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1.
J Acoust Soc Am ; 138(4): 2350-8, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26520316

RESUMO

This study revisits the issue of the spectral ripple resolution abilities of cochlear implant (CI) users. The spectral ripple resolution of recently implanted CI recipients (implanted during the last 10 years) were compared to those of CI recipients implanted 15 to 20 years ago, as well as those of normal-hearing and hearing-impaired listeners from previously published data from Henry, Turner, and Behrens [J. Acoust. Soc. Am. 118, 1111-1121 (2005)]. More recently, implanted CI recipients showed significantly better spectral ripple resolution. There is no significant difference in spectral ripple resolution for these recently implanted subjects compared to hearing-impaired (acoustic) listeners. The more recently implanted CI users had significantly better pre-operative speech perception than previously reported CI users. These better pre-operative speech perception scores in CI users from the current study may be related to better performance on the spectral ripple discrimination task; however, other possible factors such as improvements in internal and external devices cannot be excluded.


Assuntos
Implantes Cocleares , Percepção da Fala , Adulto , Idoso , Limiar Auditivo , Desenho de Equipamento , Feminino , Perda Auditiva Neurossensorial/psicologia , Perda Auditiva Neurossensorial/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Ruído , Fonética , Fatores de Tempo , Adulto Jovem
2.
Ear Hear ; 36(6): 723-32, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26295607

RESUMO

OBJECTIVES: Nucleus Hybrid Cochlear Implant (CI) users hear low-frequency sounds via acoustic stimulation and high-frequency sounds via electrical stimulation. This within-subject study compares three different methods of coordinating programming of the acoustic and electrical components of the Hybrid device. Speech perception and cortical auditory evoked potentials (CAEP) were used to assess differences in outcome. The goals of this study were to determine whether (1) the evoked potential measures could predict which programming strategy resulted in better outcome on the speech perception task or was preferred by the listener, and (2) CAEPs could be used to predict which subjects benefitted most from having access to the electrical signal provided by the Hybrid implant. DESIGN: CAEPs were recorded from 10 Nucleus Hybrid CI users. Study participants were tested using three different experimental processor programs (MAPs) that differed in terms of how much overlap there was between the range of frequencies processed by the acoustic component of the Hybrid device and range of frequencies processed by the electrical component. The study design included allowing participants to acclimatize for a period of up to 4 weeks with each experimental program prior to speech perception and evoked potential testing. Performance using the experimental MAPs was assessed using both a closed-set consonant recognition task and an adaptive test that measured the signal-to-noise ratio that resulted in 50% correct identification of a set of 12 spondees presented in background noise. Long-duration, synthetic vowels were used to record both the cortical P1-N1-P2 "onset" response and the auditory "change" response (also known as the auditory change complex [ACC]). Correlations between the evoked potential measures and performance on the speech perception tasks are reported. RESULTS: Differences in performance using the three programming strategies were not large. Peak-to-peak amplitude of the ACC was not found to be sensitive enough to accurately predict the programming strategy that resulted in the best performance on either measure of speech perception. All 10 Hybrid CI users had residual low-frequency acoustic hearing. For all 10 subjects, allowing them to use both the acoustic and electrical signals provided by the implant improved performance on the consonant recognition task. For most subjects, it also resulted in slightly larger cortical change responses. However, the impact that listening mode had on the cortical change responses was small, and again, the correlation between the evoked potential and speech perception results was not significant. CONCLUSIONS: CAEPs can be successfully measured from Hybrid CI users. The responses that are recorded are similar to those recorded from normal-hearing listeners. The goal of this study was to see if CAEPs might play a role either in identifying the experimental program that resulted in best performance on a consonant recognition task or in documenting benefit from the use of the electrical signal provided by the Hybrid CI. At least for the stimuli and specific methods used in this study, no such predictive relationship was found.


Assuntos
Córtex Auditivo/fisiopatologia , Implante Coclear , Implantes Cocleares , Potenciais Evocados Auditivos/fisiologia , Perda Auditiva Neurossensorial/reabilitação , Adulto , Idoso , Eletroencefalografia , Feminino , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade
3.
Ear Hear ; 34(2): 142-50, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23059851

