Speech Perception and Sound Localization by Adults with Bilateral Cochlear Implants

Adult patients with bilateral cochlear implants report a significant gain in health-related quality of life relative to having a single cochlear implant. Gains are found in multiple domains—in this article, we focus on hearing and speech understanding. There are several factors that likely contribute to the hearing-related gain in quality of life. The provision of bilateral implants improves the probability that (1) if there are large between-ear differences in speech recognition, then the ear with the best recognition ability will be stimulated; (2) patients will benefit from the head shadow effect, which provides large gains in speech intelligibility; (3) patients will receive the relatively smaller benefits due to summation and squelch; and (4) patients will be able to better localize sound sources in the horizontal plane by using interaural-level difference cues. It is reasonable to suppose that these improvements in performance combine to reduce the stress that is associated with listening via electrical stimulation and thereby improve hearing-related quality of life.

[1]  Blake S Wilson,et al.  Multicenter U.S. Bilateral MED-EL Cochlear Implantation Study: Speech Perception over the First Year of Use , 2007, Ear and hearing.

[2]  Bernhard Laback,et al.  Sensitivity to Interaural Level and Envelope Time Differences of Two Bilateral Cochlear Implant Listeners Using Clinical Sound Processors , 2004, Ear and hearing.

[3]  Jan Kiefer,et al.  Hearing preservation in cochlear implantation for electric acoustic stimulation , 2004, Acta oto-laryngologica.

[4]  Anthony J Spahr,et al.  Relationship between perception of spectral ripple and speech recognition in cochlear implant and vocoder listeners. , 2007, The Journal of the Acoustical Society of America.

[5]  D. M. Green,et al.  Sound localization by human listeners. , 1991, Annual review of psychology.

[6]  Blake S Wilson,et al.  Cochlear implants: some likely next steps. , 2003, Annual review of biomedical engineering.

[7]  D. Grantham.  Chapter 9 – Spatial Hearing and Related Phenomena , 1995 .

[8]  Aaron Parkinson,et al.  Simultaneous Bilateral Cochlear Implantation in Adults: A Multicenter Clinical Study , 2006, Ear and hearing.

[9]  Blake S. Wilson,et al.  The design of cochlear implants , 2012 .

[10]  Michael A Akeroyd,et al.  The psychoacoustics of binaural hearing , 2006, International journal of audiology.

[11]  Richard Ramsden,et al.  Evaluation of Bilaterally Implanted Adult Subjects with the Nucleus 24 Cochlear Implant System , 2005, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[12]  Ruth Y Litovsky,et al.  Effect of age at onset of deafness on binaural sensitivity in electric hearing in humans. , 2010, The Journal of the Acoustical Society of America.

[13]  Yi Hu,et al.  Speech recognition by bilateral cochlear implant users in a cocktail-party setting. , 2009, The Journal of the Acoustical Society of America.

[14]  Ruth Y Litovsky,et al.  Spatial Hearing and Speech Intelligibility in Bilateral Cochlear Implant Users , 2009, Ear and hearing.

[15]  F L Wightman,et al.  Monaural sound localization revisited. , 1997, The Journal of the Acoustical Society of America.

[16]  P C Loizou,et al.  On the number of channels needed to understand speech. , 1999, The Journal of the Acoustical Society of America.

[17]  Jan Kiefer,et al.  Combined Electric and Acoustic Stimulation of the Auditory System: Results of a Clinical Study , 2005, Audiology and Neurotology.

[18]  Bruce J Gantz,et al.  Combining acoustic and electrical speech processing: Iowa/Nucleus hybrid implant , 2004, Acta oto-laryngologica.

[19]  Olivier Sterkers,et al.  Speech Performance and Sound Localization in a Complex Noisy Environment in Bilaterally Implanted Adult Patients , 2008, Audiology and Neurotology.

[20]  D. Grantham,et al.  Horizontal-Plane Localization of Noise and Speech Signals by Postlingually Deafened Adults Fitted With Bilateral Cochlear Implants* , 2007, Ear and hearing.

[21]  Ruth Y Litovsky,et al.  The benefit of binaural hearing in a cocktail party: effect of location and type of interferer. , 2004, The Journal of the Acoustical Society of America.

[22]  R. Tyler,et al.  Speech perception, localization, and lateralization with bilateral cochlear implants. , 2003, The Journal of the Acoustical Society of America.

[23]  M Haggard,et al.  Magnitude of diotic summation in speech-in-noise tasks: performance region and appropriate baseline. , 1990, British journal of audiology.

[24]  B. Seeber,et al.  Localization cues with bilateral cochlear implants. , 2008, The Journal of the Acoustical Society of America.

[25]  Observer weighting of level and timing cues in bilateral cochlear implant users , 2008 .

[26]  Thomas Lenarz,et al.  Benefits of Bilateral Electrical Stimulation with the Nucleus Cochlear Implant in Adults: 6-Month Postoperative Results , 2004, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[27]  R. V. Hoesel,et al.  Sensitivity to binaural timing in bilateral cochlear implant users. , 2007 .

[28]  Piotr Majdak,et al.  Lateralization discrimination of interaural time delays in four-pulse sequences in electric and acoustic hearing. , 2007, The Journal of the Acoustical Society of America.

[29]  R V Shannon,et al.  Speech recognition as a function of the number of electrodes used in the SPEAK cochlear implant speech processor. , 1997, Journal of speech, language, and hearing research : JSLHR.

[30]  Belinda A Henry,et al.  Spectral peak resolution and speech recognition in quiet: normal hearing, hearing impaired, and cochlear implant listeners. , 2005, The Journal of the Acoustical Society of America.

[31]  Michael F Dorman,et al.  Speech Understanding by Cochlear-Implant Patients with Different Left- and Right-Ear Electrode Arrays , 2004, Ear and hearing.

[32]  Richard S Tyler,et al.  Benefits of localization and speech perception with multiple noise sources in listeners with a short-electrode cochlear implant. , 2010, Journal of the American Academy of Audiology.

[33]  Robert F Labadie,et al.  Speech Recognition for Unilateral and Bilateral Cochlear Implant Modes in the Presence of Uncorrelated Noise Sources , 2006, Ear and hearing.

[34]  W. Koenig,et al.  Subjective Effects in Binaural Hearing , 1950 .

[35]  Zachary M. Smith,et al.  Using Evoked Potentials to Match Interaural Electrode Pairs with Bilateral Cochlear Implants , 2007, Journal of the Association for Research in Otolaryngology.

[36]  R. Shannon,et al.  Speech recognition in noise as a function of the number of spectral channels: comparison of acoustic hearing and cochlear implants. , 2001, The Journal of the Acoustical Society of America.

[37]  Becky B. Poon,et al.  Sensitivity to interaural time difference with bilateral cochlear implants: Development over time and effect of interaural electrode spacing. , 2009, The Journal of the Acoustical Society of America.

[38]  C. Trahiotis,et al.  Lateralization of low-frequency, complex waveforms: the use of envelope-based temporal disparities. , 1985, The Journal of the Acoustical Society of America.