Electric And Acoustic Stimulation Research Articles

A glimpsing account for the benefit of simulated combined acoustic and electric hearing

The benefits of combined electric and acoustic stimulation (EAS) in terms of speech recognition in noise are well established; however the underlying factors responsible for this benefit are not clear. The present study tests the hypothesis that having access to acoustic information in the low frequencies makes it easier for listeners to glimpse the target. Normal-hearing listeners were presented with vocoded speech alone (V), low-pass (LP) filtered speech alone, combined vocoded and LP speech (LP+V) and with vocoded stimuli constructed so that the low-frequency envelopes were easier to glimpse. Target speech was mixed with two types of maskers (steady-state noise and competing talker) at -5 to 5 dB signal-to-noise ratios. Results indicated no advantage of LP+V in steady noise, but a significant advantage over V in the competing talker background, an outcome consistent with the notion that it is easier for listeners to glimpse the target in fluctuating maskers. A significant improvement in performance was noted with the modified glimpsed stimuli over the original vocoded stimuli. These findings taken together suggest that a significant factor contributing to the EAS advantage is the enhanced ability to glimpse the target.

The Benefits of Combining Acoustic and Electric Stimulation for the Recognition of Speech, Voice and Melodies

Fifteen patients fit with a cochlear implant in one ear and a hearing aid in the other ear were presented with tests of speech and melody recognition and voice discrimination under conditions of electric (E) stimulation, acoustic (A) stimulation and combined electric and acoustic stimulation (EAS). When acoustic information was added to electrically stimulated information performance increased by 17–23 percentage points on tests of word and sentence recognition in quiet and sentence recognition in noise. On average, the EAS patients achieved higher scores on CNC words than patients fit with a unilateral cochlear implant. While the best EAS patients did not outperform the best patients fit with a unilateral cochlear implant, proportionally more EAS patients achieved very high scores on tests of speech recognition than unilateral cochlear implant patients.

Hearing Preservation in Patients With a Cochlear Implant

Hearing Preservation in Patients With a Cochlear Implant

Effect of digital frequency compression (DFC) on speech recognition in candidates for combined electric and acoustic stimulation (EAS).

To compare the effects of conventional amplification (CA) and digital frequency compression (DFC) amplification on the speech recognition abilities of candidates for a partial-insertion cochlear implant, that is, candidates for combined electric and acoustic stimulation (EAS). The participants were 6 patients whose audiometric thresholds at 500 Hz and below were <or=60 dB HL and whose thresholds at 2000 Hz and above were >or=80 dB HL. Six tests of speech understanding were administered with CA and DFC. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was also administered following use of CA and DFC. Group mean scores were not statistically different in the CA and DFC conditions. However, 2 patients received substantial benefit in DFC conditions. APHAB scores suggested increased ease of communication, but also increased aversive sound quality. Results suggest that a relatively small proportion of individuals who meet EAS candidacy will receive substantial benefit from a DFC hearing aid and that a larger proportion will receive at least a small benefit when speech is presented against a background of noise. This benefit, however, comes at a cost-aversive sound quality.

Auditory Function and Speech Understanding in Listeners Who Qualify for EAS Surgery

For patients with relatively good low-frequency hearing and relatively poor high-frequency hearing, who met the pre-implant criteria for combined electric and acoustic stimulation (EAS), our aims were to i) assess deficits in low-frequency auditory function, ii) to identify measures which might be sensitive to changes resulting from the insertion of an intracochlear electrode array, and iii) to quantify the relationship between measures of auditory function and performance on tasks of speech and melody recognition. Measures of frequency selectivity, temporal resolution, and nonlinear cochlear function, along with measures of word, sentence, consonant, vowel, and melody recognition, were obtained from 5 normal-hearing and 17 hearing-impaired listeners. The hearing-impaired listeners had auditory thresholds at 500 Hz, ranging from 20 to 60 dB HL, and thresholds at 1 kHz, ranging from 60 to 100 dB HL. Nonlinear cochlear function was either reduced or absent. Frequency selectivity at 500 Hz was significantly reduced but still present in most patients. Temporal resolution, when measured at low modulation frequencies, was normal. Speech recognition in a modulated background revealed significantly poorer performance than normal. Speech and melody recognition varied over a large range. No measure of auditory function was correlated significantly with speech recognition. However, frequency selectivity was related to melody recognition. (1) Patients who qualify for EAS surgery have a wide range of speech and melody recognition abilities. (2) A number of the psychophysical measures tested may prove more sensitive than the audiogram in determining the degree of damage inflicted by the intracochlear electrode array. (3) Speech recognition was not correlated with any of the measures of auditory function.

Combined Electric and Acoustic Stimulation of the Auditory System: Results of a Clinical Study

Combined electric and acoustic stimulation (EAS) of the auditory system is a new therapy for patients with severe to profound high- and mid-frequency hearing loss but remaining low-frequency hearing. In a prospective study, 13 patients with low-frequency hearing of better than 60 dB below 1 kHz were implanted with a MED-EL COMBI 40+ cochlear implant. Pure tone thresholds as well as monosyllabic word scores and Hochmair-Schulz-Moser sentences in quiet and in noise were measured with hearing aids, cochlear implant alone and in the combined stimulation mode (EAS) in the same ear. Hearing could be partially preserved in 11 out of the 13 patients. All patients scored significantly higher with cochlear implant alone than with hearing aids. Seven patients scored higher in the EAS mode than with cochlear implant alone for sentences in noise, 4 remained unchanged, and 2 could not use EAS. Synergistic effects of EAS were most prominent for hearing in noise with increases of up to 72% as compared to cochlear implant alone.