RESUMO

OBJECTIVES: The aim of this study was to determine an optimal approach to program combined acoustic plus electric (A+E) hearing devices in the same ear to maximize speech-recognition performance. DESIGN: Ten participants with at least 1 year of experience using Nucleus Hybrid (short electrode) A+E devices were evaluated across three different fitting conditions that varied in the frequency ranges assigned to the acoustically and electrically presented portions of the spectrum. Real-ear measurements were used to optimize the acoustic component for each participant, and the acoustic stimulation was then held constant across conditions. The lower boundary of the electric frequency range was systematically varied to create three conditions with respect to the upper boundary of the acoustic spectrum: Meet, Overlap, and Gap programming. Consonant recognition in quiet and speech recognition in competing-talker babble were evaluated after participants were given the opportunity to adapt by using the experimental programs in their typical everyday listening situations. Participants provided subjective ratings and evaluations for each fitting condition. RESULTS: There were no significant differences in performance between conditions (Meet, Overlap, Gap) for consonant recognition in quiet. A significant decrement in performance was measured for the Overlap fitting condition for speech recognition in babble. Subjective ratings indicated a significant preference for the Meet fitting regimen. CONCLUSIONS: Participants using the Hybrid ipsilateral A+E device generally performed better when the acoustic and electric spectra were programmed to meet at a single frequency region, as opposed to a gap or overlap. Although there is no particular advantage for the Meet fitting strategy for recognition of consonants in quiet, the advantage becomes evident for speech recognition in competing-talker babble and in patient preferences.


Assuntos
Implantes Cocleares , Auxiliares de Audição , Perda Auditiva Neurossensorial/terapia , Percepção da Fala/fisiologia , Estimulação Acústica , Idoso , Implante Coclear , Terapia Combinada , Humanos , Pessoa de Meia-Idade
4.
J Acoust Soc Am ; 132(5): 3406-17, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23145621

RESUMO

Consonant recognition was measured as a function of the number of stimulation channels for Hybrid short-electrode cochlear implant (CI) users, long-electrode CI users, and normal-hearing (NH) listeners in quiet and background noise. Short-electrode CI subjects were tested with 1-6 channels allocated to a frequency range of 1063-7938 Hz. Long-electrode CI subjects were tested with 1-6, 8, or 22 channels allocated to 188-7938 Hz, or 1-6 or 15 channels from the basal 15 electrodes allocated to 1063-7938 Hz. NH listeners were tested with simulations of each CI group/condition. Despite differences in intracochlear electrode spacing for equivalent channel conditions, all CI subject groups performed similarly at each channel condition and improved up to at least four channels in quiet and noise. All CI subject groups underperformed relative to NH subjects. These preliminary findings suggest that the limited channel benefit seen for CI users may not be due solely to increases in channel interactions as a function of electrode density. Other factors such as pre-operative patient history, location of stimulation in the base versus apex, or a limit on the number of electric channels that can be processed cognitively, may also interact with the effects of electrode contact spacing along the cochlea.


Assuntos
Cóclea/fisiopatologia , Implante Coclear/instrumentação , Implantes Cocleares , Correção de Deficiência Auditiva/psicologia , Pessoas com Deficiência Auditiva/reabilitação , Reconhecimento Psicológico , Acústica da Fala , Percepção da Fala , Estimulação Acústica , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Audiometria da Fala , Limiar Auditivo , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ruído/efeitos adversos , Mascaramento Perceptivo , Pessoas com Deficiência Auditiva/psicologia , Desenho de Prótese , Processamento de Sinais Assistido por Computador , Adulto Jovem
5.
Ear Hear ; 32(4): 536-40, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21307775

RESUMO

OBJECTIVES: Recent studies suggest that pitch perceived through cochlear implants (CIs) changes with experience to minimize spectral mismatches between electric and acoustic hearing. This study aimed to test whether perceived spectral mismatches are similarly minimized between two electric inputs. DESIGN: Pitch perception was studied in a subject with a 10-mm CI in one ear and a 24-mm CI in the other ear. Both processors were programmed to allocate information from the same frequency range of 188-7938 Hz, despite the large differences in putative insertion depth and stimulated cochlear locations between the CIs. RESULTS: After 2 and 3 years of experience, pitch-matched electrode pairs between CIs were aligned closer to the processor-provided frequencies than to cochlear position. CONCLUSIONS: Pitch perception may have adapted to reduce perceived spectral discrepancies between bilateral CI inputs, despite 2-3 octave differences in tonotopic mapping.


Assuntos
Adaptação Fisiológica/fisiologia , Implante Coclear/métodos , Implantes Cocleares , Perda Auditiva Bilateral/terapia , Percepção da Altura Sonora/fisiologia , Mapeamento Encefálico , Eletrodos Implantados , Perda Auditiva Bilateral/fisiopatologia , Humanos , Pessoa de Meia-Idade
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