Semin Hear 2011; 32(1): 073-089
DOI: 10.1055/s-0031-1271949
© Thieme Medical Publishers

Speech Perception and Sound Localization by Adults with Bilateral Cochlear Implants

Michael F. Dorman1 , William A. Yost1 , Blake S. Wilson2 , Rene H. Gifford3
  • 1Department of Speech and Hearing Science, Arizona State University, Tempe, Arizona
  • 2Duke Hearing Center, Duke University Medical Center, Durham, North Carolina
  • 3Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
17. Februar 2011 (online)

ABSTRACT

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.

REFERENCES

  • 1 Bichey B G, Miyamoto R T. Outcomes in bilateral cochlear implantation.  Otolaryngol Head Neck Surg. 2008;  138 (5) 655-661
  • 2a Noble W, Tyler R, Dunn C, Bhullar N. Unilateral and bilateral and the implant-plus-hearing aid profile: comparing self assessed and measured abilities.  Int J Audiol. 2008;  47 (8) 505-514
  • 2b Gifford R H, Shallop J K, Peterson A M. Speech recognition materials and ceiling effects: considerations for cochlear implant programs.  Audiol Neurootol. 2008;  13 (3) 193-205
  • 3 Helms J, Müller J, Schön F et al. Evaluation of performance with the COMBI40 cochlear implant in adults: a multicentric clinical study.  ORL J Otorhinolaryngol Relat Spec. 1997;  59 (1) 23-35
  • 4 Dorman M F. Speech perception by adults with cochlear implants. In: Waltzman S B, Roland J T Cochlear Implants. New York, NY: Thieme; 2006: 193-204
  • 5 Middlebrooks J C, Bierer J A. Auditory cortical images of cochlear-implant stimuli: Coding of stimulus level and current level.  J Neurophysiol. 2002;  87 (1) 493-507
  • 6 Henry B A, Turner C W, Behrens A. Spectral peak resolution and speech recognition in quiet: normal hearing, hearing impaired, and cochlear implant listeners.  J Acoust Soc Am. 2005;  118 (2) 1111-1121
  • 7 Litvak L M, Spahr A J, Saoji A A, Fridman G Y. Relationship between perception of spectral ripple and speech recognition in cochlear implant and vocoder listeners.  J Acoust Soc Am. 2007;  122 (2) 982-991
  • 8 Dorman M F, Gifford R H, Spahr A J, McKarns S A. The benefits of combining acoustic and electric stimulation for the recognition of speech, voice and melodies.  Audiol Neurootol. 2008;  13 (2) 105-112
  • 9 Koch D B, Soli S D, Downing M, Osberger M J. Simultaneous bilateral cochlear implantation: prospective study in adults.  Cochlear Implants Int. 2010;  11 (2) 84-99
  • 10 Litovsky R, Parkinson A, Arcaroli J, Sammeth C. Simultaneous bilateral cochlear implantation in adults: a multicenter clinical study.  Ear Hear. 2006;  27 (6) 714-731
  • 11 Buss E, Pillsbury H C, Buchman C A et al. Multicenter U.S. bilateral MED-EL cochlear implantation study: speech perception over the first year of use.  Ear Hear. 2008;  29 (1) 20-32
  • 12 Ramsden R, Greenham P, O'Driscoll M et al. Evaluation of bilaterally implanted adult subjects with the nucleus 24 cochlear implant system.  Otol Neurotol. 2005;  26 (5) 988-998
  • 13 Davis A, Haggard M, Bell I. Magnitude of diotic summation in speech-in-noise tasks: performance region and appropriate baseline.  Br J Audiol. 1990;  24 (1) 11-16
  • 14 Eapen R J, Buss E, Adunka M C, Pillsbury III H C, Buchman C A. Hearing-in-noise benefits after bilateral simultaneous cochlear implantation continue to improve 4 years after implantation.  Otol Neurotol. 2009;  30 (2) 153-159
  • 15 Dorman M F, Dahlstrom L. Speech understanding by cochlear-implant patients with different left- and right-ear electrode arrays.  Ear Hear. 2004;  25 (2) 191-194
  • 16 Wilson B S, Lawson D T, Muller J M, Tyler R S, Kiefer J. Cochlear implants: some likely next steps.  Annu Rev Biomed Eng. 2003;  5 207-249
  • 17 Wilson B, Dorman M. The design of cochlear implants. In: Niparko J K Cochlear Implants, Principals and Practices. Philadelphia, PA: Lippincott, Williams & Wilkins; 2009: 95-136
  • 18 Fishman K E, Shannon R V, Slattery W H. Speech recognition as a function of the number of electrodes used in the SPEAK cochlear implant speech processor.  J Speech Lang Hear Res. 1997;  40 (5) 1201-1215
