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Semin Hear 2014; 35(03): 177-192
DOI: 10.1055/s-0034-1383503
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cochlear Implants and Remote Microphone Technology

Jace Wolfe
1   Hearts for Hearing, Oklahoma City, Oklahoma
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Publication History

Publication Date:
25 July 2014 (online)

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Abstract

Advances in cochlear implant (CI) technology have allowed for impressive outcomes for implant recipients. In fact, many CI recipients achieve ceiling-level scores (i.e., near 100%) on sentence-recognition tests in quiet used in clinical settings. It is, however, well known that CI users often continue to experience difficulty with speech understanding in noisy and reverberant environments (e.g., classroom, restaurant, etc.). Recent research has indicated that performance in these difficult situations may be improved through the use of wireless remote microphone technology. In this article, a review will be provided of several studies that have explored the use of wireless remote microphones for CI users. Specifically, this review will focus on studies that have addressed both induction neckloop and directly coupled radiofrequency (RF) systems, fixed receiver gain settings, audio mixing ratio, adaptive frequency-modulated (FM) systems, cochlear implant signal processing, and digital RF systems. The effect of each of these items on a CI recipient's performance will be discussed. Additionally, clinical tips to optimize hearing assistance technology benefit for CI users will be provided as well as a protocol for fitting and verifying the appropriateness of wireless remote microphone technology for CI users and for optimizing user benefit.

Keywords

Autosensitivity control - cochlear implant - frequency modulation - input dynamic range - receiver gain - remote microphone radio frequency technology
 

