Unilateral spectral and temporal compression reduces binaural fusion for normal hearing listeners with cochlear implant simulations

The relationship between interaural coherence, interaural level differences, and binaural fusion

Binaural fusion is the perception of a single auditory image when signals are presented to the two ears. Decreasing the interaural coherence of the signals often degrades binaural fusion. However, perception of interaural level differences (ILDs) is minimally affected by interaural coherence changes. This study aims to determine if there is an interaction between ILDs and binaural fusion in the presence of reduced interaural coherence. In Experiment 1, vocoded stimuli with varying envelope interaural coherences were presented containing a range of ILDs. Participants indicated the perceived size and lateralization of the auditory image they perceived. Stimuli with reduced interaural coherence were binaurally fused when there was a large ILD, even when participants indicated that the same stimulus was unfused when there was a 0 dB ILD. This suggests that signals with low interaural coherence can become binaurally fused when the stimulus has large ILDs. To determine if participants could choose to attend to only one ear for stimuli that were reported to be fused in the presence of ILDs in Experiment 1 (i.e. if complete binaural fusion occurred), participants indicated the perceived loudness in their right ear for stimuli with varying right-ear intensities in Experiment 2. When the stimulus had a left-biased ILD, participants had a reduced ability to report changes in right ear signal intensity, suggesting that largely complete binaural fusion was fostered by the presence of large ILDs.

Binaural fusion: Complexities in definition and measurement

Despite the growing interest in studying binaural fusion, there is little consensus over its definition or how it is best measured. This review seeks to describe the complexities of binaural fusion, highlight measurement challenges, provide guidelines for rigorous perceptual measurements, and provide a working definition that encompasses this information. First, it is argued that binaural fusion may be multidimensional and might occur in one domain but not others, such as fusion in the spatial but not the spectral domain or vice versa. Second, binaural fusion may occur on a continuous scale rather than on a binary one. Third, binaural fusion responses are highly idiosyncratic, which could be a result of methodology, such as the specific experimental instructions, suggesting a need to explicitly report the instructions given. Fourth, it is possible that direct ("Did you hear one sound or two?") and indirect ("Where did the sound come from?" or "What was the pitch of the sound?") measurements of fusion will produce different results. In conclusion, explicit consideration of these attributes and reporting of methodology are needed for rigorous interpretation and comparison across studies and listener populations.

Interaural asymmetry of dynamic range: Abnormal fusion, bilateral interference, and shifts in attention

Speech information in the better ear interferes with the poorer ear in patients with bilateral cochlear implants (BiCIs) who have large asymmetries in speech intelligibility between ears. The goal of the present study was to assess how each ear impacts, and whether one dominates, speech perception using simulated CI processing in older and younger normal-hearing (ONH and YNH) listeners. Dynamic range (DR) was manipulated symmetrically or asymmetrically across spectral bands in a vocoder. We hypothesized that if abnormal integration of speech information occurs with asymmetrical speech understanding, listeners would demonstrate an atypical preference in accuracy when reporting speech presented to the better ear and fusion of speech between the ears (i.e., an increased number of one-word responses when two words were presented). Results from three speech conditions showed that: (1) When the same word was presented to both ears, speech identification accuracy decreased if one or both ears decreased in DR, but listeners usually reported hearing one word. (2) When two words with different vowels were presented to both ears, speech identification accuracy and percentage of two-word responses decreased consistently as DR decreased in one or both ears. (3) When two rhyming words (e.g., bed and led) previously shown to phonologically fuse between ears (e.g., bled) were presented, listeners instead demonstrated interference as DR decreased. The word responded in (2) and (3) came from the right (symmetric) or better (asymmetric) ear, especially in (3) and for ONH listeners in (2). These results suggest that the ear with poorer dynamic range is downweighted by the auditory system, resulting in abnormal fusion and interference, especially for older listeners.

Interdisciplinary Approaches to the Study of Listening Effort in Young Children with Cochlear Implants

Very early bilateral implantation is thought to significantly reduce the attentional effort required to acquire spoken language, and consequently offer a profound improvement in quality of life. Despite the early intervention, however, auditory and communicative outcomes in children with cochlear implants remain poorer than in hearing children. The distorted auditory input via the cochlear implants requires more auditory attention resulting in increased listening effort and fatigue. Listening effort and fatigue may critically affect attention to speech, and in turn language processing, which may help to explain the variation in language and communication abilities. However, measuring attention to speech and listening effort is demanding in infants and very young children. Three objective techniques for measuring listening effort are presented in this paper that may address the challenges of testing very young and/or uncooperative children with cochlear implants: pupillometry, electroencephalography, and functional near-infrared spectroscopy. We review the studies of listening effort that used these techniques in paediatric populations with hearing loss, and discuss potential benefits of the systematic evaluation of listening effort in these populations.

