J Am Acad Audiol 2019; 30(08): 736-737
DOI: 10.3766/jaaa.308ceu
JAAA CEU Program
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JAAA CEU Program

Volume 30, Number 8 (September 2019)
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25. Mai 2020 (online)

Questions refer to Zaleski-King et al, “Bimodal Cochlear Implant Listeners’ Ability to Perceive Minimal Audible Angle Differences,” 659–671.

Learner Outcomes:

Readers of this article should be able to:

  • Summarize the literature describing bimodal access to interaural level and interaural timing difference cues.

  • Discuss the limitations adversely affecting bimodal binaural integration.

CEU Questions:

  1. The literature has shown that some bimodal listeners can take advantage of interaural cues when speech sources are spatially separated, based on:

    • the head shadow effect

    • binaural summation

    • interaural time difference (ITD) integration

  2. Many of the documented binaural benefits of bimodal stimulation have been demonstrated in:

    • environments providing opportunities for “dip listening” during fluctuations in noise

    • optimized, directly controlled laboratory conditions

    • in comparison to patients with bilateral hearing aids

  3. As high-frequency content increases, interaural level differences (ILDs) are:

    • more salient

    • less salient

    • unchanged

  4. Hearing aid processing produces a(n) _______ timing delay in comparison to cochlear implant (CI) processors, resulting in ________.

    • smaller, difficulty for computation of neural cues

    • larger, difficulty for computation of neural cues

    • equivalent, optimized binaural computation

  5. A broadband stimulus was used in the study to:

    • optimize ILD cues

    • improve access to overall loudness cues

    • provide an opportunity for acoustic and electric stimulation overlap

  6. The interdevice delay (IDD) was used in this study to represent:

    • the difference in delay required for lateralization of the broadband stimulus

    • the delay between the hearing aid (HA) and CI processors required for the listener to achieve a percept of a centered, single stimulus

    • the loudness difference required for equal between-ear intensity percept

  7. The results of this study generally showed that:

    • providing ITD access to bimodal listeners can be achieved through determining the IDD

    • providing localization information to bimodal listeners necessitates more substantial changes to device speech-processing algorithms and fitting procedures

    • providing access to ILDs requires monaural listening for bimodal patients

  8. The authors hypothesized the Listener B6 demonstrated greater difficulty establishing differences in loudness cues because:

    • this listener could not identify ITDs

    • this listener had the most pronounced low-frequency hearing loss in the hearing aid ear

    • this listener had the least experience listening bimodally

  9. One limitation identified by the authors that might have contributed to the variability in interaural loudness perception:

    • differences in compression ratios

    • differences in age of participants

    • differences in hearing aid manufacturer/model

  10. In conclusion, the high variability and the general difficulty demonstrated in tasks requiring binaural comparisons supports the idea that:

    • CIs best preserve ILD cues used for the head shadow effect

    • listeners likely extracted monaural loudness cues to complete the task

    • listening experience determines the ability to compute binaural cues