Studies on bilateral cochlear implants at the University of Wisconsin's Binaural Hearing and Speech Laboratory

Across-frequency combination of interaural time difference in bilateral cochlear implant listeners

The current study examined how cochlear implant (CI) listeners combine temporally interleaved envelope-ITD information across two sites of stimulation. When two cochlear sites jointly transmit ITD information, one possibility is that CI listeners can extract the most reliable ITD cues available. As a result, ITD sensitivity would be sustained or enhanced compared to single-site stimulation. Alternatively, mutual interference across multiple sites of ITD stimulation could worsen dual-site performance compared to listening to the better of two electrode pairs. Two experiments used direct stimulation to examine how CI users can integrate ITDs across two pairs of electrodes. Experiment 1 tested ITD discrimination for two stimulation sites using 100-Hz sinusoidally modulated 1000-pps-carrier pulse trains. Experiment 2 used the same stimuli ramped with 100 ms windows, as a control condition with minimized onset cues. For all stimuli, performance improved monotonically with increasing modulation depth. Results show that when CI listeners are stimulated with electrode pairs at two cochlear sites, sensitivity to ITDs was similar to that seen when only the electrode pair with better sensitivity was activated. None of the listeners showed a decrement in performance from the worse electrode pair. This could be achieved either by listening to the better electrode pair or by truly integrating the information across cochlear sites.

The effect of interaural fluctuation rate on correlation change discrimination

While bilateral cochlear implants (CIs) provide some binaural benefits, these benefits are limited compared to those observed in normal-hearing (NH) listeners. The large frequency-to-electrode allocation bandwidths (BWs) in CIs compared to auditory filter BWs in NH listeners increases the interaural fluctuation rate available for binaural unmasking, which may limit binaural benefits. The purpose of this work was to investigate the effect of interaural fluctuation rate on correlation change discrimination and binaural masking-level differences in NH listeners presented a CI simulation using a pulsed-sine vocoder. In experiment 1, correlation-change just-noticeable differences (JNDs) and tone-in-noise thresholds were measured for narrowband noises with different BWs and center frequencies (CFs). The results suggest that the BW, CF, and/or interaural fluctuation rate are important factors for correlation change discrimination. In experiment 2, the interaural fluctuation rate was systematically varied and dissociated from changes in BW and CF by using a pulsed-sine vocoder. Results indicated that the interaural fluctuation rate did not affect correlation change JNDs for correlated reference noises; however, slow interaural fluctuations increased correlation change JNDs for uncorrelated reference noises. In experiment 3, the BW, CF, and vocoder pulse rate were varied while interaural fluctuation rate was held constant. JNDs increased for increasing BW and decreased for increasing CF. In summary, relatively fast interaural fluctuation rates are not detrimental for detecting changes in interaural correlation. Thus, limiting factors to binaural benefits in CI listeners could be a result of other temporal and/or spectral deficiencies from electrical stimulation.

Effect of mismatched place-of-stimulation on binaural fusion and lateralization in bilateral cochlear-implant users

Bilateral cochlear implants (CIs) have provided some success in improving spatial hearing abilities to patients, but with large variability in performance. One reason for the variability is that there may be a mismatch in the place-of-stimulation arising from electrode arrays being inserted at different depths in each cochlea. Goupell et al. [(2013b). J. Acoust. Soc. Am. 133(4), 2272-2287] showed that increasing interaural mismatch led to non-fused auditory images and poor lateralization of interaural time differences in normal hearing subjects listening to a vocoder. However, a greater bandwidth of activation helped mitigate these effects. In the present study, the same experiments were conducted in post-lingually deafened bilateral CI users with deliberate and controlled interaural mismatch of single electrode pairs. Results show that lateralization was still possible with up to 3 mm of interaural mismatch, even when off-center, or multiple, auditory images were perceived. However, mismatched inputs are not ideal since it leads to a distorted auditory spatial map. Comparison of CI and normal hearing listeners showed that the CI data were best modeled by a vocoder using Gaussian-pulsed tones with 1.5 mm bandwidth. These results suggest that interaural matching of electrodes is important for binaural cues to be maximally effective.

Reaching for sound measures: an ecologically valid estimate of spatial hearing in 2- to 3-year-old children with bilateral cochlear implants

HYPOTHESIS

A novel reaching for sound (RFS) methodology can yield a high level of spatial hearing ability in 2- to 3-year-old children with normal hearing and with bilateral cochlear implants (BiCIs).

BACKGROUND

A growing number of children who are deaf are receiving BiCIs at a young age. Their spatial hearing abilities are emerging but highly variable within the population. Our novel reaching for sound method uses an ecologically valid approach that engages children and maintains their motivation. The present work was aimed at using the novel RFS method to evaluate spatial hearing in 2- to 3-year-olds with normal hearing and with BiCIs.

METHODS

Six children with BiCIs and 15 children with NH, ages 2 to 3 years participated. In the BiCI group, testing was performed in bilateral or single CI (unilateral) conditions. Loudspeakers were separated by ± 60, ± 45, ± 30, or ± 15 degrees. On each trial, a small toy was hidden behind one of the loudspeakers, and the child's task was to reach through a hole in the curtain above the loudspeaker, to indicate source location. Children were reinforced for correct responses. At each angle, the ability of the child to reach criterion of 80% or greater correct was assessed.

RESULTS

All BiCI users reached criterion at all angles tested in the bilateral condition; however, performance was poorer when using a single CI. Of the 15 NH children, 13 were able to perform the task accurately and reached criterion at all angles.

CONCLUSION

Spatial hearing skills studied with the RFS method revealed novel findings regarding the emergence of sound localization in very young BiCI users.

Mapping procedures can produce non-centered auditory images in bilateral cochlear implantees

Good localization accuracy depends on an auditory spatial map that provides consistent binaural information across frequency and level. This study investigated whether mapping bilateral cochlear implants (CIs) independently contributes to distorted perceptual spatial maps. In a meta-analysis, interaural level differences necessary to perceptually center sound images were calculated for 127 pitch-matched pairs of electrodes; many needed large current adjustments to be perceptually centered. In a separate experiment, lateralization was also found to be inconsistent across levels. These findings suggest that auditory spatial maps are distorted in the mapping process, which likely reduces localization accuracy and target-noise separation in bilateral CIs.