Good Speech Perception Research Articles

Speech perception in modulated noise assessed in bimodal CI users.

Although good speech perception in quiet is achievable with cochlear implants (CIs), speech perception in noise is severely impaired compared to normal hearing (NH). In the case of abimodal CI fitting with ahearing aid (HA) in the opposite ear, the amount of residual acoustic hearing influences speech perception in noise. The aim of this work was to investigate speech perception in noise in agroup of bimodal CI users and compare the results to age-matched HA users and people without subjective hearing loss, as well as with ayoung NH group. Study participants comprised 19bimodal CI users, 39HA users, and 40subjectively NH subjects in the age group 60-90years and 14young NH subjects. Speech reception thresholds (SRTs) in noise were adaptively measured using the Oldenburg Sentence Test for the two spatial test conditions S0N0 (speech and noise from the front) and multisource-noise field (MSNF; speech from the front, four spatially distributed noise sources) in continuous noise of the Oldenburg Sentence Test (Ol-noise) and amplitude-modulated Fastl noise (Fastl-noise). With increasing hearing loss, the median SRT worsened significantly in all conditions. In test condition S0N0, the SRT of the CI group was 5.6 dB worse in Ol-noise than in the young NH group (mean age 26.4years) and 22.5 dB worse in Fastl-noise; in MSNF, the differences were 6.6 dB (Ol-noise) and 17.3 dB (Fastl-noise), respectively. In the young NH group, median SRT in condition S0N0 improved by 11 dB due to gap listening; in the older NH group, SRTs improved by only 3.1 dB. In the HA and bimodal CI groups there was no gap listening effect and SRTs in Fastl-noise were even worse than in Ol-noise. With increasing hearing loss, speech perception in modulated noise is even more impaired than in continuous noise.

Cortical responses correlate with speech performance in pre-lingually deaf cochlear implant children.

Cochlear implantation is currently the most successful intervention for severe-to-profound sensorineural hearing loss, particularly in deaf infants and children. Nonetheless, there remains a significant degree of variability in the outcomes of CI post-implantation. The purpose of this study was to understand the cortical correlates of the variability in speech outcomes with a cochlear implant in pre-lingually deaf children using functional near-infrared spectroscopy (fNIRS), an emerging brain-imaging technique. In this experiment, cortical activities when processing visual speech and two levels of auditory speech, including auditory speech in quiet and in noise with signal-to-noise ratios of 10 dB, were examined in 38 CI recipients with pre-lingual deafness and 36 normally hearing children whose age and sex matched CI users. The HOPE corpus (a corpus of Mandarin sentences) was used to generate speech stimuli. The regions of interest (ROIs) for the fNIRS measurements were fronto-temporal-parietal networks involved in language processing, including bilateral superior temporal gyrus, left inferior frontal gyrus, and bilateral inferior parietal lobes. The fNIRS results confirmed and extended findings previously reported in the neuroimaging literature. Firstly, cortical responses of superior temporal gyrus to both auditory and visual speech in CI users were directly correlated to auditory speech perception scores, with the strongest positive association between the levels of cross-modal reorganization and CI outcome. Secondly, compared to NH controls, CI users, particularly those with good speech perception, showed larger cortical activation in the left inferior frontal gyrus in response to all speech stimuli used in the experiment. In conclusion, cross-modal activation to visual speech in the auditory cortex of pre-lingually deaf CI children may be at least one of the neural bases of highly variable CI performance due to its beneficial effects for speech understanding, thus supporting the prediction and assessment of CI outcomes in clinic. Additionally, cortical activation of the left inferior frontal gyrus may be a cortical marker for effortful listening.

Cochlear Implant Adult Speech Perception Outcomes: Seniors Have Similar Good Outcomes.

