Asymmetric Hearing Loss in Adult Cochlear Implant Recipients: Results and Recommendations From a Multisite Prospective Clinical Trial.

Objective: A multisite clinical trial was conducted to obtain cochlear implant (CI) efficacy data in adults with asymmetric hearing loss (AHL) and establish an evidence-based framework for clinical decision-making regarding CI candidacy, counseling, and assessment tools. Study hypotheses were threefold: (1) 6-month postimplant performance in the poor ear (PE) with a CI will be significantly better than preimplant performance with a hearing aid (HA), (2) 6-month postimplant performance with a CI and HA (bimodal) will be significantly better than preimplant performance with bilateral HAs (Bil HAs), and (3) 6-month postimplant bimodal performance will be significantly better than aided, better ear (BE) performance.

Design: Forty adults with AHL from four, metropolitan CI centers participated.

Evaluation of the American English Matrix Test with Cochlear Implant Recipients.

Objective: Currently, the variety of speech recognition tests used to evaluate cochlear implant (CI) recipients makes it difficult to compare results, especially across languages. The Matrix Test limits contextual cues and is available in multiple languages, including American English. The current study investigated test format and noise type for the American English Matrix Test (AMT) and compared results to AzBio sentence scores in adult CI recipients.

Cortical Regions Activated by Spectrally Degraded Speech in Adults With Single Sided Deafness or Bilateral Normal Hearing.

Those with profound sensorineural hearing loss from single sided deafness (SSD) generally experience greater cognitive effort and fatigue in adverse sound environments. We studied cases with right ear, SSD compared to normal hearing (NH) individuals. SSD cases were significantly less correct in naming last words in spectrally degraded 8- and 16-band vocoded sentences, despite high semantic predictability.

Evaluation of a New Algorithm to Optimize Audibility in Cochlear Implant Recipients.

Objectives: A positive relation between audibility and speech understanding has been established for cochlear implant (CI) recipients. Sound field thresholds of 20 dB HL across the frequency range provide CI users the opportunity to understand soft and very soft speech. However, programming the sound processor to attain good audibility can be time-consuming and difficult for some patients.

Front- and rear-facing horizontal sound localization results in adults with unilateral hearing loss and normal hearing.

Binaural hearing allows listeners to take advantage of auditory cues that are necessary for sound localization. Patients with asymmetric or unilateral hearing loss receive degraded or absent binaural cues and often demonstrate decreased sound localization in the horizontal plane. Given the importance of sound localization for everyday function, there is a need for clinically feasible methods to evaluate localization, particularly as validation of intervention for patients with unilateral hearing loss.

Results in Adult Cochlear Implant Recipients With Varied Asymmetric Hearing: A Prospective Longitudinal Study of Speech Recognition, Localization, and Participant Report.

Objectives: Asymmetric hearing with severe to profound hearing loss (SPHL) in one ear and better hearing in the other requires increased listening effort and is detrimental for understanding speech in noise and sound localization. Although a cochlear implant (CI) is the only treatment that can restore hearing to an ear with SPHL, current candidacy criteria often disallows this option for patients with asymmetric hearing. The present study aimed to evaluate longitudinal performance outcomes in a relatively large group of adults with asymmetric hearing who received a CI in the poor ear.

Unilateral Hearing Loss: Understanding Speech Recognition and Localization Variability-Implications for Cochlear Implant Candidacy.

Objectives: At a minimum, unilateral hearing loss (UHL) impairs sound localization ability and understanding speech in noisy environments, particularly if the loss is severe to profound. Accompanying the numerous negative consequences of UHL is considerable unexplained individual variability in the magnitude of its effects. Identification of covariables that affect outcome and contribute to variability in UHLs could augment counseling, treatment options, and rehabilitation.

A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance.

Purpose: Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities.

Method: A prospective longitudinal study included 24 bilaterally implanted children (mean ear surgeries at 5.

Quantification of speech-in-noise and sound localisation abilities in children with unilateral hearing loss and comparison to normal hearing peers.

The study objective was to quantify abilities of children with unilateral hearing loss (UHL) on measures that address known deficits for this population, i.e. speech understanding in quiet and noise, and sound localisation.

Localization training results in individuals with unilateral severe to profound hearing loss.

Adults with unilateral hearing loss often demonstrate decreased sound localization ability and report that situations requiring spatial hearing are especially challenging. Few studies have evaluated localization abilities combined with training in this population. The present pilot study examined whether localization of two sound types would improve after training, and explored the relation between localization ability or training benefit and demographic factors.

A longitudinal study in adults with sequential bilateral cochlear implants: time course for individual ear and bilateral performance.

Purpose: The purpose of this study was to examine the rate of progress in the 2nd implanted ear as it relates to the 1st implanted ear and to bilateral performance in adult sequential cochlear implant recipients. In addition, this study aimed to identify factors that contribute to patient outcomes.

Method: The authors performed a prospective longitudinal study in 21 adults who received bilateral sequential cochlear implants.

Changes in auditory perceptions and cortex resulting from hearing recovery after extended congenital unilateral hearing loss.

