Sprachverstehen im Störschall—Überlegungen zur ökologisch validen Bewertung der Kommunikationsfähigkeit mit Cochleaimplantat

Abstract

Background Nowadays, cochlear implant (CI) patients mostly show good to very good speech comprehension in quiet, but there are known problems with communication in everyday noisy situations. There is thus a need for ecologically valid measurements of speech comprehension in real-life listening situations for hearing-impaired patients. The additional methodological effort must be balanced with clinical human and spatial resources. This study investigates possible simplifications of a complex measurement setup. Methods The study included 20 adults from long-term follow-up after CI fitting with postlingual onset of hearing impairment. The complexity of the investigated listening situations was influenced by changing the spatiality of the noise sources and the temporal characteristics of the noise. To compare different measurement setups, speech reception thresholds (SRT) were measured unilaterally with different CI processors and settings. Ten normal-hearing subjects served as reference. Results In a complex listening situation with four loudspeakers, differences in SRT from CI subjects to the control group of up to 8 dB were found. For CI subjects, this SRT correlated with the situation with frontal speech signal and fluctuating interference signal from the side with R2 = 0.69. For conditions with stationary interfering signals, R2 values <0.2 were found. Conclusion There is no universal solution for all audiometric questions with respect to the spatiality and temporal characteristics of noise sources. In the investigated context, simplification of the complex spatial audiometric setting while using fluctuating competing signals was possible.

Enhancing Cochlear Implant Outcomes across Age Groups: The Interplay of Forward Focus and Advanced Combination Encoder Coding Strategies in Noisy Conditions

“…Compared with age-specific reference data for the same spatial signal and noise configurations [ 32 ], the present results demonstrate that some CI users are able to perform similar to normal-hearing listeners. Thus, despite the fact that studies often overestimate the performance of CIs due to the experimental design [ 40 , 41 ], we conclude that FF provides a tool that significantly reduces hearing deficits in some situations.…”

“…Although hearing tests in noise are becoming more relevant in everyday clinical practice, their ecological validity needs to be improved [ 41 ]. Several studies have shown that fluctuating interfering signals or competing talkers [ 45 ] can best reflect everyday situations [ 42 , 46 ].…”

“…Several studies have shown that fluctuating interfering signals or competing talkers [ 45 ] can best reflect everyday situations [ 42 , 46 ]. Hey et al [ 41 ] recently revealed that a stationary noise cannot replace interfering signals if used in speech audiometry. The results of our study are based on the recommended icra5 noise [ 22 , 47 ] and can thus contribute to the standardization of clinical measurements, especially in comparison with the recently published data of normal-hearing subjects [ 32 ].…”