The primary aim was to analyze the speech perception outcomes of patients with cochlear implants 65 years and older, compared with those younger than 65 years. The secondary aim was to analyze if preoperative hearing levels, severe compared with profound, had an effect on speech perception outcomes in senior citizens. Retrospective case review of 785 patients, between 2009 and 2016. A large cochlear implant program. Cochlear implant adult recipients younger than 65 years and 65 years and older at the time of surgery. Therapeutic-cochlear implant. Speech perception outcomes, using City University of New York (CUNY) sentences and Consonant-Nucleus-Consonant (CNC) words. Outcomes were measured preoperatively and postoperatively at 3, 6and 12 months for cohorts younger than 65 years and 65 years and older. Adult recipients younger than 65 years compared with those 65 years and older had comparable outcomes for CUNY sentence scores outcomes ( p = 0.11) and CNC word scores ( p = 0.69). The preoperative four-frequency average severe hearing loss (HL) cohort was significantly better compared with the profound HL cohort, for both the CUNY sentence scores ( p < 0.001) and CNC word scores ( p < 0.0001). The four-frequency average severe HL cohort had better outcomes irrespective of age. Senior citizens have similarly good speech perception outcomes as adults younger than 65 years. Those with preoperative severe HL have better outcomes than profound loss. These finds are reassuring and can be used when counseling older cochlear implant candidates.

Symptoms: Dizziness and Deafness

Symptoms: Dizziness and Deafness

Cross-Modal Reorganization From Both Visual and Somatosensory Modalities in Cochlear Implanted Children and Its Relationship to Speech Perception.

We hypothesized that children with cochlear implants (CIs) who demonstrate cross-modal reorganization by vision also demonstrate cross-modal reorganization by somatosensation and that these processes are interrelated and impact speech perception. Cross-modal reorganization, which occurs when a deprived sensory modality's cortical resources are recruited by other intact modalities, has been proposed as a source of variability underlying speech perception in deaf children with CIs. Visual and somatosensory cross-modal reorganization of auditory cortex have been documented separately in CI children, but reorganization in these modalities has not been documented within the same subjects. Our goal was to examine the relationship between cross-modal reorganization from both visual and somatosensory modalities within a single group of CI children. We analyzed high-density electroencephalogram responses to visual and somatosensory stimuli and current density reconstruction of brain activity sources. Speech perception in noise testing was performed. Current density reconstruction patterns were analyzed within the entire subject group and across groups of CI children exhibiting good versus poor speech perception. Positive correlations between visual and somatosensory cross-modal reorganization suggested that neuroplasticity in different sensory systems may be interrelated. Furthermore, CI children with good speech perception did not show recruitment of frontal or auditory cortices during visual processing, unlike CI children with poor speech perception. Our results reflect changes in cortical resource allocation in pediatric CI users. Cross-modal recruitment of auditory and frontal cortices by vision, and cross-modal reorganization of auditory cortex by somatosensation, may underlie variability in speech and language outcomes in CI children.

Cochlear Implantation in Patients with Mitochondrial Gene Mutation: Decline in Speech Perception in Retrospective Long-Term Follow-Up Study.

Clinical evidence of the effectiveness of cochlear implantation for hearing loss with mitochondrial DNA mutation is limited. Most reports have only described short-term postoperative speech perception, which may not reflect the limitations of cochlear implantation caused by progressive retrocochlear dysfunction. The present study aimed to investigate long-term speech perception after cochlear implantation in patients with severe to profound hearing loss associated with mitochondrial DNA mutation. A retrospective chart review was performed on patients with mitochondrial DNA mutation who had undergone cochlear implantation at the Department of Otolaryngology and Head and Neck Surgery at the University of Tokyo Hospital. We extracted data on causative mutations, clinical types, clinical course, perioperative complications, and short-term and long-term postoperative speech perception. Nine patients with mitochondrial DNA mutation underwent cochlear implantation. The mean observation period was 5.5 ± 4.2 years (range, 1–13 years), and seven patients were followed for more than 3 years. Two of the seven patients who initially showed good speech perception exhibited deterioration during long-term follow-up. The absence of an acute progression of cognitive decline in patients, showing a gradual decrease in speech perception, suggests that the deterioration of speech perception was caused by progressive retrocochlear degeneration. Although most patients with mitochondrial DNA mutation maintained good speech perception for more than 3 years after cochlear implantation, retrocochlear degeneration could cause the deterioration of speech perception during long-term follow-up.

