Mario A Svirsky

New York University | NYU · Department of Otolaryngology

Cochlear implants (CIs) are neuroprosthetic devices that can provide hearing to deaf people1. Despite the benefits offered by CIs, the time taken for hearing to be restored and perceptual accuracy after long-term CI use remain highly variable2,3. CI use is believed to require neuroplasticity in the central auditory system, and differential engageme...

One important obstacle to optimizing fitting and sound coding for auditory implants is lack of flexible, powerful and portable platforms that can be used in real-world listening environments by implanted patients. The clinical processors and the typically available research tools either do not have sufficient computational power and flexibility or...

Introduction Many cochlear implant (CI) users who do quite well in standard clinical tests of speech perception report that a great amount of effort is required when listening in real-world situations. We hypothesize that the combined constraints of the sharply degraded signal provided by a CI and finite cognitive resources may lead to a “tipping p...

Objective: To investigate a new surgical and signal processing technique that provides apical stimulation of the cochlea using a cochlear implant without extending the length of the electrode array. Patients: Three adult patients who underwent cochlear implantation using this new technique. Interventions: The patients received a cochlear impla...

Hypothesis: This study tests the hypothesis that it is possible to find tone or noise vocoders that sound similar and result in similar speech perception scores to a cochlear implant (CI). This would validate the use of such vocoders as acoustic models of CIs. We further hypothesize that those valid acoustic models will require a personalized amou...

Speech prosody, including pitch contour, word stress, pauses, and vowel lengthening, can aid the detection of the clausal structure of a multi-clause sentence and this, in turn, can help listeners determine the meaning. However, for cochlear implant (CI) users, the reduced acoustic richness of the signal raises the question of whether CI users may...

Objectives/Hypothesis The aim of this study was to obtain a reliable estimate of single-sided deafness (SSD) prevalence in the adult U.S. population. Methods A cross-sectional national epidemiologic study was performed. Participants were included from the National Health and Nutrition Examination Survey (NHANES). Each cohort includes a nationally...

Binaural unmasking, a key feature of normal binaural hearing, can refer to the improved intelligibility of masked speech by adding masking that facilitates perceived separation of target and masker. A question relevant for cochlear implant users with single-sided deafness (SSD-CI) is whether binaural unmasking can still be achieved if the additiona...

No PDF available ABSTRACT Bilateral cochlear implant (CI) listeners have limited access to interaural time differences (ITDs) at low frequencies in part because clinical processors do not coordinate the timing of stimulation across the ears. Further, clinical strategies, which are optimized for good speech reception, operate at stimulation rates th...

The presence of spiral ganglion cells (SGCs) is widely accepted to be a prerequisite for successful speech perception with a cochlear implant (CI), because SGCs provide the only known conduit between the implant electrode and the central auditory system. By extension, it has been hypothesized that the number of SGCs might be an important factor in...

Cochlear implants are neuroprosthetic devices that can provide hearing to deaf patients1. Despite significant benefits offered by cochlear implants, there are highly variable outcomes in how quickly hearing is restored and perceptual accuracy after months or years of use2,3. Cochlear implant use is believed to require neuroplasticity within the cen...

The reasons why clinical outcomes with auditory brainstem implants (ABIs) are generally poorer than with cochlear implants (CIs) are still somewhat elusive. Prior work has focused on differences in processing of spectral information due to possibly poorer tonotopic representation and higher channel interaction with ABIs than with CIs. In contrast,...

Binaural unmasking, a key feature of normal binaural hearing, refers to the improved intelligibility of masked speech by adding masking noise that facilities perceived spatial separation of target and masker. A question particularly relevant for cochlear implant users with single-sided deafness (SSD-CI) is whether binaural unmasking can still be ac...

Purpose Differences across language environments of prelingually deaf children who receive cochlear implants (CIs) may affect language acquisition; yet, whether mothers show individual differences in how they modify infant-directed (ID) compared with adult-directed (AD) speech has seldom been studied. This study assessed individual differences in h...