Using unilateral stimulation to create a reference for bilateral fusion judgments

Measuring binaural fusion can be challenging, especially with bilateral cochlear implant (CI) users. This study validated a technique of using unilateral stimulation to create a reference for measuring fusion. Seven bilateral CI users listened to stimuli randomly presented to the right, left, or both ears. Participants indicated the size, number, and location of the resulting image(s) they perceived. The participants had largely unitary, punctate percepts that were lateralized to the stimulated ear for unilateral stimuli. The image was centered but more diffuse when the stimuli were presented bilaterally. The results suggest unilateral stimuli can provide a reference for binaural fusion.

Reducing interaural tonotopic mismatch preserves binaural unmasking in cochlear implant simulations of single-sided deafness

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 additional masking is spectrally degraded and shifted. CIs restore some aspects of binaural hearing to these listeners, although binaural unmasking remains limited. Notably, these listeners may experience a mismatch between the frequency information perceived through the CI and that perceived by their normal hearing ear. Employing acoustic simulations of SSD-CI with normal hearing listeners, the present study confirms a previous simulation study that binaural unmasking is severely limited when interaural frequency mismatch between the input frequency range and simulated place of stimulation exceeds 1-2 mm. The present study also shows that binaural unmasking is largely retained when the input frequency range is adjusted to match simulated place of stimulation, even at the expense of removing low-frequency information. This result bears implications for the mechanisms driving the type of binaural unmasking of the present study and for mapping the frequency range of the CI speech processor in SSD-CI users.

Effects of Spectral Resolution and Frequency Mismatch on Speech Understanding and Spatial Release From Masking in Simulated Bilateral Cochlear Implants

OBJECTIVES

Due to interaural frequency mismatch, bilateral cochlear-implant (CI) users may be less able to take advantage of binaural cues that normal-hearing (NH) listeners use for spatial hearing, such as interaural time differences and interaural level differences. As such, bilateral CI users have difficulty segregating competing speech even when the target and competing talkers are spatially separated. The goal of this study was to evaluate the effects of spectral resolution, tonotopic mismatch (the frequency mismatch between the acoustic center frequency assigned to CI electrode within an implanted ear relative to the expected spiral ganglion characteristic frequency), and interaural mismatch (differences in the degree of tonotopic mismatch in each ear) on speech understanding and spatial release from masking (SRM) in the presence of competing talkers in NH subjects listening to bilateral vocoder simulations.

DESIGN

During testing, both target and masker speech were presented in five-word sentences that had the same syntax but were not necessarily meaningful. The sentences were composed of five categories in fixed order (Name, Verb, Number, Color, and Clothes), each of which had 10 items, such that multiple sentences could be generated by randomly selecting a word from each category. Speech reception thresholds (SRTs) for the target sentence presented in competing speech maskers were measured. The target speech was delivered to both ears and the two speech maskers were delivered to (1) both ears (diotic masker), or (2) different ears (dichotic masker: one delivered to the left ear and the other delivered to the right ear). Stimuli included the unprocessed speech and four 16-channel sine-vocoder simulations with different interaural mismatch (0, 1, and 2 mm). SRM was calculated as the difference between the diotic and dichotic listening conditions.

RESULTS

With unprocessed speech, SRTs were 0.3 and -18.0 dB for the diotic and dichotic maskers, respectively. For the spectrally degraded speech with mild tonotopic mismatch and no interaural mismatch, SRTs were 5.6 and -2.0 dB for the diotic and dichotic maskers, respectively. When the tonotopic mismatch increased in both ears, SRTs worsened to 8.9 and 2.4 dB for the diotic and dichotic maskers, respectively. When the two ears had different tonotopic mismatch (e.g., there was interaural mismatch), the performance drop in SRTs was much larger for the dichotic than for the diotic masker. The largest SRM was observed with unprocessed speech (18.3 dB). With the CI simulations, SRM was significantly reduced to 7.6 dB even with mild tonotopic mismatch but no interaural mismatch; SRM was further reduced with increasing interaural mismatch.