Clinical and Genetic Characteristics of Finnish Patients with Autosomal Recessive and Dominant Non-Syndromic Hearing Loss Due to Pathogenic TMC1 Variants.

Sensorineural hearing loss (SNHL) is one of the most common sensory deficits worldwide, and genetic factors contribute to at least 50–60% of the congenital hearing loss cases. The transmembrane channel-like protein 1 (TMC1) gene has been linked to autosomal recessive (DFNB7/11) and autosomal dominant (DFNA36) non-syndromic hearing loss, and it is a relatively common genetic cause of SNHL. Here, we report eight Finnish families with 11 affected family members with either recessively inherited homozygous or compound heterozygous TMC1 variants associated with congenital moderate-to-profound hearing loss, or a dominantly inherited heterozygous TMC1 variant associated with postlingual progressive hearing loss. We show that the TMC1 c.1534C>T, p.(Arg512*) variant is likely a founder variant that is enriched in the Finnish population. We describe a novel recessive disease-causing TMC1 c.968A>G, p.(Tyr323Cys) variant. We also show that individuals in this cohort who were diagnosed early and received timely hearing rehabilitation with hearing aids and cochlear implants (CI) have reached good speech perception in noise. Comparison of the genetic data with the outcome of CI rehabilitation increases our understanding of the extent to which underlying pathogenic gene variants explain the differences in CI rehabilitation outcomes.

Comparing Clinically Applicable Behavioral and Electrophysiological Measures of Speech Detection, Discrimination, and Comprehension.

Effective communication requires good speech perception abilities. Speech perception can be assessed with behavioral and electrophysiological methods. Relating these two types of measures to each other can provide a basis for new clinical tests. In audiological practice, speech detection and discrimination are routinely assessed, whereas comprehension-related aspects are ignored. The current study compared behavioral and electrophysiological measures of speech detection, discrimination, and comprehension. Thirty young normal-hearing native Danish speakers participated. All measurements were carried out with digits and stationary speech-shaped noise as the stimuli. The behavioral measures included speech detection thresholds (SDTs), speech recognition thresholds (SRTs), and speech comprehension scores (i.e., response times). For the electrophysiological measures, multichannel electroencephalography (EEG) recordings were performed. N100 and P300 responses were evoked using an active auditory oddball paradigm. N400 and Late Positive Complex (LPC) responses were evoked using a paradigm based on congruent and incongruent digit triplets, with the digits presented either all acoustically or first visually (digits 1-2) and then acoustically (digit 3). While no correlations between the SDTs and SRTs and the N100 and P300 responses were found, the response times were correlated with the EEG responses to the congruent and incongruent triplets. Furthermore, significant differences between the response times (but not EEG responses) obtained with auditory and visual-then-auditory stimulus presentation were observed. This pattern of results could reflect a faster recall mechanism when the first two digits are presented visually rather than acoustically. The visual-then-auditory condition may facilitate the assessment of comprehension-related processes in hard-of-hearing individuals.

Deep Learning-Based Speech Enhancement With a Loss Trading Off the Speech Distortion and the Noise Residue for Cochlear Implants.