In recent years there has been an increasing percentage of cochlear implant (CI) users who have usable residual hearing in the contralateral, nonimplanted ear, typically aided by acoustic amplification. This raises the issue of the extent to which the signal presented through the cochlear implant may influence how listeners process information in t...

Cochlear implants are one of the most successful neuroprosthetic devices that have been developed to date. Profoundly deaf patients can achieve speech perception after complete loss of sensory input. Despite the improvements many patients experience, there is still a large degree of outcome variability. It has been proposed that central plasticity...

No PDF available ABSTRACT Caregivers modify their speaking style from adult-directed speech (ADS) to infant-directed speech (IDS) when talking to infants. However, it is unclear how individual caregivers acoustically implement differences between ADS and IDS, and how these differences may affect experienced speech intelligibility by infants, partic...

Objectives: Cochlear implants (CIs) restore speech perception in quiet but they also eliminate or distort many acoustic cues that are important for music enjoyment. Unfortunately, quantifying music enjoyment by CI users has been difficult because comparisons must rely on their recollection of music before they lost their hearing. Here, we aimed to...

Background: Measurement of the angular depth of insertion (aDOI) of cochlear implant electrode arrays has numerous clinical and research applications. Plain-film radiographs are easily obtained intraoperatively and have been described as a means to calculate aDOI. CT imaging with 3D reformatting can also be used for this measurement, but is less c...

Many studies have demonstrated benefits of infant-directed speech (IDS) over adult-directed speech (ADS) for language development. For deaf children who use cochlear implants (CIs), a variety of factors might reduce the advantage of IDS in language development. We hypothesized that spectral degradation due to the number of channels in CI processing...

Objective: Examine the relationship between duration of unilateral deafness and speech perception outcomes after cochlear implantation in adults with single-sided deafness. Methods: A systematic review of PubMed articles containing individual speech perception and duration of deafness data from single-sided deaf adults. Studies were selected for de...

Objectives: (1) To determine the effect of hearing aid (HA) bandwidth on bimodal speech perception in a group of unilateral cochlear implant (CI) patients with diverse degrees and configurations of hearing loss in the nonimplanted ear, (2) to determine whether there are demographic and audiometric characteristics that would help to determine the a...

Neural representations of the external world are constructed and updated in a manner that depends on behavioral context. For neocortical networks, this contextual information is relayed by a diverse range of neuromodulatory systems, which govern attention and signal the value of internal state variables such as arousal, motivation, and stress. Neur...

Stimulation pulse rate affects current amplitude discrimination by cochlear implant (CI) users, indicated by the evidence that the JND (just noticeable difference) in current amplitude delivered by a CI electrode becomes larger at higher pulse rates. However, it is not clearly understood whether pulse rate would affect discrimination of speech inte...

The overall goal of this study was to identify an objective physiological correlate of electric-acoustic pitch matching in unilaterally implanted cochlear implant (CI) participants with residual hearing in the non-implanted ear. Electrical and acoustic stimuli were presented in a continuously alternating fashion across ears. The acoustic stimulus a...

Background: Many recipients of bilateral cochlear implants (CIs) may have differences in electrode insertion depth. Previous reports indicate that when a bilateral mismatch is imposed, performance on tests of speech understanding or sound localization becomes worse. If recipients of bilateral CIs cannot adjust to a difference in insertion depth, a...

Hypothesis: A novel smartphone-based software application can facilitate self-selection of frequency allocation tables (FAT) in postlingually deaf cochlear implant (CI) users. Background: CIs use FATs to represent the tonotopic organization of a normal cochlea. Current CI fitting methods typically use a standard FAT for all patients regardless o...

The first medical device to restore a human sense, a cochlear implant converts sound into a train of current pulses that directly stimulate the auditory nerve of a profoundly deaf ear.

