Fine structure processing improves telephone speech perception in cochlear implant users.
ABSTRACT The objective of this study was to compare telephone speech perception and subjective preferences in cochlear implant users with two different speech-processing strategies: high-definition continuous interleaved sampling (HDCIS) and fine structure processing (FSP). A randomized double-blind study was designed for intra-individual comparison of HDCIS and FSP. Twenty-five post-lingually deafened patients with either the PulsarCI(100) or SonataTI(100) and Opus2 acoustic processor were tested consecutively with both coding strategies, assigned in a random order. Disyllabic word speech perception was tested 6 weeks after each fitting under the following conditions: landline use with (LWN) and without (LWoN) background noise, mobile use with (MWN), and without (MWoN) background noise and mobile use with a Bluetooth magnetic field transmitter necklace (MB). Changes in health-related quality of life (QoL) were assessed using the Glasgow Benefit Inventory (GBI) and Faber's questionnaire. Personal preferences between strategies were surveyed upon completion of the study. All subjects included in this study performed better with FSP in the landline tests. There was an improvement of 11.5 % in LWN use (p = 0.014; CI 95 % = 3-20 %) and 10 % in LWoN use (p = 0.001; CI 95 % = 5-15 %). MWoN showed an improvement of 6.3 % with FSP (p = 0.03; CI 95 % = 0-13 %). MB tests showed an improvement of 11 % with FSP (p < 0.05; CI 95 % = 1.5-22 %). Quality of life was significantly better using FSP. Eighty-four percent of participants preferred FSP. The FSP speech coding strategy improved the speech recognition of cochlear implant users when using the telephone compared to HDCIS. Cochlear implantation with FSP coding improved QoL.
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ABSTRACT: Individuals with sensorineural hearing loss often report frustration with speech being loud but not clear, especially in background noise. Despite advanced digital technology, hearing aid users may resort to removing their hearing aids in noisy environments due to the perception of excessive loudness. In an animal model, sensorineural hearing loss results in greater auditory nerve coding of the stimulus envelope, leading to a relative deficit of stimulus fine structure. Based on the hypothesis that brainstem encoding of the temporal envelope is greater in humans with sensorineural hearing loss, speech-evoked brainstem responses were recorded in normal hearing and hearing impaired age-matched groups of older adults. In the hearing impaired group, there was a disruption in the balance of envelope-to-fine structure representation compared to that of the normal hearing group. This imbalance may underlie the difficulty experienced by individuals with sensorineural hearing loss when trying to understand speech in background noise. This finding advances the understanding of the effects of sensorineural hearing loss on central auditory processing of speech in humans. Moreover, this finding has clinical potential for developing new amplification or implantation technologies, and in developing new training regimens to address this relative deficit of fine structure representation.The Journal of the Acoustical Society of America 05/2013; 133(5):3030-8. · 1.65 Impact Factor