The cochlea plays a key role in the transmission from acoustic vibration to neural stimulation upon which the brain perceives the sound. A cochlear implant (CI) is an auditory prosthesis to replace the damaged cochlear hair cells to achieve acoustic-to-neural conversion. However, the CI is a very coarse bionic imitation of the normal cochlea. The highly resolved time-frequency-intensity information transmitted by the normal cochlea, which is vital to high-quality auditory perception such as speech perception in challenging environments, cannot be guaranteed by CIs. Although CI recipients with state-of-the-art commercial CI devices achieve good speech perception in quiet backgrounds, they usually suffer from poor speech perception in noisy environments. Therefore, noise suppression or speech enhancement (SE) is one of the most important technologies for CI. In this study, we introduce recent progress in deep learning (DL), mostly neural networks (NN)-based SE front ends to CI, and discuss how the hearing properties of the CI recipients could be utilized to optimize the DL-based SE. In particular, different loss functions are introduced to supervise the NN training, and a set of objective and subjective experiments is presented. Results verify that the CI recipients are more sensitive to the residual noise than the SE-induced speech distortion, which has been common knowledge in CI research. Furthermore, speech reception threshold (SRT) in noise tests demonstrates that the intelligibility of the denoised speech can be significantly improved when the NN is trained with a loss function bias to more noise suppression than that with equal attention on noise residue and speech distortion.

Restoration of High Frequency Auditory Perception After Robot-Assisted or Manual Cochlear Implantation in Profoundly Deaf Adults Improves Speech Recognition.

Background and Purpose: Robot-assisted cochlear implantation has recently been implemented in clinical practice; however, its effect on hearing outcomes is unknown. The aim of this preliminary study was to evaluate hearing performance 1 year post-implantation whether the electrode array was inserted manually or assisted by a robot.Methods: Forty-two profoundly deaf adults were implanted either manually (n = 21) or assisted by a robot (RobOtol®, Collin, Bagneux, France) with three different electrode array types. Participants were paired by age, and electrode array type. The scalar position of the electrode array in the cochlea was assessed by 3D reconstruction from the pre- and post-implantation computed tomography. Pure-tone audiometry and speech perception in silence (percentage of disyllabic words at 60 dB) were tested on the implanted ear 1 year post-implantation in free-field conditions. The pure-tone average was calculated at 250–500–750 Hz, 500–1,000–2,000–3,000 Hz, and 3,000–4,000–8,000 Hz for low, mid, and high frequencies, respectively.Results: One year after cochlear implantation, restoration of the high-frequency thresholds was associated with better speech perception in silence, but not with low or mid frequencies (p < 0.0001; Adjusted R2 = 0.64, polynomial non-linear regression). Although array translocation was similar using either technique, the number of translocated electrodes was lower when the electrode arrays had been inserted with the assistance of the robot compared with manual insertion (p = 0.018; Fisher's exact test).Conclusion: The restoration of high-frequency thresholds (3,000–4,000–8,000 Hz) by cochlear implantation was associated with good speech perception in silence. The numbers of translocated electrodes were reduced after a robot-assisted insertion.

The effect of increased channel interaction on speech perception with cochlear implants

Cochlear implants (CIs) are neuroprostheses that partially restore hearing for people with severe-to-profound hearing loss. While CIs can provide good speech perception in quiet listening situations for many, they fail to do so in environments with interfering sounds for most listeners. Previous research suggests that this is due to detrimental interaction effects between CI electrode channels, limiting their function to convey frequency-specific information, but evidence is still scarce. In this study, an experimental manipulation called spectral blurring was used to increase channel interaction in CI listeners using Advanced Bionics devices with HiFocus 1J and MS electrode arrays to directly investigate its causal effect on speech perception. Instead of using a single electrode per channel as in standard CI processing, spectral blurring used up to 6 electrodes per channel simultaneously to increase the overlap between adjacent frequency channels as would occur in cases with severe channel interaction. Results demonstrated that this manipulation significantly degraded CI speech perception in quiet by 15% and speech reception thresholds in babble noise by 5 dB when all channels were blurred by a factor of 6. Importantly, when channel interaction was increased just on a subset of electrodes, speech scores were mostly unaffected and were only significantly degraded when the 5 most apical channels were blurred. These apical channels convey information up to 1 kHz at the apical end of the electrode array and are typically located at angular insertion depths of about 250 up to 500°. These results confirm and extend earlier findings indicating that CI speech perception may not benefit from deactivating individual channels along the array and that efforts should instead be directed towards reducing channel interaction per se and in particular for the most-apical electrodes. Hereby, causal methods such as spectral blurring could be used in future research to control channel interaction effects within listeners for evaluating compensation strategies.

