Significant Improvement In Speech Perception Research Articles

Single-Sided Deafness and Hearing Rehabilitation Modalities: Contralateral Routing of Signal Devices, Bone Conduction Devices, and Cochlear Implants.

Single sided deafness (SSD) is characterized by significant sensorineural hearing loss, severe or profound, in only one ear. SSD adversely affects various aspects of auditory perception, including causing impairment in sound localization, difficulties with speech comprehension in noisy environments, and decreased spatial awareness, resulting in a significant decline in overall quality of life (QoL). Several treatment options are available for SSD, including cochlear implants (CI), contralateral routing of signal (CROS), and bone conduction devices (BCD). The lack of consensus on outcome domains and measurement tools complicates treatment comparisons and decision-making. This narrative overview aims to summarize the treatment options available for SSD in adult and pediatric populations, discussing their respective advantages and disadvantages. Rerouting devices (CROS and BCD) attenuate the effects of head shadow and improve sound awareness and signal-to-noise ratio in the affected ear; however, they cannot restore binaural hearing. CROS devices, being non-implantable, are the least invasive option. Cochlear implantation is the only strategy that can restore binaural hearing, delivering significant improvements in speech perception, spatial localization, tinnitus control, and overall QoL. Comprehensive preoperative counseling, including a discussion of alternative technologies, implications of no treatment, expectations, and auditory training, is critical to optimizing therapeutic outcomes.

Cognitive function in older adults with hearing loss; outcomes for treated versus untreated groups at 3‐year follow‐up.

AbstractBackgroundHearing loss has been identified as the largest potentially modifiable risk factor for dementia and affects 50% adults aged 50‐64 years, and 70% aged 70 years and older. The quality of evidence the effect of hearing aid use on cognition in older adults is currently poor due to methodological limitations. Few studies have objectively studied these outcomes beyond 6‐12 months. This prospective longitudinal observational cohort study investigated the effects of hearing aid use on cognitive performance in older adults over 3 years.Method183 first‐time hearing aid users aged 60 years and older with mild to severe hearing loss were assessed using gold standard measures before hearing aid fitting, with subsets of this group re‐assessed after 18 and 36 months as they reached these timepoints. Outcomes for the treatment group were compared with those of participants of a large longitudinal cohort study of community‐living older adults (AIBL) using the same measures. Objective assessment measures included cognitive function, hearing loss, hearing aid use, genetic phenotyping, and speech perception. Subjective measures included hearing disability, mood, quality of life, social isolation, and loneliness.ResultThe treatment group showed good hearing aid compliance, significant improvement in speech perception (quiet and noise) and decreased self‐reported listening disability despite further significant hearing loss over the 3‐year follow‐up. There was significant improvement in cognitive performance from baseline for the treatment group versus the comparative group for working memory, attention, psychomotor function, and visual learning. Comparatively, AIBL participants showed statistically significant decline across all cognitive functions.ConclusionOlder adults with untreated hearing loss are expected to decline cognitively at 2‐5 times the rate of adults without hearing loss. Comparatively, cognitive performance in treated participants in this study instead improved after 3 years of hearing aid use, while the comparative group declined. These results suggest that treatment of hearing loss with hearing aids may delay cognitive decline.

Efficacy of Bilateral Cochlear Implantation in Pediatric and Adult Patients with Profound Sensorineural Hearing Loss: A Retrospective Analysis in a Developing European Country.

This retrospective study aimed to evaluate the outcomes of bilateral cochlear implantation in patients with severe-to-profound sensorineural hearing loss at the Timisoara Municipal Emergency Clinical Hospital ENT Clinic. The study involved 77 participants, divided into four groups based on their hearing loss characteristics and implantation history. Assessments were conducted pre- and post-implantation, focusing on speech perception, speech production, and reading achievement. Standard surgical procedures were performed, and participants were provided with a comprehensive rehabilitation program involving auditory training and communication therapy. The variables considered for analysis included demographic factors, implantation period, and quality of life assessment, with no statistically significant differences pre-implantation between the four study groups. Results revealed significant improvements in speech perception, speech production, and reading achievement after cochlear implantation. In adult patients, speech perception scores increased from 21.3% to 73.4% for WIPI and from 22.7% to 68.4% for HINT after 12 months of rehabilitation. Speech production scores improved from 33.5% to 76.8% and reading achievement scores increased from 76.2 to 106.3. Moreover, there was a significant improvement in patients' quality of life following cochlear implantation, with mean scores increasing from 2.0 to 4.2. Although it is known that bilateral cochlear implantation significantly improves speech perception, speech production, reading achievement, and quality of life in patients with severe-to-profound sensorineural hearing loss, this is the first study of its kind from Romania. Further research is warranted to optimize patient selection and rehabilitation strategies to maximize outcomes and determine better policies towards funding and access of cochlear implants for a wider range of patients in need.

