Enhanced hearing in noise for cochlear implant recipients: clinical trial results for a commercially available speech-enhancement strategy.

OBJECTIVE: To demonstrate benefits for speech perception and everyday listening in quiet and in noise with a speech-enhancement strategy called ClearVoice, which was designed to improve listening in complex acoustic environments without compromising hearing in quiet. STUDY DESIGN: A 2-week randomized crossover design was used to evaluate ClearVoice in 46 adults unilaterally implanted with a CII/HiRes 90K cochlear implant who had at least 6 months experience with HiRes Fidelity 120 sound processing. Speech perception was assessed using the AzBio sentences presented in quiet, in speech-spectrum noise and in multitalker babble. Subjective listening benefit and strategy preference were assessed with a questionnaire. ClearVoice has 3 gain settings (low, medium, and high), each intended as a full-time listening option according to individual preference. Speech understanding after acute use of ClearVoice-low was compared with HiRes Fidelity 120 during an initial test session. Speech perception abilities were compared with HiRes Fidelity 120 after 2 weeks of exclusive use of ClearVoice-medium, and after 2 weeks of exclusive use of ClearVoice-high. During a fifth week, participants were fit with 3 programs for comparison (HiRes Fidelity 120, ClearVoice-medium, and ClearVoice-high), after which, they reported preference and everyday listening benefits via a questionnaire. RESULTS: ClearVoice significantly improved speech understanding in speech-spectrum noise and multitalker babble, did not compromise listening in quiet, was preferred for everyday listening, and provided improved hearing in real-life situations. CONCLUSION: ClearVoice improves hearing in noise for cochlear implant recipients who use HiRes Fidelity 120 sound processing.