  • References

  • 1 Helms J, Weichbold V, Baumann U , et al. Analysis of ceiling effects occurring with speech recognition tests in adult cochlear-implanted patients. ORL J Otorhinolaryngol Relat Spec 2004; 66 (3) 130-135
    CrossrefPubMedGoogle Scholar
  • 2 Gifford RH, Shallop JK, Peterson AM. Speech recognition materials and ceiling effects: considerations for cochlear implant programs. Audiol Neurootol 2008; 13 (3) 193-205
    CrossrefPubMedGoogle Scholar
  • 3 Schafer EC, Thibodeau LM. Speech recognition performance of children using cochlear implants and FM systems. J Educ Audiol 2003; 11: 15-26
    PubMedGoogle Scholar
  • 4 Schafer EC, Thibodeau LM. Speech recognition abilities of adults using cochlear implants with FM systems. J Am Acad Audiol 2004; 15 (10) 678-691
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Spahr AJ, Dorman MF, Loiselle LH. Performance of patients using different cochlear implant systems: effects of input dynamic range. Ear Hear 2007; 28 (2) 260-275
    CrossrefPubMedGoogle Scholar
  • 6 Wolfe J, Schafer EC, Heldner B, Mülder H, Ward E, Vincent B. Evaluation of speech recognition in noise with cochlear implants and dynamic FM. J Am Acad Audiol 2009; 20 (7) 409-421
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Holden LK, Brenner C, Reeder RM, Firszt JB. Postlingual adult performance in noise with HiRes 120 and Clear Voice Low. Medium, and High. Cochlear Implants Int 2013; 14 (5) 276-286
    PubMedGoogle Scholar
  • 8 Buechner A, Brendel M, Saalfeld H, Litvak L, Frohne-Buechner C, Lenarz T. Results of a pilot study with a signal enhancement algorithm for HiRes 120 cochlear implant users. Otol Neurotol 2010; 31 (9) 1386-1390
    PubMedGoogle Scholar
  • 9 Kam AC, Ng IH, Cheng MM, Wong TK, Tong MC. Evaluation of the ClearVoice strategy in adults using HiResolution Fidelity 120 sound processing. Clin Exp Otorhinolaryngol 2012; 5 (1) , Suppl (Suppl. 01) S89-S92
    CrossrefPubMedGoogle Scholar
  • 10 Koch DB, Quick A, Osberger MJ, Saoji A, Litvak L. Enhanced hearing in noise for cochlear implant recipients: clinical trial results for a commercially available speech-enhancement strategy. Otol Neurotol 2014; 35 (5) 803-809
    CrossrefPubMedGoogle Scholar
  • 11 Dawson PW, Mauger SJ, Hersbach AA. Clinical evaluation of signal-to-noise ratio-based noise reduction in Nucleus® cochlear implant recipients. Ear Hear 2011; 32 (3) 382-390
    CrossrefPubMedGoogle Scholar
  • 12 Mauger SJ, Dawson PW, Hersbach AA. Perceptually optimized gain function for cochlear implant signal-to-noise ratio based noise reduction. J Acoust Soc Am 2012; 131 (1) 327-336
    CrossrefPubMedGoogle Scholar
  • 13 Gifford RH, Revit LJ. Speech perception for adult cochlear implant recipients in a realistic background noise: effectiveness of preprocessing strategies and external options for improving speech recognition in noise. J Am Acad Audiol 2010; 21 (7) 441-451 , quiz 487–488
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Spriet A, Van Deun L, Eftaxiadis K , et al. Speech understanding in background noise with the two-microphone adaptive beamformer BEAM in the Nucleus Freedom Cochlear Implant System. Ear Hear 2007; 28 (1) 62-72
    CrossrefPubMedGoogle Scholar
  • 15 Wolfe J, Parkinson A, Schafer EC , et al. Benefit of a commercially available cochlear implant processor with dual-microphone beamforming: a multi-center study. Otol Neurotol 2012; 33 (4) 553-560
    CrossrefPubMedGoogle Scholar
  • 16 Ricketts T, Dhar S. Comparison of performance across three directional hearing aids. J Am Acad Audiol 1999; 10 (4) 180-189
    PubMedGoogle Scholar
  • 17 Fitzpatrick EM, Fournier P, Séguin C, Armstrong S, Chénier J, Schramm D. Users' perspectives on the benefits of FM systems with cochlear implants. Int J Audiol 2010; 49 (1) 44-53
    CrossrefPubMedGoogle Scholar
  • 18 Schafer EC, Huynh C, Romine D, Jimenez R. Speech recognition and subjective perceptions of neck-loop FM receivers with cochlear implants. Am J Audiol 2013; 22 (1) 53-64
    CrossrefPubMedGoogle Scholar
  • 19 Schafer EC, Kleineck MP. Improvements in speech-recognition performance using cochlear implants and three types of FM systems: a meta-analytic approach. J Educ Audiol 2009; 15: 4-14
    PubMedGoogle Scholar
  • 20 Schafer EC, Romine D, Musgrave E, Momin S, Huynh C. Electromagnetic versus electrical coupling of personal frequency modulation (FM) receivers to cochlear implant sound processors. J Am Acad Audiol 2013; 24 (10) 927-940
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Wolfe J, Schafer E, Parkinson A , et al. Effects of input processing and type of personal frequency modulation system on speech-recognition performance of adults with cochlear implants. Ear Hear 2013; 34 (1) 52-62
    PubMedGoogle Scholar
  • 22 American Academy of Audiology. AAA Clinical Practice Guidelines: Remote Microphone Hearing Assistance Technologies for Children and Youth Birth-21 Years. 2008. Available at: http://www.audiology.org/resources/documentlibrary/Documents/HAT_Guidelines_Supplement_A.pdf . Accessed June 17, 2014
    PubMedGoogle Scholar
  • 23 Wolfe J, Morais M, Schafer E , et al. Evaluation of speech recognition of cochlear implant recipients using a personal digital adaptive radio frequency system. J Am Acad Audiol 2013; 24 (8) 714-724
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Wolfe J, Morais M, Schafer E , et al. Better speech recognition with digital RF system in study of cochlear implants. Hear J 2013; 66 (7) 24-26
    PubMedGoogle Scholar
  • 25 Schafer EC, Wolfe J, Lawless T, Stout B. Effects of FM-receiver gain on speech-recognition performance of adults with cochlear implants. Int J Audiol 2009; 48 (4) 196-203
    CrossrefPubMedGoogle Scholar
  • 26 Lewis D, Eiten L. Assessment of advanced hearing instrument and FM technology. In: Fabry DA, DeConde Johnson C. , Eds. ACCESS: Achieving Clear Communication Employing Sound Solutions—2003. Proceedings of the First International FM Conference, Murten, Switzerland: Phonak AG; 2004: 167-174
    Google Scholar
  • 27 Thibodeau L. Benefits of adaptive FM systems on speech recognition in noise for listeners who use hearing aids. Am J Audiol 2010; 19 (1) 36-45
    CrossrefPubMedGoogle Scholar
  • 28 Wolfe J, Schafer EC. Optimizing the benefits of Auria sound processors coupled to personal FM systems with iConnect adaptors. J Am Acad Audiol 2008; 19 (8) 585-594
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Wolfe J, Schafer EC. Effects of accessory-mixing ratio on performance with personal FM and cochlear implants. In: Deconde-Johnson C, Lewis DE, Mulder HE, Thibodeau LM, Eds. ACCESS 2: Achieving Clear Communications Employing Sound Solutions—2008: Proceedings of the First International Virtual Conference. Murten, Switzerland: Phonak AG; 2010: 145-153
    Google Scholar
  • 30 Wolfe J, Schafer EC, John A, John AB, Hudson M. The effect of front-end processing on cochlear implant performance of children. Otol Neurotol 2011; 32 (4) 533-538
    CrossrefPubMedGoogle Scholar
  • 31 Schafer EC, Musgrave E, Momin S, Sandrock C, Romine D. A proposed electroacoustic test protocol for personal FM receivers coupled to cochlear implant sound processors. J Am Acad Audiol 2013; 24 (10) 941-954
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Mulla I. FM technology: when to introduce to children. Presented at: A Sound Foundation Through Early Amplification 2013: 6th International Pediatric Audiology Conference December 9, 2013; Chicago, IL
    PubMedGoogle Scholar