Visual and Auditory Verbal Memory in Older Adults: Comparing Postlingually Deaf Cochlear Implant Users to Normal-Hearing Controls

Purpose The aim of this study was to test whether a group of older postlingually deafened cochlear implant users (OCIs) use similar verbal memory strategies to those used by older normal-hearing adults (ONHs). Verbal memory functioning was assessed in the visual and auditory modalities separately, enabling us to eliminate possible modality-based biases. Method Participants performed two separate visual and auditory verbal memory tasks. In each task, the visually or aurally presented study words were learned by vocal production (saying aloud) or by no production (reading silently or listening), followed by a free recall test. Twenty-seven older adults (> 60 years) participated (OCI = 13, ONH = 14), all of whom demonstrated intact cognitive abilities. All OCIs showed good open-set speech perception results in quiet. Results Both ONHs and OCIs showed production benefits (higher recall rates for vocalized than nonvocalized words) in the visual and auditory tasks. The ONHs showed similar production benefits in the visual and auditory tasks. The OCIs demonstrated a smaller production effect in the auditory task. Conclusions These results may indicate that different modality-specific memory strategies were used by the ONHs and the OCIs. The group differences in memory performance suggest that, even when deafness occurs after the completion of language acquisition, the reduced and distorted external auditory stimulation leads to a deterioration in the phonological representation of sounds. Possibly, this deterioration leads to a less efficient auditory long-term verbal memory.

Individual Hearing Preservation Cochlear Implantation Using the Concept of Partial Insertion.

Aim of this study was to evaluate the method of partial insertion of flexible lateral wall electrodes in patients with residual hearing and potential electric-acoustic stimulation (EAS) users. N = 6 patients with a high-frequency hearing loss were treated with a partial insertion using atraumatic lateral wall electrodes. In three cases, a electrode of 24 mm length was inserted with the aim to achieve a 16 mm insertion depth and in three cases a electrode of 28 mm length to achieve a 20 mm insertion depth. Differences between the pre- and postoperative unaided air-conducted pure tone thresholds in low frequencies (125 Hz-1.5 kHz) were analyzed. Freiburg monosyllables (FBM) at 65 dB and Hochmair-Desoyer sentence test in noise (10 dB SNR) were performed. The pre- and postoperative cochlea images were analyzed. Residual hearing could be preserved in all patients (n = 6) and is stable up to 6 months follow-up. All patients could use EAS with an average speech understanding score of 65% in monosyllables (FBM) and 76% in sentences in noise. All patients benefit significantly compared to the preoperative best aided situation. First results of patients treated with partially inserted atraumatic lateral wall electrodes show good hearing preservation rates and very good speech perception results in EAS. Partial insertion appears to be a method for an individualized cochlea implantation. In case of postoperative hearing loss the electrode can be further inserted, so the patients can benefit from deeper insertion using electric stimulation only equivalent to larger electrodes.

The relationship between behavioral language laterality, face laterality and language performance in left-handers.

Left-handers provide unique information about the relationship between cognitive functions because of their larger variability in hemispheric dominance. This study presents the laterality distribution of, correlations between and test-retest reliability of behavioral lateralized language tasks (speech production, reading and speech perception), face recognition tasks, handedness measures and language performance tests based on data from 98 left-handers. The results show that a behavioral test battery leads to percentages of (a)typical dominance that are similar to those found in neuropsychological studies even though the incidence of clear atypical lateralization (about 20%) may be overestimated at the group level. Significant correlations were found between the language tasks for both reaction time and accuracy lateralization indices. The degree of language laterality could however not be linked to face laterality, handedness or language performance. Finally, individuals were classified less consistently than expected as being typical, bilateral or atypical across all tasks. This may be due to the often good (speech production and perception tasks) but sometimes weak (reading and face tasks) test-retest reliabilities. The lack of highly reliable and valid test protocols for functions unrelated to speech remains one of the largest impediments for individual analysis and cross-task investigations in laterality research.

