Abstract
ObjectiveCochlear implantation has become a well-accepted treatment option for people with single-sided deafness (SSD) and has become a clinical standard in many countries. A cochlear implant (CI) is the only device which restores binaural hearing. The effect of microphone directionality (MD) settings has been investigated in other CI indication groups, but its impact on speech perception in noise has not been established in CI users with SSD. The focus of this investigation was, therefore, to assess binaural hearing effects using different MD settings in CI users with SSD.MethodsTwenty-nine experienced CI users with SSD were recruited to determine speech reception thresholds with varying target and noise sources to define binaural effects (head shadow, squelch, summation, and spatial release from masking), sound localization, and sound quality using the SSQ12 and HISQUI19 questionnaires. Outcome measures included the MD settings “natural”, “adaptive”, and “omnidirectional”.ResultsThe 29 participants involved in the study were divided into two groups: 11 SONNET users and 18 OPUS 2/RONDO users. In both groups, a significant head shadow effect of 7.4–9.2 dB was achieved with the CI. The MD setting “adaptive” provided a significant head shadow effect of 9.2 dB, a squelch effect of 0.9 dB, and spatial release from masking of 7.6 dB in the SONNET group. No significant summation effect could be determined in either group with CI. Outcomes with the omnidirectional setting were not significantly different between groups. For both groups, localization improved significantly when the CI was activated and was best when the omnidirectional setting was used. The groups’ sound quality scores did not significantly differ.ConclusionsAdaptive directional microphone settings improve speech perception and binaural hearing abilities in CI users with SSD. Binaural effect measures are valuable to quantify the benefit of CI use, especially in this indication group.
Highlights
Cochlear implant (CI) provision is an accepted treatment in Europe for many people with single-sided deafness (SSD)
SSD is defined as a pure-tone average (PTA) of ≥ 70 dB HL in the poorer ear and of ≤ 30 dB HL in the better ear, with PTA referring to the mean threshold at pure-tone frequencies of 0.5, 1, 2, and 4 kHz [12]
The results of this study indicate two key points: (1) using a CI with an adaptive microphone directionality setting improves CI users with SSD’s speech understanding in noise, and (2) when testing CI users with SSD, it is important to assess binaural effect measures to quantify the benefit, rather than only looking at SRT in noise
Summary
Cochlear implant (CI) provision is an accepted treatment in Europe for many people with single-sided deafness (SSD). The reported benefits of CI use include significantly better speech understanding in noise, improved localization abilities, reduction of tinnitus, improved self-esteem, and less fatigue [1,2,3,4,5,6,7] The challenge in this patient group is the. A consensus treatment road map for SSD patients was published in 2017 It suggested offering a contralateral routing of signal (CROS) and bone conduction (BCD) hearing aid trial prior to implantation [11, 12]. This consensus paper recommended reporting on the same outcome measures across centers to ensure comparability [12]. Since providing CI recipients with the best possible hearing is our goal, determining which audio processor can provide users with the best objective and subjective hearing is of obvious clinical interest
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