Speech Perception in Noise and Sound Localization for Cochlear Implant With Single-Sided Deafness Compared With Contralateral Routing of Signal Hearing Aids.

Cochlear implantation (CI) for the treatment of single-sided deafness (SSD) is a relatively new treatment modality. Although comparing the effectiveness of CI and contralateral routing of signal (CROS) hearing aids (HAs) is important, very few reports on this topic exist. In this study, objective assessments and subjective assessments were conducted to determine which SSD individuals would prefer CI or CROS HAs. Objective assessments (speech perception and sound localization) and subjective assessments (Hearing Handicap Inventory for Adults (HHIA), Abbreviated Profile of Hearing Aid Benefit (APHAB), MOS Short-Form 36-Item Health Survey version 2 (SF-36v2)) were performed on 87 SSD patients. Of the 87 SSD patients, 33 patients hoped for CROS HAs, and 17 patients hoped for CI. The CI group underwent subjective and objective assessments at 6 and 12 months postoperatively. The CROS HAs group underwent objective assessments at 1 month after wearing CROS HAs. After the intervention, the localization ability was significantly improved in the CI group (p < 0.05) with no significant improvement in that of the CROS HAs group (p = 0.48). No significant improvement in speech perception in noise was observed in the CROS (Signal-to-Noise ratio + 10, p = 0.08; SN + 0, p = 0.17); however, a significant improvement in the CI group was observed at 12 months postoperatively. The APHAB subscale "background noise" and SF-36v2 health concepts of role-physical, general health, vitality, role-emotional, and mental health were significantly higher in the CI group. CI was superior to CROS HAs in speech perception in terms of noise and sound localization. Patients with postlingual acute-onset hearing loss and more handicaps and a more positive view of their hearing loss possibly tend to choose CI.

Effects of an evidence-based model for cochlear implant aftercare delivery on clinical efficiency and patient outcomes

Objectives To assess an evidence-based model (EBM) approach to cochlear implant (CI) aftercare that includes a modified, reduced treatment schedule for newly-implanted adult CI recipients consisting of four appointments (initial activation, 1-, 3- and 6- months postactivation) in the first year post-surgery. Method This prospective multicenter proof-of-concept study was conducted across three clinics in the United States by five experienced CI clinicians. Seventeen newly-implanted adult patients with postlingual hearing loss enrolled in the study. Hearing outcomes were measured using objective speech testing and subjective self-report measures. Results Most recipients (14/17; 82%) were able to follow the four-appointment EBM schedule. The reduced number of visits translated into an average time savings of 3 hours per patient. Significant improvements in speech perception were observed at both 3- and 6-months postactivation, as measured by CNC words in quiet and AzBio sentences at +10 dB SNR, consistent with published results achieved by traditional practices. Recipients were significantly satisfied with telephone, music, small group conversation, and television listening at 6 months postactivation. Recipient satisfaction with overall service was rated as ”excellent” by 14/14 (100%) respondents. Conclusion The four-appointment EBM approach delivered efficient and effective audiological aftercare to CI recipients in the first year following CI implantation.

