Effect of noise and reverberation on speech intelligibility for cochlear implant recipients in realistic sound environments.

Previous studies have suggested a strong effect of reverberation on speech intelligibility (SI) in cochlear implant (CI) recipients. In many of them, different reverberation conditions were obtained by altering the acoustic absorption of a single room, thereby omitting the effect of the room volume. In addition, studies that have investigated the combined effects of reverberation and noise on SI have overlooked the effect of reverberation on the modulation of the noise.

Sequential stream segregation with bilateral cochlear implants.

Sequential stream segregation on the basis of binaural 'ear-of-entry', modulation rate and electrode place-of-stimulation cues was investigated in bilateral cochlear implant (CI) listeners using a rhythm anisochrony detection task. Sequences of alternating 'A' and 'B' bursts were presented via direct electrical stimulation and comprised either an isochronous timing structure or an anisochronous structure that was generated by delaying just the 'B' bursts. 'B' delay thresholds that enabled rhythm anisochrony detection were determined.

Speech Detection in Noise for Young Bilaterally Implanted Children: Is There Evidence of Binaural Benefit Over the Shadowed Ear Alone?

Objectives: To measure binaural benefit over the shadowed ear alone for young bilateral cochlear implant (CI) users. It was hypothesized that children who received bilateral CIs at a young age (<4 years), and had significant bilateral experience, would demonstrate lower detection thresholds for speech sounds in background noise in the bilateral CI over the unilateral CI condition when the added CI was ipsilateral to the noise source.

Design: Children receiving bilateral CIs at the Eye and Ear Hospital Clinic in Melbourne were invited to participate in a wider research project evaluating outcomes; those participating in the wider project who were bilaterally implanted by 4 years and were approximately 2 years postoperative were included in the present study.

Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.

Objective: To examine post-implantation benefit and time taken to acclimate to the cochlear implant for adult candidates with more hearing in the contralateral non-implanted ear than has been previously considered within local candidacy guidelines.

Design: Prospective, within-subject experimental design.

Study Sample: Forty postlingual hearing-impaired adult subjects with a contralateral ear word score in quiet ranging from 27% to 100% (median 67%).

Factors Predicting Postoperative Unilateral and Bilateral Speech Recognition in Adult Cochlear Implant Recipients with Acoustic Hearing.

Objectives: The first objective was to examine factors that could be predictive of postoperative unilateral (cochlear implant alone) speech recognition ability in a group of subjects with greater degrees of preoperative acoustic hearing than has been previously examined. Second, the study aimed to identify factors predictive of speech recognition in the best-aided, bilateral listening condition.

Design: Participants were 65 postlinguistically hearing-impaired adults with preoperative phoneme in quiet scores of greater than or equal to 46% in one or both ears.

An evaluation of the performance of two binaural beamformers in complex and dynamic multitalker environments.

Objective: Binaural beamformers are super-directional hearing aids created by combining microphone outputs from each side of the head. While they offer substantial improvements in SNR over conventional directional hearing aids, the benefits (and possible limitations) of these devices in realistic, complex listening situations have not yet been fully explored. In this study we evaluated the performance of two experimental binaural beamformers.

Audio-visual speech intelligibility benefits with bilateral cochlear implants when talker location varies.

One of the key benefits of using cochlear implants (CIs) in both ears rather than just one is improved localization. It is likely that in complex listening scenes, improved localization allows bilateral CI users to orient toward talkers to improve signal-to-noise ratios and gain access to visual cues, but to date, that conjecture has not been tested. To obtain an objective measure of that benefit, seven bilateral CI users were assessed for both auditory-only and audio-visual speech intelligibility in noise using a novel dynamic spatial audio-visual test paradigm.

Clinical outcomes for adult cochlear implant recipients experiencing loss of usable acoustic hearing in the implanted ear.

Objectives: The first aim of the study was to quantify the change in clinical performance after cochlear implantation for adults who had pre-operative levels of acoustic hearing in each ear of greater than or equal to 46% phoneme score on an open-set monosyllabic word test, and who subsequently experienced loss of useable acoustic hearing in the implanted ear. Pre- and postoperative spatial hearing abilities were assessed, because a clinical consideration for candidates with bilateral acoustic hearing is the potential for post-operative reduction in spatial hearing ability. Second, it was of interest to examine whether preoperative localization ability, as an indicator of access to interaural timing and level cues preoperatively, might be correlated with post-operative change in spatial hearing abilities.