  • 19 Friesen L M, Shannon R V, Baskent D, Wang X. Speech recognition in noise as a function of the number of spectral channels: comparison of acoustic hearing and cochlear implants.  J Acoust Soc Am. 2001;  110 (2) 1150-1163
  • 20 Loizou P C, Dorman M, Tu Z. On the number of channels needed to understand speech.  J Acoust Soc Am. 1999;  106 (4 Pt 1) 2097-2103
  • 21 Lawson D T, Wilson B, Zerbi M, Finley C. Speech reception with bilateral cochlear implants and update on longitudinal studies. Fourth Quarterly Progress Report, NIH Project NOI-DC-8-2105, Neural Prosthesis Program. Bethesda, MD: National Institutes of Health; 1999: 1-27
  • 22 Akeroyd M A. The psychoacoustics of binaural hearing.  Int J Audiol. 2006;  45 (Suppl 1) S25-S33
  • 23 Yost W, Hafter E. Lateralization. In: Gourevitch G, Yost W Directional Hearing. New York, NY: Springer-Verlag; 1987: 49-84
  • 24 Grantham D W. Spatial hearing and related phenomena. In: Moore B Hearing. San Diego, CA: Academic Press; 1995: 297-345
  • 25 Schleich P, Nopp P, D'Haese P. Head shadow, squelch, and summation effects in bilateral users of the MED-EL COMBI 40/40 + cochlear implant.  Ear Hear. 2004;  25 (3) 197-204
  • 26 Koenig W. Subjective effects in binaural hearing.  J Acoust Soc Am. 1950;  22 (1) 61-62
  • 27 van Hoesel R, Böhm M, Pesch J, Vandali A, Battmer R D, Lenarz T. Binaural speech unmasking and localization in noise with bilateral cochlear implants using envelope and fine-timing based strategies.  J Acoust Soc Am. 2008;  123 (4) 2249-2263
  • 28 Ricketts T A, Grantham D W, Ashmead D H, Haynes D S, Labadie R F. Speech recognition for unilateral and bilateral cochlear implant modes in the presence of uncorrelated noise sources.  Ear Hear. 2006;  27 (6) 763-773
  • 29 Mosnier I, Sterkers O, Bebear J P et al. Speech performance and sound localization in a complex noisy environment in bilaterally implanted adult patients.  Audiol Neurootol. 2009;  14 (2) 106-114
  • 30 Schön F, Müller J, Helms J. Speech reception thresholds obtained in a symmetrical four-loudspeaker arrangement from bilateral users of MED-EL cochlear implants.  Otol Neurotol. 2002;  23 (5) 710-714
  • 31 Gifford R, Dorman M, Brown C. Psychophysical properties of low-frequency hearing: implications for electric and acoustic stimulation (EAS). In: van de Heyning P, ed. Cochlear Implants and Hearing Preservation. Advances in ORL. 2010. 67: 51-60
  • 32 Revit L J, Killion M C, Compton-Conley C L. Developing and testing a laboratory sound system that yields accurate real-world results.  Hearing Rev. 2007;  In press
  • 33 Kidd G J, Mason C R, Richards V M, Gallun F J, Durlach N I. Informational masking. In: Yost W A, Fay R R Auditory Perception of Sound Sources. New York, NY: Springer; 2008
  • 34 Hawley M L, Litovsky R Y, Culling J F. The benefit of binaural hearing in a cocktail party: effect of location and type of interferer.  J Acoust Soc Am. 2004;  115 (2) 833-843
  • 35 Loizou P C, Hu Y, Litovsky R et al. Speech recognition by bilateral cochlear implant users in a cocktail-party setting.  J Acoust Soc Am. 2009;  125 (1) 372-383
  • 36 Nopp P, Schleich P, D'Haese P. Sound localization in bilateral users of MED-EL COMBI 40/40 + cochlear implants.  Ear Hear. 2004;  25 (3) 205-214
  • 37 Laszig R, Aschendorff A, Stecker M et al. Benefits of bilateral electrical stimulation with the nucleus cochlear implant in adults: 6-month postoperative results.  Otol Neurotol. 2004;  25 (6) 958-968
  • 38 van Hoesel R J, Tyler R S. Speech perception, localization, and lateralization with bilateral cochlear implants.  J Acoust Soc Am. 2003;  113 (3) 1617-1630
  • 39 Litovsky R Y, Parkinson A, Arcaroli J. Spatial hearing and speech intelligibility in bilateral cochlear implant users.  Ear Hear. 2009;  30 (4) 419-431
  • 40 Grantham D W, Ashmead D H, Ricketts T A, Labadie R F, Haynes D S. Horizontal-plane localization of noise and speech signals by postlingually deafened adults fitted with bilateral cochlear implants.  Ear Hear. 2007;  28 (4) 524-541