Acoustic environments that support equally accessible oral higher education as a human right

Purpose: People have the right to freedom of opinion and expression, as defined in Article 19 of the Universal Declaration of Human Rights. Higher education plays a major role in helping students to develop and express their own opinions and, therefore, should be equally accessible to all. This article focuses on how students judge the accessibility to oral instruction in higher education listening contexts.Method: We collected data from 191 students in higher education by means of a questionnaire, addressing understanding speech in different types of classrooms and various educational settings.Result: In lecture halls, understanding speech was judged to be significantly worse than in smaller classrooms. Two important negative factors were identified: background noise in classrooms and lecture halls and the non-use of a microphone.Conclusions: In lecture halls students achieve good or excellent speech perception only when lecturers are using a microphone. Nevertheless, this is not a standard practice. To achieve genuine inclusion in tertiary education programs, it is essential to remove acoustic barriers to understanding speech as much as possible. This study is a first step to identify communication facilitators to oral higher education instruction, for students with hearing loss or communication impairment.

Spectral integration of English speech for non-native English speakers.

When listening in noisy environments, good speech perception often relies on the ability to integrate cues distributed across disparate frequency regions. The present study evaluated this ability in non-native speakers of English. Native English-speaking and native Mandarin-speaking listeners who acquired English as their second language participated. English sentence recognition was evaluated in a two-stage procedure. First, the bandwidth associated with ∼15% correct was determined for a band centered on 500 Hz and a band centered at 2500 Hz. Performance was then evaluated for each band alone and both bands combined. Data indicated that non-natives needed significantly wider bandwidths than natives to achieve comparable performance with just the low or just the high band alone. Further, even when provided with wider bandwidth within each frequency region, non-natives were worse than natives at integrating information across bands. These data support the idea that greater bandwidth requirements and a reduced ability to integrate speech cues distributed across frequency may play an important role in the greater difficulty non-natives often experience when listening to English speech in noisy environments.

Functional Interplay Between the Putative Measures of Rostral and Caudal Efferent Regulation of Speech Perception in Noise.

Efferent modulation has been demonstrated to be very important for speech perception, especially in the presence of noise. We examined the functional relationship between two efferent systems: the rostral and caudal efferent pathways and their individual influences on speech perception in noise. Earlier studies have shown that these two efferent mechanisms were correlated with speech perception in noise. However, previously, these mechanisms were studied in isolation, and their functional relationship with each other was not investigated. We used a correlational design to study the relationship if any, between these two mechanisms in young and old normal hearing individuals. We recorded context-dependent brainstem encoding as an index of rostral efferent function and contralateral suppression of otoacoustic emissions as an index of caudal efferent function in groups with good and poor speech perception in noise. These efferent mechanisms were analysed for their relationship with each other and with speech perception in noise. We found that the two efferent mechanisms did not show any functional relationship. Interestingly, both the efferent mechanisms correlated with speech perception in noise and they even emerged as significant predictors. Based on the data, we posit that the two efferent mechanisms function relatively independently but with a common goal of fine-tuning the afferent input and refining auditory perception in degraded listening conditions.