Monaural hearing induces auditory system reorganization. Imbalanced input also degrades time-intensity cues for sound localization and signal segregation for listening in noise. While there have been studies of bilateral auditory deprivation and later hearing restoration (e.

Effects of unilateral input and mode of hearing in the better ear: self-reported performance using the speech, spatial and qualities of hearing scale.

Objective: To evaluate effects of hearing mode (normal hearing, cochlear implant, or hearing aid) on everyday communication among adult unilateral listeners using the Speech, Spatial and Qualities of Hearing Scale (SSQ). Individuals with one good, naturally hearing ear were expected to have higher overall ratings than unilateral listeners dependent on a cochlear implant or hearing aid. The authors anticipated that listening environments reliant on binaural processing for successful communication would be rated most disabling by all unilateral listeners.

Postlingual adult performance in noise with HiRes 120 and ClearVoice Low, Medium, and High.

Objectives: The study's objectives were to evaluate speech recognition in multiple listening conditions using several noise types with HiRes 120 and ClearVoice (Low, Medium, High) and to determine which ClearVoice program was most beneficial for everyday use.

Methods: Fifteen postlingual adults attended four sessions; speech recognition was assessed at sessions 1 and 3 with HiRes 120 and at sessions 2 and 4 with all ClearVoice programs. Test measures included sentences presented in restaurant noise (R-SPACE), in speech-spectrum noise, in four- and eight-talker babble, and connected discourse presented in 12-talker babble.

Cochlear implantation in nontraditional candidates: preliminary results in adolescents with asymmetric hearing loss.

Objective: Traditionally, children are cochlear implant (CI) candidates if bilateral severe to profound hearing loss is present and amplification benefit is limited. The current study investigated abilities of adolescents with asymmetric hearing loss (one ear with severe to profound hearing loss and better hearing contralaterally), where the poorer ear received a CI and the better ear maintained amplification.

Study Design: Within-subject case study.

Auditory abilities after cochlear implantation in adults with unilateral deafness: a pilot study.

Objective: This pilot study examined speech recognition, localization, temporal and spectral discrimination, and subjective reports of cochlear implant (CI) recipients with unilateral deafness.

Study Design: Three adult male participants with short-term unilateral deafness (<5 yr) participated. All had sudden onset of severe-to-profound hearing loss in 1 ear, which then received a CI, and normal or near normal hearing in the other ear.

Evaluation of TIMIT sentence list equivalency with adult cochlear implant recipients.

Background: Current measures used to determine sentence recognition abilities in cochlear implant recipients often include tests with one talker and one rate of speech. Performance with these measures may not accurately represent the speech recognition abilities of the listeners. Evaluation of cochlear implant performance should include measures that reflect realistic listening conditions.

Optimization of programming parameters in children with the advanced bionics cochlear implant.

Background: Cochlear implants provide access to soft intensity sounds and therefore improved audibility for children with severe-to-profound hearing loss. Speech processor programming parameters, such as threshold (or T-level), input dynamic range (IDR), and microphone sensitivity, contribute to the recipient's program and influence audibility. When soundfield thresholds obtained through the speech processor are elevated, programming parameters can be modified to improve soft sound detection.

Cochlear implantation in adults with asymmetric hearing loss.

Objective: Bilateral severe to profound sensorineural hearing loss is a standard criterion for cochlear implantation. Increasingly, patients are implanted in one ear and continue to use a hearing aid in the nonimplanted ear to improve abilities such as sound localization and speech understanding in noise. Patients with severe to profound hearing loss in one ear and a more moderate hearing loss in the other ear (i.

Optimizing the perception of soft speech and speech in noise with the Advanced Bionics cochlear implant system.

Objective: This study aimed to provide guidelines to optimize perception of soft speech and speech in noise for Advanced Bionics cochlear implant (CI) users.

Design: Three programs differing in T-levels were created for ten subjects. Using the T-level setting that provided the lowest FM-tone, sound-field threshold levels for each subject, three additional programs were created with input dynamic range (IDR) settings of 50, 65 and 80 dB.

Two ears and two (or more?) devices: a pediatric case study of bilateral profound hearing loss.

Advances in technology and expanding candidacy guidelines have motivated many clinics to consider children with precipitously sloping high-frequency hearing loss as candidates for cochlear implants (CIs). A case study is presented of a pediatric CI patient whose hearing thresholds were preserved within 10 dB of preimplant levels (125-750 Hz) after receiving a fully inserted 31.5-mm electrode array at one ear.

Speech recognition in cochlear implant recipients: comparison of standard HiRes and HiRes 120 sound processing.

Objective: HiRes (HR) 120 is a sound-processing strategy purported to offer an increase in the precision of frequency-to-place mapping through the use of current steering. This within-subject study was designed to compare speech recognition as well as music and sound quality ratings for HR and HR 120 processing.

Setting: Cochlear implant/tertiary referral center.

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

With today's technology and the demonstrated success of cochlear implantation, along with expanded candidacy criteria, the opportunity to provide optimal hearing to both ears for individuals with severe-to-profound hearing loss is greater than ever. This article reviews the advantages of binaural hearing and the disadvantages of hearing with only one ear or hearing with two ears with significantly different sound thresholds. A case study is presented that demonstrates the benefit of bimodal hearing (i.