Comparison of speech perception performance between Sprint/Esprit 3G and Freedom processors in children implanted with nucleus cochlear implants.

OBJECTIVE: To compare speech perception performance in children fitted with previous generation Nucleus sound processor, Sprint or Esprit 3G, and the Freedom, the most recently released system from the Cochlear Corporation that features a larger input dynamic range. STUDY DESIGN: Prospective intrasubject comparative study. SETTING: University Medical Center. SUBJECTS: Seventeen prelingually deafened children who had received the Nucleus 24 cochlear implant and used the Sprint or Esprit 3G sound processor. INTERVENTION: Cochlear implantation with Cochlear device. MAIN OUTCOME MEASURES: Speech perception was evaluated at baseline (Sprint, n = 11; Esprit 3G, n = 6) and after 1 month's experience with the Freedom sound processor. Identification and recognition of disyllabic words and identification of vowels were performed via recorded voice in quiet (70 dB [A]), in the presence of background noise at various levels of signal-to-noise ratio (+10, +5, 0, -5) and at a soft presentation level (60 dB [A]). Consonant identification and recognition of disyllabic words, trisyllabic words, and sentences were evaluated in live voice. Frequency discrimination was measured in a subset of subjects (n = 5) by using an adaptive, 3-interval, 3-alternative, forced-choice procedure. RESULTS: Identification of disyllabic words administered at a soft presentation level showed a significant increase when switching to the Freedom compared with the previously worn processor in children using the Sprint or Esprit 3G. Identification and recognition of disyllabic words in the presence of background noise as well as consonant identification and sentence recognition increased significantly for the Freedom compared with the previously worn device only in children fitted with the Sprint. Frequency discrimination was significantly better when switching to the Freedom compared with the previously worn processor. CONCLUSION: Serial comparisons revealed that that speech perception performance evaluated in children aged 5 to 15 years was superior with the Freedom than previous generations of Nucleus sound processors. These differences are deemed to ensue from an increased input dynamic range, a feature that offers potentially enhanced phonemic discrimination.

Cochlear implantation outcome in prelingually deafened young adults. A speech perception study.

The outcome of cochlear implantation in patients with deafness of prelingual onset is largely unpredictable due to high individual variability. This study evaluated speech perception performances in a group of 18 prelingually deafened subjects (aged 13-30 years) which was homogeneous with respect to duration of deafness, hearing aid use before cochlear implantation, mode of communication and administration of auditory-oral speech therapy. Word discrimination length, word and sentence identification, phoneme identification and word and sentence recognition were tested before cochlear implantation and at 6 months, 1, 2 and 3 years of cochlear implant use. Scores on all tests significantly improved after cochlear implantation, although mean values were lower compared to those achieved by postlingually deafened patients. Speech performances on both word and sentence recognition continued to increase over time also beyond 1 year after cochlear implantation. Moreover, scores on sentence recognition tests were significantly higher compared to disyllabic words at 3 years of cochlear implant use. The presence of an auditory input delivered by hearing aids before cochlear implantation associated with auditory-oral therapy and a good level of education may positively influence the cochlear implant outcome in prelingually deafened adults.