Evaluation of outcome of cochlear implanted children after 2 years of rehabilitation in Alexandria: a retrospective study

BackgroundCochlear implantation (CI) is an electronic hearing device that is surgically implanted to bypass damaged portions of the ear and directly stimulate the auditory nerve. Nowadays, CI prospects for children with profound hearing loss (HL) have been significantly improved. Now, most implanted children can expect similar audiological outcomes to those with moderate to severe HL with aids depending on the time of loss and cognitive function.AimThis study aimed at assessing the progress in all aspects of language acquisition and the effect of various factors on the outcome of cochlear implantation in children undergoing auditory training for at least 2 years after surgery.ResultsThe results showed the effectiveness of early implantation in terms of improvement in linguistic skills, indicated by significant change of language age scores when compared before and after surgery (median age 1.167 years to 4.75 years with p value < 0.0001). Significant improvement in degree of hearing level (HL median from 100 dB to 25 with p value < 0.0001), in addition to its effect on improving the general IQ (mean from 82.42 ± 9.46 to 88.61 ± 8.13 with p value = 0.006) and abstract IQ scores (mean from 83.48 ± 9.81 to 94.45 ± 10.41 with p value = 0.0001).ConclusionCI children showed significant improvement in speech perception, auditory skills, and IQ scores as well as receptive and expressive language after CI denoted by the improvement of language age. Significant improvement was found in early implantation age (under 2 years) in the postoperative degree of hearing level and in language test scores in comparison to older aged children.

How Does a Face Mask Impact Speech Perception?

Face masks are mandatory during the COVID-19 pandemic, leading to attenuation of sound energy and loss of visual cues which are important for communication. This study explores how a face mask affects speech performance for individuals with and without hearing loss. Four video recordings (a female speaker with and without a face mask and a male speaker with and without a face mask) were used to examine individuals’ speech performance. The participants completed a listen-and-repeat task while watching four types of video recordings. Acoustic characteristics of speech signals based on mask type (no mask, surgical, and N95) were also examined. The availability of visual cues was beneficial for speech understanding—both groups showed significant improvements in speech perception when they were able to see the speaker without the mask. However, when the speakers were wearing the mask, no statistical significance was observed between no visual cues and visual cues conditions. Findings of the study demonstrate that provision of visual cues is beneficial for speech perception for individuals with normal hearing and hearing impairment. This study adds value to the importance of the use of communication strategies during the pandemic where visual information is lost due to the face mask.

Cochlear Implantation in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis.

To determine the clinical outcomes of adult patients with single-sided deafness (SSD) undergoing ipsilateral cochlear implantation. An electronic search of Medline and Embase articles. A systematic review was performed with a search strategy developed by a licensed librarian to identify studies of adult patients with SSD who underwent ipsilateral cochlear implantation. Articles were managed in Covidence and evaluated by 2 independent reviewers. Risk of bias was assessed and data were extracted, including patient demographics, etiology of deafness, duration of deafness, and postoperative change in speech recognition, tinnitus, sound localization, and quality of life (QoL). A meta-analysis was performed, and pooled mean differences were calculated for each outcome of interest via random effects models by each outcome, as well as subgroup analyses by the individual clinical score used. Of 2309 studies identified, 185 full texts were evaluated, and 50 were ultimately included involving 674 patients. Speech perception scores in quiet and noise, tinnitus control, sound localization, and QoL all significantly improved after implantation. Pooled outcomes demonstrated score improvements in speech perception (standardized mean difference [SMD], 2.8 [95% CI, 2.16-3.43]), QoL (SMD, 0.68 [95% CI, 0.45-0.91]), sound localization (SMD, -1.13 [95% CI, -1.68 to -0.57]), and tinnitus score reduction (SMD, -1.32 [95% CI, -1.85 to -0.80]). Cochlear implantation in adults with SSD results in significant improvements in speech perception, tinnitus control, sound localization, and QoL.

Review of Speech Outcomes in Cochlear Implant Recipients at a Nascent Cochlear Implant Program.

