearing and sound quality from combined acoustic and electric hearing (Ching et al, 2004;Firszt et al, 2008;Flynn & Schmidtke, 2004;Potts et al, 2009). However, the benefit of the addition of amplification to CI use is variable across individuals, particularly for speech perception, and an effective clinical protocol for programming of multiple hearing modalities has not yet been determined, as not every parameter has been investigated (Blamey & Saunders, 2008;Dorman, Spahr, Loizou, Dana, & Schmidt, 2005;Heo, Lee, & Lee, 2013;…”

mentioning

confidence: 99%

Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing

Fowler

Eggleston

Reavis³

et al. 2016

J Speech Lang Hear Res

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a Purpose: The objective was to determine whether speech perception could be improved for bimodal listeners (those using a cochlear implant [CI] in one ear and hearing aid in the contralateral ear) by removing low-frequency information provided by the CI, thereby reducing acoustic-electric overlap. Method: Subjects were adult CI subjects with at least 1 year of CI experience. Nine subjects were evaluated in the CI-only condition (control condition), and 26 subjects were evaluated in the bimodal condition. CIs were programmed with 4 experimental programs in which the low cutoff frequency (LCF) was progressively raised. Speech perception was evaluated using Consonant-Nucleus-Consonant words in quiet, AzBio sentences in background babble, and spondee words in background babble. Results: The CI-only group showed decreased speech perception in both quiet and noise as the LCF was raised. Bimodal subjects with better hearing in the hearing aid ear (< 60 dB HL at 250 and 500 Hz) performed best for words in quiet as the LCF was raised. In contrast, bimodal subjects with worse hearing (> 60 dB HL at 250 and 500 Hz) performed similarly to the CI-only group. Conclusions: These findings suggest that reducing lowfrequency overlap of the CI and contralateral hearing aid may improve performance in quiet for some bimodal listeners with better hearing.

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Restoring hearing symmetry with two cochlear implants or one cochlear implant and a contralateral hearing aid

Cited by 83 publications

References 88 publications

The Contribution of a Frequency-Compression Hearing Aid to Contralateral Cochlear Implant Performance

The Contribution of a Frequency-Compression Hearing Aid to Contralateral Cochlear Implant Performance

A Retrospective Multicenter Study Comparing Speech Perception Outcomes for Bilateral Implantation and Bimodal Rehabilitation

Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing

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