Purpose We describe the natural auditory environment of people with cochlear implants (CIs), how it changes across the life span, and how it varies between individuals. Method We performed a retros...

https://pubs.asha.org/doi/pdf/10.1044/2016_JSLHR-H-16-0162

Auditory Environment Across the Life Span of Cochlear Implant Users: Insights From Data Logging

Background Cochlear implant recipients often experience difficulty with understanding speech in the presence of noise. Cochlear implant manufacturers have developed sound processing algorithms designed to improve speech recognition in noise, and research has shown these technologies to be effective. Remote microphone technology utilizing adaptive, digital wireless radio transmission has also been shown to provide significant improvement in speech recognition in noise. There are no studies examining the potential improvement in speech recognition in noise when these two technologies are used simultaneously. Purpose The goal of this study was to evaluate the potential benefits and limitations associated with the simultaneous use of a sound processing algorithm designed to improve performance in noise (Advanced Bionics ClearVoice) and a remote microphone system that incorporates adaptive, digital wireless radio transmission (Phonak Roger). Research design A two-by-two way repeated measures design was used to examine performance differences obtained without these technologies compared to the use of each technology separately as well as the simultaneous use of both technologies. Study sample Eleven Advanced Bionics (AB) cochlear implant recipients, ages 11 to 68 yr. Data collection and analysis AzBio sentence recognition was measured in quiet and in the presence of classroom noise ranging in level from 50 to 80 dBA in 5-dB steps. Performance was evaluated in four conditions: (1) No ClearVoice and no Roger, (2) ClearVoice enabled without the use of Roger, (3) ClearVoice disabled with Roger enabled, and (4) simultaneous use of ClearVoice and Roger. Results Speech recognition in quiet was better than speech recognition in noise for all conditions. Use of ClearVoice and Roger each provided significant improvement in speech recognition in noise. The best performance in noise was obtained with the simultaneous use of ClearVoice and Roger. Conclusions ClearVoice and Roger technology each improves speech recognition in noise, particularly when used at the same time. Because ClearVoice does not degrade performance in quiet settings, clinicians should consider recommending ClearVoice for routine, full-time use for AB implant recipients. Roger should be used in all instances in which remote microphone technology may assist the user in understanding speech in the presence of noise.

Evaluation of Speech Recognition of Cochlear Implant Recipients Using Adaptive, Digital Remote Microphone Technology and a Speech Enhancement Sound Processing Algorithm.

Currently, there are no studies assessing everyday use of cochlear implant (CI) processors by recipients by means of objective tools. The Nucleus 6 sound processor features a data logging system capable of real-time recording of CI use in different acoustic environments and under various categories of loudness levels. In this study, we report data logged for the different scenes and different loudness levels of 1,366 CI patients, as recorded by SCAN. Monitoring device use in cochlear implant recipients of all ages provides important information about the listening conditions encountered in recipients' daily lives that may support counseling and assist in the further management of their device settings. The findings for this large cohort of active CI users confirm differences between age groups concerning device use and exposure to various noise environments, especially between the youngest and oldest age groups, while similar levels of loudness were observed.

A Multicenter Clinical Evaluation of Data Logging in Cochlear Implant Recipients Using Automated Scene Classification Technologies.

A general binaural noise reduction system is considered that employs the multichannel Wiener filter with partial noise estimation ( $\text{MWF}_\eta$ ) allowing for an explicit tradeoff between noise reduction and binaural noise cue preservation. In this paper, it is assumed that along with the general binaural system, a remote microphone signal with a high input signal-to-noise ratio (SNR) is available for inclusion in the $\text{MWF}_\eta$ . The use of this remote microphone signal with a high input SNR allows for a simultaneous increase in both noise reduction performance and preservation of the binaural noise cues. To further increase the performance, a modification to the partial noise estimation (PNE) variable, $\eta$ , is proposed which relies on exploiting the aforementioned trade-off by either constraining the output SNR or binaural noise cues to the same level before and after the addition of the remote microphone signal. The validity of the theoretical results are supplemented via simulations using a binaural setup with a single speech and noise source.