Introduction: The use of cochlear implantation to rehabilitate moderate to profound sensorineural hearing loss has become more widespread; however, the adult utilization rate of cochlear implant candidates is still very less. The study aims to examine the percentage of adult patients in a heterogeneous group of cochlear implant recipients at a nascent cochlear implant program who demonstrate improvements in speech outcomes.Methods: Speech outcome scores were assessed preoperatively and postoperatively at three, six, and 12-month intervals using consonant-nucleus-consonant (CNC) words and AzBio sentences in quiet. Mean speech outcome scores at each time point and binomial distribution tables with 95% CI were used to assess individual improvement in speech understanding.Results: 45 patients underwent a total of 49 cochlear implantation surgeries. The mean age at surgery was 62 years. The mean preoperative CNC score in the ear to be implanted was 18%±18, while the mean postoperative CNC score at three, six, and 12 months was 35%±21, 44%±23, and 45%±25, respectively. The mean preoperative AzBio score in the ear to be implanted was 22%±26 while the mean postoperative AzBio score at three, six, and 12 months was 50%±29, 56%±27, and 63%±26, respectively. Of the implantations, 74% (32 of 43) and 69% (22 of 32) showed significant improvement at six months or one year using AzBio and CNC binomial distribution tables, respectively.Conclusions: Findings demonstrate significant improvements in speech perception following cochlear implantation for patients not benefiting from hearing aid aural rehabilitation. The study provides realistic expectations for new and emerging programs hoping to demonstrate cochlear implant utility for improving patients’ speech outcomes.

Cochlear Implantation and Perioperative Management in Autoimmune Inner Ear Disease: A Systematic Review and Meta-Analysis.

To assess outcomes in autoimmune inner ear disease (AIED) after cochlear implantation (CI) through systematic review and meta-analysis. PubMed, MedLine, Embase, and CINAHL. Databases were queried for inclusion of AIED patients who underwent CI with outcomes recorded ≥3 months postoperatively. We examined demographics, pure-tone average (PTA), speech perception, preoperative imaging, intraoperative management, and postoperative complications. Twenty-six articles encompassing 124 patients met inclusion criteria. Mean implantation age was 26.2 years (range 4-65 years) with average length of follow-up at 28.2 months (range 3-120 months). Meta-analysis demonstrated significant improvement in speech perception following CI. There was a statistically significant improvement in speech recognition score (SRS) (standard mean difference [SMD] = 6.5, 95% confidence interval [CI], 4.8-8.0, P < 0.0001) as well as word recognition score (WRS) (SMD = 5.5, 95% CI, 4.2-6.8, P < 0.0001) after CI. Anomalous preoperative radiologic manifestations were reported by 57.7% (15/26) studies. Disease activity-related intraoperative adjustment was noted in 57.7% (15/26) studies; common consequences were cochlear drill-out (53.3%), difficult round window insertion (26.7%), and scala vestibuli insertion (26.7%). Frequent postoperative complications noted in 26.9% (7/26) studies included systemic AIED flares (71.4%) and wound healing delay (42.9%). Findings of this systematic review of AIED cochlear implant literature demonstrate a lack of consistent reporting standards for PTA and speech perception as well as a lack of long-term follow-up. Despite these findings, meta-analysis suggests that CI is a viable treatment for improving speech perception in AIED patients.

Cochlear Implantation in Pediatric Patients With Enlarged Vestibular Aqueduct: A Systematic Review

To describe cochlear implantation (CI) outcomes, with speech perception, auditory, language, and parent-reported auditory and speech behaviors, in children with an enlarged vestibular aqueduct (EVA) and incomplete partition type 2 (IP-II) and compare to control children without inner ear malformations (IEMs) and to determine cerebrospinal fluid gusher rates and effect on outcomes. Systematic review and meta-analysis. MEDLINE, Embase, Cochrane, and CINAHL databases were searched from inception to February 2020. Studies reporting relevant outcomes in children with EVA or EVA + IP-II and controls without IEMs undergoing CI were included. Mean differences in speech perception, auditory, and language scores between cases and controls were meta-analyzed. Gusher rates were determined by proportion meta-analyses. Of 214 identified articles, 42 met inclusion criteria, evaluating 775 cases and 2,191 controls. Of -cases, 578 (74.6%) had EVA and 197 (25.4%) had EVA + IP-II. Cases showed a significant improvement in speech perception, auditory and language performance, comparable to controls. Parent-reported auditory and speech production behaviors outcomes were positive among cases and comparable to controls. Pooled gusher proportions in EVA and EVA + IP-II cases were 27.7% (95% CI: 17.6-39.1) and 48.6% (95% CI: 28.6-69.0), respectively, with a proportion difference of 20.9% (95% CI: 11.0-30.1). Gusher occurrence did not impact speech perception or language outcomes. Outcomes in children with EVA or EVA + IP-II undergoing CI are favorable and largely comparable to outcomes in children with hearing loss undergoing CI without IEMs. Intraoperative gusher is more prevalent among children with EVA + IP-II as compared to iEVA. Gusher does not influence speech perception and language development outcomes. NA Laryngoscope, 132:1459-1472, 2022.