Auditory and verbal memory predictors of spoken language skills in children with cochlear implants

BackgroundLarge variability in individual spoken language outcomes remains a persistent finding in the group of children with cochlear implants (CIs), particularly in their grammatical development. AimsIn the present study, we examined the extent of delay in lexical and morphosyntactic spoken language levels of children with CIs as compared to those of a normative sample of age-matched children with normal hearing. Furthermore, the predictive value of auditory and verbal memory factors in the spoken language performance of implanted children was analyzed. Methods & proceduresThirty-nine profoundly deaf children with CIs were assessed using a test battery including measures of lexical, grammatical, auditory and verbal memory tests. Furthermore, child-related demographic characteristics were taken into account. Outcomes & resultsThe majority of the children with CIs did not reach age-equivalent lexical and morphosyntactic language skills. Multiple linear regression analyses revealed that lexical spoken language performance in children with CIs was best predicted by age at testing, phoneme perception, and auditory word closure. The morphosyntactic language outcomes of the CI group were best predicted by lexicon, auditory word closure, and auditory memory for words. ConclusionsQualitatively good speech perception skills appear to be crucial for lexical and grammatical development in children with CIs. Furthermore, strongly developed vocabulary skills and verbal memory abilities predict morphosyntactic language skills.

Cochlear Implantation in Patients With Intracochlear and Intralabyrinthine Schwannomas.

Schwannomas may arise primarily within the inner ear, or invade the cochlea or labyrinth from the distal internal auditory canal through transmodiolar or transmacular extension, respectively. To date, very limited data exists regarding cochlear implant (CI) outcomes in this unique population. Retrospective case review. Ten ears (nine patients) with inner ear schwannomas that underwent CI at a single tertiary referral center. Cochlear implantation. Surgical approach, CI performance. Ten ears (nine patients) were implanted with conventional CI arrays. Three cases had primary inner ear schwannomas, while seven were in patients with neurofibromatosis type 2 (NF2) having transmodiolar invasion of the inner ear from a vestibular schwannoma (VS). In all cases, intracochlear tumor was left in situ to preserve cochlear anatomy and a full electrode insertion was achieved. Use of a styleted electrode with late deployment aided advancement through the intracochlear tumor. In all cases, the ipsilateral internal auditory canal and inner ear could be visualized on postoperative magnetic resonance imaging (MRI) for tumor surveillance. Eight ears achieved good open-set word recognition (median, Consonant-Nucleus-Consonant [CNC] 50% [range, 28-88%], median, AzBio 73% [range, 60-91%]); two patients with NF2 and prolonged deafness (15 and 22 years) received limited benefit. Cochlear implantation in patients with inner ear schwannomas and an intact cochlear nerve is feasible. Leaving intracochlear schwannoma in situ preserves cochlear architecture and use of a styleted electrode may aid in achieving a full insertion when obstructing tumor is present. Postoperative MRI surveillance is still adequate after CI and a high percentage of patients achieve good open-set speech perception performance.

Only Behavioral But Not Self-Report Measures of Speech Perception Correlate with Cognitive Abilities.

Good speech perception and communication skills in everyday life are crucial for participation and well-being, and are therefore an overarching aim of auditory rehabilitation. Both behavioral and self-report measures can be used to assess these skills. However, correlations between behavioral and self-report speech perception measures are often low. One possible explanation is that there is a mismatch between the specific situations used in the assessment of these skills in each method, and a more careful matching across situations might improve consistency of results. The role that cognition plays in specific speech situations may also be important for understanding communication, as speech perception tests vary in their cognitive demands. In this study, the role of executive function, working memory (WM) and attention in behavioral and self-report measures of speech perception was investigated. Thirty existing hearing aid users with mild-to-moderate hearing loss aged between 50 and 74 years completed a behavioral test battery with speech perception tests ranging from phoneme discrimination in modulated noise (easy) to words in multi-talker babble (medium) and keyword perception in a carrier sentence against a distractor voice (difficult). In addition, a self-report measure of aided communication, residual disability from the Glasgow Hearing Aid Benefit Profile, was obtained. Correlations between speech perception tests and self-report measures were higher when specific speech situations across both were matched. Cognition correlated with behavioral speech perception test results but not with self-report. Only the most difficult speech perception test, keyword perception in a carrier sentence with a competing distractor voice, engaged executive functions in addition to WM. In conclusion, any relationship between behavioral and self-report speech perception is not mediated by a shared correlation with cognition.