The Benefit of Remote and On-Ear Directional Microphone Technology Persists in the Presence of Visual Information.

BACKGROUND: Both the Roger remote microphone and on-ear, adaptive beamforming technologies (e.g., Phonak UltraZoom) have been shown to improve speech understanding in noise for cochlear implant (CI) listeners when tested in audio-only (A-only) test environments. PURPOSE: Our aim was to determine if adult and pediatric CI recipients benefited from these technologies in a more common environment-one in which both audio and visual cues were available and when overall performance was high. STUDY SAMPLE: Ten adult CI listeners (Experiment 1) and seven pediatric CI listeners (Experiment 2) were tested. DESIGN: Adults were tested in quiet and in two levels of noise (level 1 and level 2) in A-only and audio-visual (AV) environments. There were four device conditions: (1) an ear canal-level, omnidirectional microphone (T-mic) in quiet, (2) the T-mic in noise, (3) an adaptive directional mic (UltraZoom) in noise, and (4) a wireless, remote mic (Roger Pen) in noise. Pediatric listeners were tested in quiet and in level 1 noise in A-only and AV environments. The test conditions were: (1) a behind-the-ear level omnidirectional mic (processor mic) in quiet, (2) the processor mic in noise, (3) the T-mic in noise, and (4) the Roger Pen in noise. DATA COLLECTION AND ANALYSES: In each test condition, sentence understanding was assessed (percent correct) and ease of listening ratings were obtained. The sentence understanding data were entered into repeated-measures analyses of variance. RESULTS: For both adult and pediatric listeners in the AV test conditions in level 1 noise, performance with the Roger Pen was significantly higher than with the T-mic. For both populations, performance in level 1 noise with the Roger Pen approached the level of baseline performance in quiet. Ease of listening in noise was rated higher in the Roger Pen conditions than in the T-mic or processor mic conditions in both A-only and AV test conditions. CONCLUSION: The Roger remote mic and on-ear directional mic technologies benefit both speech understanding and ease of listening in a realistic laboratory test environment and are likely do the same in real-world listening environments.

AutoAdaptive: A Noise Level-Sensitive Beamformer for MED EL Cochlear Implant Patients.

BACKGROUND: When cochlear implant (CI) listeners use a directional microphone or beamformer system to improve speech understanding in noise, the gain in understanding for speech presented from the front of the listener coexists with a decrease in speech understanding from the back. One way to maximize the usefulness of these systems is to keep a microphone in the omnidirectional mode in low noise and then switch to directional mode in high noise. PURPOSE: The purpose of this experiment was to assess the levels of speech understanding in noise allowed by a new signal processing algorithm for MED EL CIs, AutoAdaptive, which operates in the manner described previously. RESEARCH DESIGN: Seven listeners fit with bilateral CIs were tested in a simulation of a crowded restaurant with speech presented from the front and from the back at three noise levels, 45, 55, and 65 dB SPL. DATA COLLECTION AND ANALYSIS: The listeners were seated in the middle of an array of eight loudspeakers. Sentences from the AzBio sentence lists were presented from loudspeakers at 0 or 180° azimuth. Restaurant noise at 45, 55, and 65 dB SPL was presented from all eight loudspeakers. The speech understanding scores (words correct) were subjected to a two-factor (speaker location and noise level), repeated measures, analysis of variance with posttests. RESULTS: The analysis of variance showed a main effect for level and location and a significant interaction. Posttests showed that speech understanding scores from front and back loudspeakers did not differ significantly at the 45- and 55-dB noise levels but did differ significantly at the 65-dB noise level-with increased scores for signals from the front and decreased scores for signals from the back. CONCLUSIONS: The AutoAdaptive feature provides omnidirectional benefit at low noise levels, i.e., similar levels of speech understanding for talkers in front of, and in back of, a listener and beamformer benefit at higher noise levels, i.e., increased speech understanding for signals from in front. The automatic switching feature will be of value to the many patients who prefer not to manually switch programs on their CIs.

The Sound Quality of Cochlear Implants: Studies With Single-sided Deaf Patients.

OBJECTIVE: The goal of the present study was to assess the sound quality of a cochlear implant for single-sided deaf (SSD) patients fit with a cochlear implant (CI). BACKGROUND: One of the fundamental, unanswered questions in CI research is "what does an implant sound like?" Conventional CI patients must use the memory of a clean signal, often decades old, to judge the sound quality of their CIs. In contrast, SSD-CI patients can rate the similarity of a clean signal presented to the CI ear and candidate, CI-like signals presented to the ear with normal hearing. METHODS: For Experiment 1 four types of stimuli were created for presentation to the normal hearing ear: noise vocoded signals, sine vocoded signals, frequency shifted, sine vocoded signals and band-pass filtered, natural speech signals. Listeners rated the similarity of these signals to unmodified signals sent to the CI on a scale of 0 to 10 with 10 being a complete match to the CI signal. For Experiment 2 multitrack signal mixing was used to create natural speech signals that varied along multiple dimensions. RESULTS: In Experiment 1 for eight adult SSD-CI listeners, the best median similarity rating to the sound of the CI for noise vocoded signals was 1.9; for sine vocoded signals 2.9; for frequency upshifted signals, 1.9; and for band pass filtered signals, 5.5. In Experiment 2 for three young listeners, combinations of band pass filtering and spectral smearing lead to ratings of 10. CONCLUSION: The sound quality of noise and sine vocoders does not generally correspond to the sound quality of cochlear implants fit to SSD patients. Our preliminary conclusion is that natural speech signals that have been muffled to one degree or another by band pass filtering and/or spectral smearing provide a close, but incomplete, match to CI sound quality for some patients.

Experiments on Auditory-Visual Perception of Sentences by Users of Unilateral, Bimodal, and Bilateral Cochlear Implants.

Purpose: Five experiments probed auditory-visual (AV) understanding of sentences by users of cochlear implants (CIs). Method: Sentence material was presented in auditory (A), visual (V), and AV test conditions to listeners with normal hearing and CI users. Results: (a) Most CI users report that most of the time, they have access to both A and V information when listening to speech. (b) CI users did not achieve better scores on a task of speechreading than did listeners with normal hearing. (c) Sentences that are easy to speechread provided 12 percentage points more gain to speech understanding than did sentences that were difficult. (d) Ease of speechreading for sentences is related to phrase familiarity. (e) Users of bimodal CIs benefit from low-frequency acoustic hearing even when V cues are available, and a second CI adds to the benefit of a single CI when V cues are available. (f) V information facilitates lexical segmentation by improving the recognition of the number of syllables produced and the relative strength of these syllables. Conclusions: Our data are consistent with the view that V information improves CI users' ability to identify syllables in the acoustic stream and to recognize their relative juxtaposed strengths. Enhanced syllable resolution allows better identification of word onsets, which, when combined with place-of-articulation information from visible consonants, improves lexical access.