Purpose: Recent research suggests that visual-acoustic biofeedback can be an effective treatment for residual speech errors, but adoption remains limited due to barriers including high cost and lack of familiarity with the technology. This case study reports results from the first participant to complete a course of visual-acoustic biofeedback usi...

Cochlear implant(CI) users have access to fewer acoustic cues than normal hearing listeners, resulting in less than perfect identification of phonemes (vowels and consonants), even in quiet. This makes it possible to develop models of phoneme identification based on CI users’ ability to discriminate along a small set of linguistically-relevant cont...

Physiological correlates of speech acoustics are particularly important to study in humans because it is uncertain whether animals process speech the same way humans do. Studying the physiology of speech processing in humans, however, typically requires the use of noninvasive physiological measures. This is what we attempted in a recent study (Won,...

Ninety-four unilateral CI patients with bimodal listening experience (CI plus HA in contralateral ear) completed a questionnaire that focused on attitudes toward hearing aid use postimplantation, patterns of usage, and perceived bimodal benefits in daily life. Eighty participants continued HA use and 14 discontinued HA use at the time of the questi...

Background: Cochlear implants (CIs) successfully restore hearing in postlingually deaf adults, but in doing so impose a frequency-position function in the cochlea that may differ from the physiological one. Purpose: The CI-imposed frequency-position function is determined by the frequency allocation table programmed into the listener's speech pr...

Cochlear implant(CI) recipients have difficulty understanding speech in noise even at moderate signal-to-noise ratios. Knowing the mechanisms they use to understand speech in noise may facilitate the search for better speech processing algorithms. In the present study, a computational model is used to assess whether CI users' vowel identification i...

Background: Many recipients of bilateral cochlear implants (CIs) may have differences in electrode insertion depth. Previous reports indicate that when a bilateral mismatch is imposed, performance on tests of speech understanding or sound localization becomes worse. If recipients of bilateral CIs cannot adjust to a difference in insertion depth, ad...

Objective: To describe our initial operative experience and hearing preservation results with the Advanced Bionics (AB) Mid Scala Electrode (MSE). Study design: Retrospective review. Setting: Tertiary referral center. Patients: Sixty-three MSE implants in pediatric and adult patients were compared with age- and sex-matched 1j electrode impla...

Cochlear implants are neuroprosthetic devices that provide hearing to deaf patients, although outcomes are highly variable even with prolonged training and use. The central auditory system must process cochlear implant signals, but it is unclear how neural circuits adapt - or fail to adapt - to such inputs. Understanding these mechanisms is require...

Spoken language is a central part of our everyday lives, but the precise roles that individual cortical regions play in the production of speech are often poorly understood. To address this issue, we focally lowered the temperature of distinct cortical regions in awake neurosurgical patients, and we relate this perturbation to changes in produced s...

Even though speech signals trigger coding in the cochlea to convey speech information to the central auditory structures, little is known about the neural mechanisms involved in such processes. The purpose of this study was to understand the encoding of formant cues and how it relates to vowel recognition in listeners. Neural representations of for...

In this spreadsheet, the average (and standard error of the mean) angle of insertion is presented for every electrode contact as presented in Figure 4 of Landsberger et al. 2015. Electrodes represented are the Cochlear Contour Advance, Advanced Bionics HiFocus 1J, and the MED-EL Standard and Flex28 electrodes. Also provided is the interpolation of...

Objective: To validate a method of measuring angular depth of insertion (aDOI) as well as positional depth of each electrode contact in a cochlear implant by using intraoperative postinsertion skull radiographs. Study Design: Retrospective review. Setting: Tertiary referral center. Patients: Intraoperative postinsertion radiographs obtained from 18...

Objective: To validate a method of measuring angular depth of insertion (aDOI) as well as positional depth of each electrode contact in a cochlear implant by using intraoperative postinsertion skull radiographs. Study design: Retrospective review. Setting: Tertiary referral center. Patients: Intraoperative postinsertion radiographs obtained...

