Bilaterally Combined Electric and Acoustic Hearing in Mandarin-Speaking Listeners: The Population With Poor Residual Hearing

Duo-Duo Tao, Ji-Sheng Liu, Zhen-Dong Yang, Blake S Wilson, Ning Zhou, Duo-Duo Tao, Ji-Sheng Liu, Zhen-Dong Yang, Blake S Wilson, Ning Zhou

Abstract

The hearing loss criterion for cochlear implant candidacy in mainland China is extremely stringent (bilateral severe to profound hearing loss), resulting in few patients with substantial residual hearing in the nonimplanted ear. The main objective of the current study was to examine the benefit of bimodal hearing in typical Mandarin-speaking implant users who have poorer residual hearing in the nonimplanted ear relative to those used in the English-speaking studies. Seventeen Mandarin-speaking bimodal users with pure-tone averages of ∼80 dB HL participated in the study. Sentence recognition in quiet and in noise as well as tone and word recognition in quiet were measured in monaural and bilateral conditions. There was no significant bimodal effect for word and sentence recognition in quiet. Small bimodal effects were observed for sentence recognition in noise (6%) and tone recognition (4%). The magnitude of both effects was correlated with unaided thresholds at frequencies near voice fundamental frequencies (F0s). A weak correlation between the bimodal effect for word recognition and unaided thresholds at frequencies higher than F0s was identified. These results were consistent with previous findings that showed more robust bimodal benefits for speech recognition tasks that require higher spectral resolution than speech recognition in quiet. The significant but small F0-related bimodal benefit was also consistent with the limited acoustic hearing in the nonimplanted ear of the current subject sample, who are representative of the bimodal users in mainland China. These results advocate for a more relaxed implant candidacy criterion to be used in mainland China.

Keywords: Mandarin; acoustic residual hearing; bimodal hearing; cochlear implants.

Figures

Figure 1.
Figure 1.
Individual pure-tone thresholds. Upper panel: unaided thresholds. Lower panel: aided thresholds. Symbols represent subjects.
Figure 2.
Figure 2.
Individual performance with the A (hearing aid alone), E (cochlear implant alone), and bimodal hearing (combined stimulation). Each panel shows individual and group mean performance for one speech recognition task. Error bars represent standard deviation. In the panel titles, the subscript E stands for equal duration, N stands for naturally spoken, Q stands for quiet, and 5 dB indicates the SNR. SNR = speech-to-noise ratio.
Figure 3.
Figure 3.
The benefit of A (bimodal minus E) and benefit of E (bimodal minus A) for each of the five speech recognition tasks. Each data point represents one subject. The horizontal bars represent group means. Symbols represent subjects.
Figure 4.
Figure 4.
Benefit of the hearing aid (A) plotted as a function of the performance with the cochlear implant (E) alone. The solid lines indicate the maximum possible benefit. The circle in each panel indicates the 95% critical difference scores for the corresponding speech recognition task. Symbols represent subjects.
Figure 5.
Figure 5.
Benefit of the cochlear implant (E) plotted as a function of the performance with the hearing aid (A) alone. The solid lines indicate the maximum possible benefit. The circle in each panel indicates the 95% critical difference scores for the corresponding speech recognition task. Symbols represent subjects.
Figure 6.
Figure 6.
Scatter plots of benefit of A for tone recognition with equal-duration stimuli (upper panels) and sentence recognition in noise (lower panels) against unaided audiometric thresholds at 125 Hz, 250 Hz, and 500 Hz. Lines represent linear fit to the data. The correlation coefficients and p values are shown in each panel. Symbols represent subjects (refer to previous figures for legend).

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