Training of cochlear implant users to improve pitch perception in the presence of competing place cues.

Objectives: Perception of musical pitch in cochlear implant (CI) systems is relatively poor compared with normal hearing and can be adversely affected by changes in spectral timbre coded by stimulation place. In this study, we evaluated whether the perception of musical pitch could be improved through specific training designed to teach listeners to attend to fundamental frequency (F0) exclusively for judgment of pitch and to spectral envelope exclusively for discrimination of spectral timbre.

Design: A computer-based training program to improve musical pitch perception was developed that required listeners to match acoustic patterns of pitch and spectral timbre to visual patterns.

Factors influencing electrical place pitch perception in bimodal listeners.

Factors that might affect perceptual pitch match between acoustic and electric stimulation were examined in 25 bimodal listeners using magnitude estimation. Pre-operative acoustic thresholds in both ears, and duration of severe-profound loss, were first examined as correlates with degree of match between the measured pitch and that predicted by the spiral ganglion frequency-position model. The degree of match was examined with respect to (1) the ratio between the measured and predicted pitch percept on the most apical electrode and (2) the ratio between the slope of the measured and predicted pitch function.

Pitch and loudness matching of unmodulated and modulated stimuli in cochlear implantees.

The pitch elicited by unmodulated and amplitude modulated electrical pulse trains was examined with six adult cochlear implantees. In addition, for three of those subjects who had some hearing in their contralateral ear, the pitch of unmodulated electrical pulse trains was compared to that of complex harmonic acoustic tones. In the first experiment, pulse rate discrimination and the effects of place and level differences on pitch were examined for unmodulated pulse trains.

Enhancement of temporal cues to pitch in cochlear implants: effects on pitch ranking.

The abilities to hear changes in pitch for sung vowels and understand speech using an experimental sound coding strategy (eTone) that enhanced coding of temporal fundamental frequency (F0) information were tested in six cochlear implant users, and compared with performance using their clinical (ACE) strategy. In addition, rate- and modulation rate-pitch difference limens (DLs) were measured using synthetic stimuli with F0s below 300 Hz to determine psychophysical abilities of each subject and to provide experience in attending to rate cues for the judgment of pitch. Sung-vowel pitch ranking tests for stimuli separated by three semitones presented across an F0 range of one octave (139-277 Hz) showed a significant benefit for the experimental strategy compared to ACE.

Binaural interactions develop in the auditory brainstem of children who are deaf: effects of place and level of bilateral electrical stimulation.

Bilateral cochlear implants (CIs) might promote development of binaural hearing required to localize sound sources and hear speech in noise for children who are deaf. These hearing skills improve in children implanted bilaterally but remain poorer than normal. We thus questioned whether the deaf and immature human auditory system is able to integrate input delivered from bilateral CIs.

Contrasting benefits from contralateral implants and hearing aids in cochlear implant users.

In recent years a substantial number of studies have reported results from cochlear implant users who increasingly are being fitted with a contralateral hearing aid or second implant. Often outcomes are discussed in relation to the benefits available to listeners with normal hearing in both ears. The objective of this paper is to consider the available cues that are degraded in different ways when a cochlear implant is combined with a contralateral hearing aid or second implant, and to review the literature in that context.

Statistical bias in the assessment of binaural benefit relative to the better ear.

The comparison of measured binaural performance with the better of two monaural measures (one from each ear) may lead to underestimated binaural benefit due to statistical sampling bias that favors the monaural condition. The mathematical basis of such bias is reviewed and applied to speech reception thresholds measured in 32 bilateral cochlear implant (CI) users for coincident and spatially separated speech and noise. It is shown that the bias increases with test-retest variation and is maximal for uncorrelated samples of identical underlying performance in each ear.

Development of a temporal fundamental frequency coding strategy for cochlear implants.

A sound-coding strategy for users of cochlear implants, named enhanced-envelope-encoded tone (eTone), was developed to improve coding of fundamental frequency (F0) in the temporal envelopes of the electrical stimulus signals. It is based on the advanced combinational encoder (ACE) strategy and includes additional processing that explicitly applies F0 modulation to channel envelope signals that contain harmonics of prominent complex tones. Channels that contain only inharmonic signals retain envelopes normally produced by ACE.