Objectives: Commercially available cochlear implant systems attempt to deliver frequency information going down to a few hundred Hertz, but the electrode arrays are not designed to reach the most apical regions of the cochlea, which correspond to these low frequencies. This may cause a mismatch between the frequencies presented by a cochlear implan...

Commercially available cochlear implant systems attempt to deliver frequency information going down to a few hundred Hertz, but the electrode arrays are not designed to reach the most apical regions of the cochlea, which correspond to these low frequencies. This may cause a mismatch between the frequencies presented by a cochlear implant electrode...

Conclusion: The human frequency-to-place map may be modified by experience, even in adult listeners. However, such plasticity has limitations. Knowledge of the extent and the limitations of human auditory plasticity can help optimize parameter settings in users of auditory prostheses. Objectives: To what extent can adults adapt to sharply differ...

A growing number of minimally invasive surgical and diagnostic procedures require the insertion of an optical, mechanical, or electronic device in narrow spaces inside a human body. In such procedures, precise motion control is essential to avoid damage to the patient's tissues and/or the device itself. A typical example is the insertion of a cochl...

A growing number of minimally invasive surgical and diagnostic procedures require the insertion of an optical, mechanical, or electronic device in narrow spaces inside a human body. In such procedures, precise motion control is essential to avoid damage to the patient's tissues and/or the device itself. A typical example is the insertion of a cochl...

One of the common uses of vocoded speech is to simulate what speech would sound like when it is processed via a cochlear implant. However, listeners with normal hearing may perceive vocoded speech differently depending on the carrier signals (noise or tone) or channel bandwidths. In this study, we attempted to determine how physiological measures c...

Perception of spectrally degraded speech is particularly difficult when the signal is also distorted along the frequency axis. This might be particularly important for post-lingually deafened recipients of cochlear implants (CIs), who must adapt to a signal where there may be a mismatch between the frequencies of an input signal and the characteris...

Informationists at NYU Health Sciences Libraries (NYUHSL) successfully applied for a NLM supplement to a translational research grant obtained by PIs in the NYU School of Medicine Department of Otolaryngology titled, “Clinical Management of Cochlear Implant Patients with Contralateral Hearing Aids”. The grant involves development of evidence-based...

Acoustic models have been used in numerous studies over the past thirty years to simulate the percepts elicited by auditory neural prostheses. In these acoustic models, incoming signals are processed the same way as in a cochlear implant speech processor. The percepts that would be caused by electrical stimulation in a real cochlear implant are sim...

Objectives: The purpose of this study was to determine how the bandwidth of the hearing aid (HA) fitting affects bimodal speech recognition of listeners with a cochlear implant (CI) in one ear and severe-to-profound hearing loss in the unimplanted ear (but with residual hearing sufficient for wideband amplification using National Acoustic Laborato...

This pilot study details the use of a software tool that uses continuous impedance measurement during electrode insertion, with the eventual potential to assess and optimize electrode position and reduce insertional trauma. Software development and experimental study with human cadaveric cochleae and two live surgeries. A prototype program to measu...

The Laboratory of Translational Auditory Research (LTAR/NYUSM) is part of the Department of Otolaryngology at the New York University School of Medicine and has close ties to the New York University Cochlear Implant Center. LTAR investigators have expertise in multiple related disciplines including speech and hearing science, audiology, engineering...

This study examines behavioral and physiological measures of pitch matching in cochlear implant (CI) users who have residual hearing in the contralateral ear. Subjects adjusted the frequency of an acoustic tone to match the pitch percept elicited by electrical stimulation in the other ear, when stimulation was alternating across two ears. In genera...

A portable real-time speech processor that implements an acoustic simulation model of a cochlear implant (CI) has been developed on the Apple iPhone / iPod Touch to permit testing and experimentation under extended exposure in real-world environments. This simulator allows for both a variable number of noise band channels and electrode insertion de...