Hearing aid use and cognition in older adults: Can we delay decline or even improve cognitive function?

AbstractBackgroundHearing loss is associated with accelerated cognitive decline in older adults, and has been identified as a modifiable risk factor for dementia. Although hearing aids are a successful treatment for hearing loss, it is unknown whether hearing aid use can delay the onset of cognitive decline or improve cognitive function in older adults with hearing loss. This prospective longitudinal study is investigating the effect of hearing aid use on cognitive decline and addresses many of the methodological limitations of previous studies.MethodPatients are recruited from the University of Melbourne Academic Hearing Aids Audiology Clinic and assessed before and every 18 months after hearing aid fitting. When numbers are sufficient, results will be compared with those of a control group of approximately 400 participants of a cohort study of ageing in older adults. Assessments include cognitive function (visually presented computerised assessment battery), hearing, speech perception, quality of life, activity, diet, loneliness and isolation, anxiety, depression, medical health and genetic risk.ResultAt baseline, multiple linear regression for 98 participants (62‐82 years), controlling for age, gender, cardiovascular conditions, education, and working/retired, with mean better ear PTA 31dB showed hearing loss and age predicted significantly poorer executive function, while tertiary education predicted significantly better executive function and visual learning. At 18‐month follow up, results for a subset of participants showed significant improvements in speech perception, listening disability and quality of life. Group mean scores across the cognitive assessment battery showed no significant decline and executive function was significantly improved. There was either clinically significant improvement or stability for executive function for over 97% of the subset, and for females for working memory, visual learning and visual attention, despite significantly greater hearing loss over this period.ConclusionDespite a small initial sample size, hearing loss, age and education significantly predicted baseline cognitive function. At 18‐month follow up, the majority of participants had either remained stable or demonstrated a meaningful clinical improvement in cognitive function, with significant group mean improvements for executive function and working memory. Treatment of hearing loss with hearing aids may delay cognitive decline. These are initial results, and further follow up is required.

Benefits of a Hearing Registry: Cochlear Implant Candidacy in Quiet Versus Noise in 1,611 Patients.

Purpose This retrospective study used a cochlear implant registry to determine how performing speech recognition candidacy testing in quiet versus noise influenced patient selection, speech recognition, and self-report outcomes. Method Database queries identified 1,611 cochlear implant recipients who were divided into three implant candidacy qualifying groups based on preoperative speech perception scores (≤ 40% correct) on the AzBio sentence test: quiet qualifying group, +10 dB SNR qualifying group, and +5 dB SNR qualifying group. These groups were evaluated for demographic and preoperative hearing characteristics. Repeated-measures analysis of variance was used to compare pre- and postoperative performance on the AzBio in quiet and noise with qualifying group as a between-subjects factor. For a subset of recipients, pre- to postoperative changes on the Speech, Spatial and Qualities of Hearing Scale were also evaluated. Results Of the 1,611 patients identified as cochlear implant candidates, 63% of recipients qualified in quiet, 10% qualified in a +10 dB SNR, and 27% qualified in a +5 dB SNR. Postoperative speech perception scores in quiet and noise significantly improved for all qualifying groups. Across qualifying groups, the greatest speech perception improvements were observed when tested in the same qualifying listening condition. For a subset of patients, the total Speech, Spatial and Qualities of Hearing Scale ratings improved significantly as well. Conclusion Patients who qualified for cochlear implantation in quiet or background noise test conditions showed significant improvement in speech perception and quality of life scores, especially when the qualifying noise condition was used to track performance.