Lateralization of interimplant timing and level differences in children who use bilateral cochlear implants.

Objectives: Interaural level differences (ILD) and interaural timing differences (ITD) are important cues for locating sounds in space. Adult bilateral cochlear implant (CI) users use ILDs more effectively than ITDs. Few studies investigated the ability of children who use bilateral CIs to make use of these binaural cues.

Effect of age at onset of deafness on binaural sensitivity in electric hearing in humans.

Sensitivity to binaural cues was studied in 11 bilateral cochlear implant users, all of whom received both of their cochlear implants as adults, but who varied in the age at onset of deafness, from pre-lingual to childhood-onset to adult-onset. Sensitivity to interaural timing difference (ITD) and interaural level difference (ILD) cues was measured at basal, middle, and apical pitch-matched places of stimulation along the cochlear arrays, using a stimulation rate of 100 Hz. Results show that there is a trend for people whose onset of deafness occurred during adult life or late childhood to retain at least some sensitivity to ITDs, whereas people with onset of deafness earlier in life were insensitive to ITDs.

Interaural time-delay sensitivity in bilateral cochlear implant users: effects of pulse rate, modulation rate, and place of stimulation.

Electrical interaural time delay (ITD) discrimination was measured using 300-ms bursts applied to binaural pitch matched electrodes at basal, mid, and apical locations in each ear. Six bilateral implant users, who had previously shown good ITD sensitivity at a pulse rate of 100 pulses per second (pps), were assessed. Thresholds were measured as a function of pulse rate between 100 and 1,000 Hz, as well as modulation rate over that same range for high-rate pulse trains at 6,000 pps.

Observer weighting of level and timing cues in bilateral cochlear implant users.

The contribution of binaural level and timing cues available from each pulse in brief electrical pulse trains was determined in a lateralization task using an observer weighting paradigm. Four bilateral cochlear implant users were tested with randomized interaural time delays (ITDs) or, in a separate experimental condition, interaural level differences (ILDs) applied to each pulse at 100, 300, and 600 pulsess. To examine the effect of cue randomization, weights were also determined for stimuli with a common ITD applied to all postonset pulses.

Binaural speech unmasking and localization in noise with bilateral cochlear implants using envelope and fine-timing based strategies.

Four adult bilateral cochlear implant users, with good open-set sentence recognition, were tested with three different sound coding strategies for binaural speech unmasking and their ability to localize 100 and 500 Hz click trains in noise. Two of the strategies tested were envelope-based strategies that are clinically widely used. The third was a research strategy that additionally preserved fine-timing cues at low frequencies.

Abnormal timing delays in auditory brainstem responses evoked by bilateral cochlear implant use in children.

Hypothesis: A period of unilateral implant use before bilateral implantation affects timing of brainstem processes measured by the electrically evoked auditory brainstem response (EABR).

Background: EABR latencies decrease with unilateral implant use potentially disrupting binaural timing cues important in auditory brainstem processing of bilateral input.

Methods: EABRs were evoked by electrical pulses from the left, right, and both implants simultaneously in 3 groups of children.

Sensitivity to binaural timing in bilateral cochlear implant users.

Various measures of binaural timing sensitivity were made in three bilateral cochlear implant users, who had demonstrated moderate-to-good interaural time delay (ITD) sensitivity at 100 pulses-per-second (pps). Overall, ITD thresholds increased at higher pulse rates, lower levels, and shorter durations, although intersubject differences were evident. Monaural rate-discrimination thresholds, using the same stimulation parameters, showed more substantial elevation than ITDs with increased rate.

Amplitude-mapping effects on speech intelligibility with unilateral and bilateral cochlear implants.

Objective: A study was conducted examining the effects of amplitude-mapping adjustments on speech intelligibility with bilateral cochlear implant users, for both unilateral and bilateral device use. The main motivation for this study was the consideration that bilateral loudness summation may result in sounds becoming too loud if no adjustments are made to standard monaural amplitude-mapping functions (maps) when used bilaterally. In that case, reductions of the stimulation levels may be needed.