CONCLUSIONS

The results demonstrate that frequency resolution, tonotopic mismatch, and interaural mismatch have differential effects on speech understanding and SRM in simulation of bilateral CIs. Minimizing interaural mismatch may be critical to optimize binaural benefits and improve CI performance for competing speech, a typical listening environment. SRM (the difference in SRTs between diotic and dichotic maskers) may be a useful clinical tool to assess interaural frequency mismatch in bilateral CI users and to evaluate the benefits of optimization methods that minimize interaural mismatch.

Binaural Optimization of Cochlear Implants: Discarding Frequency Content Without Sacrificing Head-Shadow Benefit

OBJECTIVES

Single-sided deafness cochlear-implant (SSD-CI) listeners and bilateral cochlear-implant (BI-CI) listeners gain near-normal levels of head-shadow benefit but limited binaural benefits. One possible reason for these limited binaural benefits is that cochlear places of stimulation tend to be mismatched between the ears. SSD-CI and BI-CI patients might benefit from a binaural fitting that reallocates frequencies to reduce interaural place mismatch. However, this approach could reduce monaural speech recognition and head-shadow benefit by excluding low- or high-frequency information from one ear. This study examined how much frequency information can be excluded from a CI signal in the poorer-hearing ear without reducing head-shadow benefits and how these outcomes are influenced by interaural asymmetry in monaural speech recognition.

DESIGN

Speech-recognition thresholds for sentences in speech-shaped noise were measured for 6 adult SSD-CI listeners, 12 BI-CI listeners, and 9 normal-hearing listeners presented with vocoder simulations. Stimuli were presented using nonindividualized in-the-ear or behind-the-ear head-related impulse-response simulations with speech presented from a 70° azimuth (poorer-hearing side) and noise from 70° (better-hearing side), thereby yielding a better signal-to-noise ratio (SNR) at the poorer-hearing ear. Head-shadow benefit was computed as the improvement in bilateral speech-recognition thresholds gained from enabling the CI in the poorer-hearing, better-SNR ear. High- or low-pass filtering was systematically applied to the head-related impulse-response-filtered stimuli presented to the poorer-hearing ear. For the SSD-CI listeners and SSD-vocoder simulations, only high-pass filtering was applied, because the CI frequency allocation would never need to be adjusted downward to frequency-match the ears. For the BI-CI listeners and BI-vocoder simulations, both low and high pass filtering were applied. The normal-hearing listeners were tested with two levels of performance to examine the effect of interaural asymmetry in monaural speech recognition (vocoder synthesis-filter slopes: 5 or 20 dB/octave).

RESULTS

Mean head-shadow benefit was smaller for the SSD-CI listeners (~7 dB) than for the BI-CI listeners (~14 dB). For SSD-CI listeners, frequencies <1236 Hz could be excluded; for BI-CI listeners, frequencies <886 or >3814 Hz could be excluded from the poorer-hearing ear without reducing head-shadow benefit. Bilateral performance showed greater immunity to filtering than monaural performance, with gradual changes in performance as a function of filter cutoff. Real and vocoder-simulated CI users with larger interaural asymmetry in monaural performance had less head-shadow benefit.

CONCLUSIONS

The "exclusion frequency" ranges that could be removed without diminishing head-shadow benefit are interpreted in terms of low importance in the speech intelligibility index and a small head-shadow magnitude at low frequencies. Although groups and individuals with greater performance asymmetry gained less head-shadow benefit, the magnitudes of these factors did not predict the exclusion frequency range. Overall, these data suggest that for many SSD-CI and BI-CI listeners, the frequency allocation for the poorer-ear CI can be shifted substantially without sacrificing head-shadow benefit, at least for energetic maskers. Considering the two ears together as a single system may allow greater flexibility in discarding redundant frequency content from a CI in one ear when considering bilateral programming solutions aimed at reducing interaural frequency mismatch.