  • 41 van Hoesel R J. Exploring the benefits of bilateral cochlear implants.  Audiol Neurootol. 2004;  9 (4) 234-246
  • 42 Seeber B U, Fastl H. Localization cues with bilateral cochlear implants.  J Acoust Soc Am. 2008;  123 (2) 1030-1042
  • 43 Tyler R S, Gantz B J, Rubinstein J T et al. Three-month results with bilateral cochlear implants.  Ear Hear. 2002;  23 (1 Suppl) 80S-89S
  • 44 Bernstein L R, Trahiotis C. Lateralization of low-frequency, complex waveforms: the use of envelope-based temporal disparities.  J Acoust Soc Am. 1985;  77 (5) 1868-1880
  • 45 Grantham D W, Ashmead D H, Ricketts T A, Labadie R F, Haynes D S. Horizontal-plane localization of noise and speech signals by postlingually deafened adults fitted with bilateral cochlear implants.  Ear Hear. 2007;  28 (4) 524-541
  • 46 Wightman F L, Kistler D J. Headphone simulation of free-field listening. I: Stimulus synthesis.  J Acoust Soc Am. 1989;  85 (2) 858-867
  • 47 Middlebrooks J C, Green D M. Sound localization by human listeners.  Annu Rev Psychol. 1991;  42 135-159
  • 48 Wightman F L, Kistler D J. Headphone simulation of free-field listening. II: Psychophysical validation.  J Acoust Soc Am. 1989;  85 (2) 868-878
  • 49 Wightman F L, Kistler D J. Monaural sound localization revisited.  J Acoust Soc Am. 1997;  101 (2) 1050-1063
  • 50 Shub D E, Carr S P, Kong Y, Colburn H S. Discrimination and identification of azimuth using spectral shape.  J Acoust Soc Am. 2008;  124 (5) 3132-3141
  • 51 Laback B, Majdak P, Baumgartner W D. Lateralization discrimination of interaural time delays in four-pulse sequences in electric and acoustic hearing.  J Acoust Soc Am. 2007;  121 (4) 2182-2191
  • 52 van Hoesel R J. Observer weighting of level and timing cues in bilateral cochlear implant users.  J Acoust Soc Am. 2008;  124 (6) 3861-3872
  • 53 Poon B B, Eddington D K, Noel V, Colburn H S. Sensitivity to interaural time difference with bilateral cochlear implants: development over time and effect of interaural electrode spacing.  J Acoust Soc Am. 2009;  126 (2) 806-815
  • 54 van Hoesel R J. Sensitivity to binaural timing in bilateral cochlear implant users.  J Acoust Soc Am. 2007;  121 (4) 2192-2206
  • 55 Francart T, Wouters J. Perception of across-frequency interaural level differences.  J Acoust Soc Am. 2007;  122 (5) 2826-2831
  • 56 Laback B, Pok S M, Baumgartner W D, Deutsch W A, Schmid K. Sensitivity to interaural level and envelope time differences of two bilateral cochlear implant listeners using clinical sound processors.  Ear Hear. 2004;  25 (5) 488-500
  • 57 Smith Z M, Delgutte B. Using evoked potentials to match interaural electrode pairs with bilateral cochlear implants.  J Assoc Res Otolaryngol. 2007;  8 (1) 134-151
  • 58 Litovsky R Y, Jones G L, Agrawal S, van Hoesel R. Effect of age at onset of deafness on binaural sensitivity in electric hearing in humans.  J Acoust Soc Am. 2010;  127 (1) 400-414
  • 59 Hochmair I, Nopp P, Jolly C et al. MED-EL Cochlear implants: state of the art and a glimpse into the future.  Trends Amplif. 2006;  10 (4) 201-219
  • 60 Gantz B J, Turner C. Combining acoustic and electrical speech processing: Iowa/Nucleus hybrid implant.  Acta Otolaryngol. 2004;  124 (4) 344-347
  • 61 Gstoettner W, Kiefer J, Baumgartner W D, Pok S, Peters S, Adunka O. Hearing preservation in cochlear implantation for electric acoustic stimulation.  Acta Otolaryngol. 2004;  124 (4) 348-352
  • 62 Kiefer J, Pok M, Adunka O et al. Combined electric and acoustic stimulation of the auditory system: results of a clinical study.  Audiol Neurootol. 2005;  10 (3) 134-144
  • 63 Dunn C C, Perreau A, Gantz B, Tyler R S. Benefits of localization and speech perception with multiple noise sources in listeners with a short-electrode cochlear implant.  J Am Acad Audiol. 2010;  21 (1) 44-51

Michael F DormanProfessor 

Department of Speech and Hearing Science, Arizona State University

Tempe, AZ 85287-0102

eMail: mdorman@asu.edu

    >