Factors constraining the benefit to speech understanding of combining information from low-frequency hearing and a cochlear implant
Michael F Dorman, Sarah Cook, Anthony Spahr, Ting Zhang, Louise Loiselle, David Schramm, JoAnne Whittingham, Rene Gifford, Michael F Dorman, Sarah Cook, Anthony Spahr, Ting Zhang, Louise Loiselle, David Schramm, JoAnne Whittingham, Rene Gifford
Abstract
Many studies have documented the benefits to speech understanding when cochlear implant (CI) patients can access low-frequency acoustic information from the ear opposite the implant. In this study we assessed the role of three factors in determining the magnitude of bimodal benefit - (i) the level of CI-only performance, (ii) the magnitude of the hearing loss in the ear with low-frequency acoustic hearing and (iii) the type of test material. The patients had low-frequency PTAs (average of 125, 250 and 500 Hz) varying over a large range (<30 dB HL to >70 dB HL) in the ear contralateral to the implant. The patients were tested with (i) CNC words presented in quiet (n = 105) (ii) AzBio sentences presented in quiet (n = 102), (iii) AzBio sentences in noise at +10 dB signal-to-noise ratio (SNR) (n = 69), and (iv) AzBio sentences at +5 dB SNR (n = 64). We find maximum bimodal benefit when (i) CI scores are less than 60 percent correct, (ii) hearing loss is less than 60 dB HL in low-frequencies and (iii) the test material is sentences presented against a noise background. When these criteria are met, some bimodal patients can gain 40-60 percentage points in performance relative to performance with a CI. This article is part of a Special Issue entitled <Lasker Award>.
Copyright © 2014 Elsevier B.V. All rights reserved.
Figures
Source: PubMed