Abstract
Cochlear implant (CI) users have difficulty understanding speech in noisy listening conditions and perceiving music. Aided residual acoustic hearing in the contralateral ear can mitigate these limitations. The present study examined contributions of electric and acoustic hearing to speech understanding in noise and melodic pitch perception. Data was collected with the CI only, the hearing aid (HA) only, and both devices together (CI+HA). Speech reception thresholds (SRTs) were adaptively measured for simple sentences in speech babble. Melodic contour identification (MCI) was measured with and without a masker instrument; the fundamental frequency of the masker was varied to be overlapping or non-overlapping with the target contour. Results showed that the CI contributes primarily to bimodal speech perception and that the HA contributes primarily to bimodal melodic pitch perception. In general, CI+HA performance was slightly improved relative to the better ear alone (CI-only) for SRTs but not for MCI, with some subjects experiencing a decrease in bimodal MCI performance relative to the better ear alone (HA-only). Individual performance was highly variable, and the contribution of either device to bimodal perception was both subject- and task-dependent. The results suggest that individualized mapping of CIs and HAs may further improve bimodal speech and music perception.
Highlights
Due to relaxing criteria for implantation, increasing numbers of cochlear implant (CI) recipients have some amount of residual acoustic hearing [1]
Speech reception thresholds (SRTs) with the hearing aid (HA)-only could not be obtained for subjects S1, S2, S5, S7, and S9, as performance was 30 dB; the CI-only SRT could not be obtained for subject S5
HA-only SRTs were not included in the analysis as we were unable to obtain SRTs for a number of subjects; S5 was excluded from the analysis as there was no CI-only SRT for this subject
Summary
Due to relaxing criteria for implantation, increasing numbers of cochlear implant (CI) recipients have some amount of residual acoustic hearing [1]. This acoustic hearing is often aided by a hearing aid (HA), and this "bimodal" listening or "electro-acoustic stimulation" (EAS) has been shown to benefit CI users’ speech perception. CIs provide many patients with good speech understanding in quiet, easy listening conditions. CIs do not provide the spectrotemporal fine structure information needed to segregate speech from noise. The coarse spectral resolution does not support complex pitch perception which is important for musical.
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