Abstract
A significant fraction of newly implanted cochlear implant recipients use a hearing aid in their non-implanted ear. SCORE bimodal is a sound processing strategy developed for this configuration, aimed at normalising loudness perception and improving binaural loudness balance. Speech perception performance in quiet and noise and sound localisation ability of six bimodal listeners were measured with and without application of SCORE. Speech perception in quiet was measured either with only acoustic, only electric, or bimodal stimulation, at soft and normal conversational levels. For speech in quiet there was a significant improvement with application of SCORE. Speech perception in noise was measured for either steady-state noise, fluctuating noise, or a competing talker, at conversational levels with bimodal stimulation. For speech in noise there was no significant effect of application of SCORE. Modelling of interaural loudness differences in a long-term-average-speech-spectrum-weighted click train indicated that left-right discrimination of sound sources can improve with application of SCORE. As SCORE was found to leave speech perception unaffected or to improve it, it seems suitable for implementation in clinical devices.
Highlights
Many newly implanted cochlear implant (CI) recipients have residual hearing in the non-implanted ear
We only presented stimuli from angles smaller than 45 degrees, because of the non-monotonicity in the interaural level difference (ILD)-versus-angle function
Further analysis of the data indicated that for levels lower than 60 dB A, the subject always lateralised the stimulus to the hearing aids (HAs) side, which again corresponds to the observation that the interaural loudness difference (ILoD) in figure 8 for 50 and 55 dB A are below zero for all angles of incidence
Summary
Many newly implanted cochlear implant (CI) recipients have residual hearing in the non-implanted ear. I.e., the combination of a CI in one ear and acoustic stimulation in the other, has several advantages compared to a unilateral CI [1,2], such as improved speech perception in noise. There are no CIs and hearing aids (HAs) designed for combined use. This leads to suboptimal perception of binaural cues [3] and binaural balance [4], poor sound-source localisation ability and probably reduced wearing comfort. Unilateral SCORE (CI-only) had been shown to improve speech perception in quiet at low levels [5]. While SCORE bimodal normalises loudness and improves binaural balance, these factors are subordinate to speech perception. In the current study we assessed the effect of SCORE on speech perception in quiet and in noise
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