Restoration of cortical symmetry and binaural function: Cortical auditory evoked responses in adult cochlear implant users with single sided deafness.

BackgroundCochlear implantation for single-sided deafness (SSD) is the only treatment option with the potential to restore binaural hearing cues. Significant binaural benefit has been measured in adults by speech in noise and localisation tests, who receive a cochlear implant for SSD, however, little is known on the cortical changes that help provide this benefit. In the present study, detection of sound in the auditory cortex, speech testing and localisation was used to investigate the ability of a cochlear implant (CI) to restore auditory cortical latencies and improve binaural benefit in the adult SSD population.MethodsTwenty-nine adults with acquired single-sided deafness who received a CI in adulthood were studied. Speech perception in noise was tested using the Bamford-Kowal-Bench speech-in-noise test, localisation ability was measured using the auditory speech sounds evaluation (AδE) localisation test and cortical auditory evoked responses, comparing N1-P2 latencies recorded from the normal hearing ear and cochlear implant were used to investigate the synchrony of the cortical pathway from the CI and normal hearing ear (NHe) with binaural hearing function.ResultsThere was a significant improvement in speech perception in noise in all spatial configurations S0/N0 (Z = -3.066, p<0.002), S0/NHE (Z = -4.031, p<0.001), SCI/NHE (Z = -3.851, p<0.001). Localization significantly improved when tested with the cochlear implant on (p<0.001) with a shorter duration of deafness correlating to a greater improvement in localisation ability F(1:18) = 6.854; p = 0.017). There was no significant difference in N1-P2 latency recorded from the normal hearing ear and the CI.ConclusionCortical auditory evoked response latencies recorded from the CI and NHe showed no significant difference, indicating that the detection of sound in the auditory cortex occurred simultaneously, providing the cortex with auditory information for binaural hearing.

Temporal cues from visual information benefit speech perception in noise

Speech perception in noise is a challenge for older adults and listeners with hearing loss. It is also challenging for a subset of listeners with normal hearing thresholds. One way to improve performance in noisy settings is to provide visual information of the talker. The current study examines what aspects of this visual input are necessary to receive an audio-visual benefit. To test the hypothesis that a visual analogue of the speech amplitude envelope aids speech comprehension, speech sentences in babble noises, with or without visual stimuli, were presented to listeners. In this case, the visual analogue was a sphere that varies based on normal, mismatched, and reversed relation to the amplitude envelope of the speech signal. Even when the audio-visual correlation is reversed (higher amplitude = smaller volumes), a significant improvement in speech perception in the auditory-visual condition versus the audio-only condition was gained even though no visual representation of phonetic information was available. These results provide strong evidence that the amplitude envelope can be inferred from visual displays and can be integrated online in speech perception. This study has implications for potential technological enhancements to speech perception with hearing devices – in particular, the integration of a non-auditory signal.

The cognitive and psychosocial effects of auditory training and hearing aids in adults with hearing loss.

PurposeOur study assessed the efficacy of the simultaneous use of hearing aids and auditory training for improving cognition and psychosocial function in adults with hearing loss, and the relationships between hearing loss, speech perception and cognition.Participants and methodsA 40-person (aged 50–90 years) pilot study in Melbourne, Australia, was conducted. Participants with hearing impairment completed the Geriatric Depression Scale-Short Form, questions about social activity participation, a wide range of cognitive tasks and a speech perception test at baseline, 3 and 6 months. Participants underwent auditory training for 6 months and used hearing aids for 3 months.ResultsCorrelations and structural equation modeling suggested that several cognitive domains were associated with speech perception at baseline, but only the Incongruent Stroop cognition measure was associated with hearing loss. Hearing aid use reduced problems with communication, but there were no significant improvements in speech perception, social interaction or cognition. The effect of hearing aids and auditory training for improving depressive symptoms was significant with a moderate to large effect size (Cohen’s d=0.87).ConclusionThe small sample size and a relatively high rate of attrition meant that this study was underpowered. However, baseline results suggested relationships between hearing loss, speech perception and cognition, and the hearing intervention provided evidence of reduced depressive symptoms. A full-scale, randomized hearing loss intervention and a longer neuroim-aging study with cognitive outcomes measured in the short term as well as after several years of hearing aid use are needed.