Counting or discriminating the number of voices to assess binaural fusion with single-sided vocoders

For single-sided deafness cochlear-implant (SSD-CI) listeners, different peripheral representations for electric versus acoustic stimulation, combined with interaural frequency mismatch, might limit the ability to perceive bilaterally presented speech as a single voice. The assessment of binaural fusion often relies on subjective report, which requires listeners to have some understanding of the perceptual phenomenon of object formation. Two experiments explored whether binaural fusion could instead be assessed using judgments of the number of voices in a mixture. In an SSD-CI simulation, normal-hearing listeners were presented with one or two "diotic" voices (i.e., unprocessed in one ear and noise-vocoded in the other) in a mixture with additional monaural voices. In experiment 1, listeners reported how many voices they heard. Listeners generally counted the diotic speech as two separate voices, regardless of interaural frequency mismatch. In experiment 2, listeners identified which of two mixtures contained diotic speech. Listeners performed significantly better with interaurally frequency-matched than with frequency-mismatched stimuli. These contrasting results suggest that listeners experienced partial fusion: not enough to count the diotic speech as one voice, but enough to detect its presence. The diotic-speech detection task (experiment 2) might provide a tool to evaluate fusion and optimize frequency mapping for SSD-CI patients.

Accommodation of gender-related phonetic differences by listeners with cochlear implants and in a variety of vocoder simulations

Speech perception requires accommodation of a wide range of acoustic variability across talkers. A classic example is the perception of "sh" and "s" fricative sounds, which are categorized according to spectral details of the consonant itself, and also by the context of the voice producing it. Because women's and men's voices occupy different frequency ranges, a listener is required to make a corresponding adjustment of acoustic-phonetic category space for these phonemes when hearing different talkers. This pattern is commonplace in everyday speech communication, and yet might not be captured in accuracy scores for whole words, especially when word lists are spoken by a single talker. Phonetic accommodation for fricatives "s" and "sh" was measured in 20 cochlear implant (CI) users and in a variety of vocoder simulations, including those with noise carriers with and without peak picking, simulated spread of excitation, and pulsatile carriers. CI listeners showed strong phonetic accommodation as a group. Each vocoder produced phonetic accommodation except the 8-channel noise vocoder, despite its historically good match with CI users in word intelligibility. Phonetic accommodation is largely independent of linguistic factors and thus might offer information complementary to speech intelligibility tests which are partially affected by language processing.

Low-Frequency Pitch Perception in Cochlear Implant Recipients With Normal Hearing in the Contralateral Ear

Purpose Three experiments were carried out to evaluate the low-frequency pitch perception of adults with unilateral hearing loss who received a cochlear implant (CI). Method Participants were recruited from a cohort of CI users with unilateral hearing loss and normal hearing in the contralateral ear. First, low-frequency pitch perception was assessed for the 5 most apical electrodes at 1, 3, 6, and 12 months after CI activation using an adaptive pitch-matching task. Participants listened with a coding strategy that presents low-frequency temporal fine structure (TFS) and compared the pitch to that of an acoustic target presented to the normal hearing ear. Next, participants listened with an envelope-only, continuous interleaved sampling strategy. Pitch perception was compared between coding strategies to assess the influence of TFS cues on low-frequency pitch perception. Finally, participants completed a vocal pitch-matching task to corroborate the results obtained with the adaptive pitch-matching task. Results Pitch matches roughly corresponded to electrode center frequencies (CFs) in the CI map. Adaptive pitch matches exceeded the CF for the most apical electrode, an effect that was larger for continuous interleaved sampling than TFS. Vocal pitch matches were variable but correlated with the CF of the 3 most apical electrodes. There was no evidence that pitch matches changed between the 1- and 12-month intervals. Conclusions Relatively accurate and asymptotic pitch perception was observed at the 1-month interval, indicating either very rapid acclimatization or the provision of familiar place and rate cues. Early availability of appropriate pitch cues could have played a role in the early improvements in localization and masked speech recognition previously observed in this cohort. Supplemental Material https://doi.org/10.23641/asha.8862389.

Pitch Matching Adapts Even for Bilateral Cochlear Implant Users with Relatively Small Initial Pitch Differences Across the Ears

There is often a mismatch for bilateral cochlear implant (CI) users between the electrodes in the two ears that receive the same frequency allocation and the electrodes that, when stimulated, yield the same pitch. Studies with CI users who have extreme mismatches between the two ears show that adaptation occurs in terms of pitch matching, reducing the difference between which electrodes receive the same frequency allocation and which ones produce the same pitch. The considerable adaptation that occurs for these extreme cases suggests that adaptation should be sufficient to overcome the relatively minor mismatches seen with typical bilateral CI users. However, even those with many years of bilateral CI use continue to demonstrate a mismatch. This may indicate that adaptation only occurs when there are large mismatches. Alternatively, it may indicate that adaptation occurs regardless of the magnitude of the mismatch, but that adaptation is proportional to the magnitude of the mismatch, and thus never fully counters the original mismatch. To investigate this, six bilateral CI users with initial pitch-matching mismatches of less than 3 mm completed a pitch-matching task near the time of activation, 6 months after activation, and 1 year after activation. Despite relatively small initial mismatches, the results indicated that adaptation still occurred.