/pdf/binaural-noise-cue-preservation-in-a-binaural-noise-2j0lm514dd.pdf

Binaural noise cue preservation in a binaural noise reduction system with a remote microphone signal

Roger is a digital adaptive multi-channel remote microphone technology that wirelessly transmits a speaker’s voice directly to a hearing instrument or cochlear implant sound processor. Frequency hopping between channels, in combination with repeated broadcast, avoids interference issues that have limited earlier generation FM systems. This study evaluated the benefit of the Roger Pen transmitter microphone in a multiple talker network (MTN) for cochlear implant users in a simulated noisy conversation setting. Twelve post-lingually deafened adult Advanced Bionics CII/HiRes 90K recipients were recruited. Subjects used a Naida CI Q70 processor with integrated Roger 17 receiver. The test environment simulated four people having a meal in a noisy restaurant, one the CI user (listener), and three companions (talkers) talking non-simultaneously in a diffuse field of multi-talker babble. Speech reception thresholds (SRTs) were determined without the Roger Pen, with one Roger Pen, and with three Roger Pens in an MTN. Using three Roger Pens in an MTN improved the SRT by 14.8 dB over using no Roger Pen, and by 13.1 dB over using a single Roger Pen (p < 0.0001). The Roger Pen in an MTN provided statistically and clinically significant improvement in speech perception in noise for Advanced Bionics cochlear implant recipients. The integrated Roger 17 receiver made it easy for users of the Naida CI Q70 processor to take advantage of the Roger system. The listening advantage and ease of use should encourage more clinicians to recommend and fit Roger in adult cochlear implant patients.

https://link.springer.com/content/pdf/10.1007%2Fs00405-015-3643-4.pdf

Speech understanding in noise with the Roger Pen, Naida CI Q70 processor, and integrated Roger 17 receiver in a multi-talker network

Background Previous research supports the use of frequency modulation (FM) systems for improving speech recognition in noise of individuals with cochlear implants (CIs). However, at this time, there is no published research on the potential speech recognition benefit of new digital adaptive wireless radio transmission systems. Purpose The goal of this study was to compare speech recognition in quiet and in noise of CI recipients while using traditional, fixed-gain analog FM systems, adaptive analog FM systems, and adaptive digital wireless radio frequency transmission systems. Research design A three-way repeated-measures design was used to examine performance differences among devices, among speech recognition conditions in quiet and in increasing levels of background noise, and between users of Advanced Bionics and Cochlear CIs. Study sample Seventeen users of Advanced Bionics Harmony CI sound processors and 20 users of Cochlear Nucleus 5 sound processors were included in the study. Data collection and analysis Participants were tested in a total of 32 speech-recognition-in noise-test conditions, which included one no-FM and three device conditions (fixed-gain FM, adaptive FM, and adaptive digital) at the following signal levels: 64 dBA speech (at the location of the participant) in quiet and 64 dBA speech with competing noise at 50, 55, 60, 65, 70, 75, and 80 dBA noise levels. Results No significant differences were detected between the users of Advanced Bionics and Cochlear CIs. All of the radio frequency system conditions (i.e., fixed-gain FM, adaptive FM, and adaptive digital) outperformed the no-FM conditions in test situations with competing noise. Specifically, in conditions with 70, 75, and 80 dBA of competing noise, the adaptive digital system provided better performance than the fixed-gain and adaptive FM systems. The adaptive FM system did provide better performance than the fixed-gain FM system at 70 and 75 dBA of competing noise. At the lower noise levels of 50, 55, 60, and 65 dBA, no significant differences were detected across the three systems, and no significant differences were found across the quiet conditions. In all conditions, performance became poorer as the competing noise level increased. Conclusions In high levels of noise, the adaptive digital system provides superior performance when compared to adaptive analog FM and fixed-gain FM systems.

Evaluation of speech recognition of cochlear implant recipients using a personal digital adaptive radio frequency system.

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Evaluation of speech recognition of cochlear implant recipients using a personal digital adaptive radio frequency system.