Wireless binaural hearing aid technology for telephone use and listening in wind noise

Objective: To assess the speech perception benefits of binaural streaming technology for bilateral hearing aid users in two difficult listening conditions.Design: Two studies were conducted to compare hearing aid processing features relating to telephone use and wind noise. Speech perception testing was conducted in four different experimental conditions in each study.Study sample: Ten bilaterally-aided children in each study.Results: Significant improvements in speech perception were obtained with a wireless feature for telephone use. Significant speech perception benefits were also obtained with wireless hearing aid features when listening to speech in simulated wind noise.Conclusions: Binaural signal processing algorithms can significantly improve speech perception for bilateral hearing aid users in challenging listening situations.

Electric and Acoustic Stimulation in Cochlear Implant Recipients with Hearing Preservation.

Hearing loss affects 30 million people in the United States, and a subset of these patients have normal low-frequency hearing and ski-sloped high-frequency hearing loss. For these patients, hearing aids alone may not provide adequate benefit. Cochlear implantation alone has been utilized to improve speech perception. The addition of high-frequency electric hearing to low-frequency acoustic hearing in these patients is beneficial. Technical improvements have allowed preservation of low-frequency hearing in cochlear implant recipients, allowing for electric and acoustic stimulation in the same ear with significant improvements in speech perception, sound localization, music appreciation, and quality of life.

Auditory and language development in Mandarin-speaking children after cochlear implantation

ObjectiveTo evaluate early auditory performance, speech perception and language skills in Mandarin-speaking prelingual deaf children in the first two years after they received a cochlear implant (CI) and analyse the effects of possible associated factors. MethodsThe Infant-Toddler Meaningful Auditory Integration Scale (ITMAIS)/Meaningful Auditory Integration Scale (MAIS), Mandarin Early Speech Perception (MESP) test and Putonghua Communicative Development Inventory (PCDI) were used to assess auditory and language outcomes in 132 Mandarin-speaking children pre- and post-implantation. ResultsChildren with CIs exhibited an ITMAIS/MAIS and PCDI developmental trajectory similar to that of children with normal hearing. The increased number of participants who achieved MESP categories 1–6 at each test interval showed a significant improvement in speech perception by paediatric CI recipients. Age at implantation and socioeconomic status were consistently associated with both auditory and language outcomes in the first two years post-implantation. ConclusionMandarin-speaking children with CIs exhibit significant improvements in early auditory and language development. Though these improvements followed the normative developmental trajectories, they still exhibited a gap compared with normative values. Earlier implantation and higher socioeconomic status are consistent predictors of greater auditory and language skills in the early stage.

Fixed and adaptive beamforming improves speech perception in noise in cochlear implant recipients equipped with the MED-EL SONNET audio processor.

ObjectiveTo determine the impact of the fixed and adaptive beamforming technology of the new MED-EL SONNET cochlear implant audio processor on speech perception in noise.MethodsThe study cohort comprises 18 postlingually deafened adult cochlear implant recipients with at least six months of experience. Speech reception thresholds were measured with the Oldenburg Sentence Test in continuous, speech-shaped noise. Target sentences were presented in front of the listener, with noise sources placed at -135° and 135°, respectively. Outcome measures were the differences in speech reception threshold using omnidirectional, fixed and adaptive beamformer microphone settings.ResultsThe use of directional microphones significantly improved speech reception thresholds: fixed beamformer vs. omnidirectional: 4.3 dB (95%-CI [3.1; 5.5]), p<0.0001; adaptive beamformer vs. omnidirectional: 6.1 dB (95%-CI [4.9; 7.3]), p<0.0001; and adaptive beamformer vs. fixed beamformer: 1.8 dB (95%-CI [0.7; 3.0]), p = 0.001.ConclusionThis study confirms the previously reported improvements in speech perception in noise of the fixed beamformer microphone setting and is the first to report significant improvements in speech perception in noise when applying the adaptive beamformer microphone settings of the SONNET audio processor. Cochlear implant users may be able to benefit from improved hearing performance especially in difficult listening situations.