Interaural Time-Difference Discrimination as a Measure of Place of Stimulation for Cochlear-Implant Users With Single-Sided Deafness

Current clinical practice in programming a cochlear implant (CI) for individuals with single-sided deafness (SSD) is to maximize the transmission of speech information via the implant, with the implicit assumption that this will also result in improved spatial-hearing abilities. However, binaural sensitivity is reduced by interaural place-of-stimulation mismatch, a likely occurrence with a standard CI frequency-to-electrode allocation table (FAT). As a step toward reducing interaural mismatch, this study investigated whether a test of interaural-time-difference (ITD) discrimination could be used to estimate the acoustic frequency yielding the best place match for a given CI electrode. ITD-discrimination performance was measured by presenting 300-ms bursts of 100-pulses-per-second electrical pulse trains to a single CI electrode and band-limited pulse trains with variable carrier frequencies to the acoustic ear. Listeners discriminated between two reference intervals (four bursts each with constant ITD) and a moving target interval (four bursts with variable ITD). For 17 out of the 26 electrodes tested across eight listeners, the function describing the relationship between ITD-discrimination performance and carrier frequency had a discernable peak where listeners achieved 70% to 100% performance. On average, this peak occurred 1.15 octaves above the CI manufacturer’s default FAT. ITD discrimination shows promise as a method of estimating the cochlear place of stimulation for a given electrode, thereby providing information to optimize the FAT for SSD-CI listeners.

Comparison between adaptive and adjustment procedures for binaural loudness balancing

Binaural loudness balancing is performed in research and clinical practice when fitting bilateral hearing devices, and is particularly important for bimodal listeners, who have a bilateral combination of a hearing aid and a cochlear implant. In this study, two psychophysical binaural loudness balancing procedures were compared. Two experiments were carried out. In the first experiment, the effect of procedure (adaptive or adjustment) on the balanced loudness levels was investigated using noise band stimuli, of which some had a frequency shift to simulate bimodal hearing. In the second experiment, the adjustment procedure was extended. The effect of the starting level of the adjustment procedure was investigated and the two procedures were again compared for different reference levels and carrier frequencies. Fourteen normal hearing volunteers participated in the first experiment, and 38 in the second experiment. Although the final averaged loudness balanced levels of both procedures were similar, the adjustment procedure yielded smaller standard deviations across four test sessions. The results of experiment 2 demonstrated that in order to avoid bias, the adjustment procedure should be conducted twice, once starting from below and once from above the expected balanced loudness level.

The Effect of Interaural Mismatches on Contralateral Unmasking With Single-Sided Vocoders

OBJECTIVES

Cochlear-implant (CI) users with single-sided deafness (SSD)-that is, one normal-hearing (NH) ear and one CI ear-can obtain some unmasking benefits when a mixture of target and masking voices is presented to the NH ear and a copy of just the masking voices is presented to the CI ear. NH listeners show similar benefits in a simulation of SSD-CI listening, whereby a mixture of target and masking voices is presented to one ear and a vocoded copy of the masking voices is presented to the opposite ear. However, the magnitude of the benefit for SSD-CI listeners is highly variable across individuals and is on average less than for NH listeners presented with vocoded stimuli. One possible explanation for the limited benefit observed for some SSD-CI users is that temporal and spectral discrepancies between the acoustic and electric ears might interfere with contralateral unmasking. The present study presented vocoder simulations to NH participants to examine the effects of interaural temporal and spectral mismatches on contralateral unmasking.

DESIGN

Speech-reception performance was measured in a competing-talker paradigm for NH listeners presented with vocoder simulations of SSD-CI listening. In the monaural condition, listeners identified target speech masked by two same-gender interferers, presented to the left ear. In the bilateral condition, the same stimuli were presented to the left ear, but the right ear was presented with a noise-vocoded copy of the interfering voices. This paradigm tested whether listeners could integrate the interfering voices across the ears to better hear the monaural target. Three common distortions inherent in CI processing were introduced to the vocoder processing: spectral shifts, temporal delays, and reduced frequency selectivity.

RESULTS

In experiment 1, contralateral unmasking (i.e., the benefit from adding the vocoded maskers to the second ear) was impaired by spectral mismatches of four equivalent rectangular bandwidths or greater. This is equivalent to roughly a 3.6-mm mismatch between the cochlear places stimulated in the electric and acoustic ears, which is on the low end of the average expected mismatch for SSD-CI listeners. In experiment 2, performance was negatively affected by a temporal mismatch of 24 ms or greater, but not for mismatches in the 0 to 12 ms range expected for SSD-CI listeners. Experiment 3 showed an interaction between spectral shift and spectral resolution, with less effect of interaural spectral mismatches when the number of vocoder channels was reduced. Experiment 4 applied interaural spectral and temporal mismatches in combination. Performance was best when both frequency and timing were aligned, but in cases where a mismatch was present in one dimension (either frequency or latency), the addition of mismatch in the second dimension did not further disrupt performance.

CONCLUSIONS

These results emphasize the need for interaural alignment-in timing and especially in frequency-to maximize contralateral unmasking for NH listeners presented with vocoder simulations of SSD-CI listening. Improved processing strategies that reduce mismatch between the electric and acoustic ears of SSD-CI listeners might improve their ability to obtain binaural benefits in multitalker environments.

Changing stimulation patterns can change the broadness of contralateral masking functions for bilateral cochlear implant users

Past studies have found that contralateral masking functions are sharper than ipsilateral masking functions for cochlear implant (CI) users. This could suggest that contralateral masking effects are only sensitive to the peak of the masker stimulation for this population. To determine if that is the case, this study investigated whether using broader stimulation patterns affects the broadness of the contralateral masking function. Contralateral masking functions were measured for six bilateral CI users using both a broad and narrow masker. Findings from this study revealed that the broad masker resulted in a broader contralateral masking function. This would suggest that stimulation outside of the peak of the masker affects contralateral masking functions for CI users.

Benefits to Speech Perception in Noise From the Binaural Integration of Electric and Acoustic Signals in Simulated Unilateral Deafness

OBJECTIVES

This study used vocoder simulations with normal-hearing (NH) listeners to (1) measure their ability to integrate speech information from an NH ear and a simulated cochlear implant (CI), and (2) investigate whether binaural integration is disrupted by a mismatch in the delivery of spectral information between the ears arising from a misalignment in the mapping of frequency to place.

DESIGN

Eight NH volunteers participated in the study and listened to sentences embedded in background noise via headphones. Stimuli presented to the left ear were unprocessed. Stimuli presented to the right ear (referred to as the CI-simulation ear) were processed using an eight-channel noise vocoder with one of the three processing strategies. An Ideal strategy simulated a frequency-to-place map across all channels that matched the delivery of spectral information between the ears. A Realistic strategy created a misalignment in the mapping of frequency to place in the CI-simulation ear where the size of the mismatch between the ears varied across channels. Finally, a Shifted strategy imposed a similar degree of misalignment in all channels, resulting in consistent mismatch between the ears across frequency. The ability to report key words in sentences was assessed under monaural and binaural listening conditions and at signal to noise ratios (SNRs) established by estimating speech-reception thresholds in each ear alone. The SNRs ensured that the monaural performance of the left ear never exceeded that of the CI-simulation ear. The advantages of binaural integration were calculated by comparing binaural performance with monaural performance using the CI-simulation ear alone. Thus, these advantages reflected the additional use of the experimentally constrained left ear and were not attributable to better-ear listening.

RESULTS

Binaural performance was as accurate as, or more accurate than, monaural performance with the CI-simulation ear alone. When both ears supported a similar level of monaural performance (50%), binaural integration advantages were found regardless of whether a mismatch was simulated or not. When the CI-simulation ear supported a superior level of monaural performance (71%), evidence of binaural integration was absent when a mismatch was simulated using both the Realistic and the Ideal processing strategies. This absence of integration could not be accounted for by ceiling effects or by changes in SNR.

CONCLUSIONS

If generalizable to unilaterally deaf CI users, the results of the current simulation study would suggest that benefits to speech perception in noise can be obtained by integrating information from an implanted ear and an NH ear. A mismatch in the delivery of spectral information between the ears due to a misalignment in the mapping of frequency to place may disrupt binaural integration in situations where both ears cannot support a similar level of monaural speech understanding. Previous studies that have measured the speech perception of unilaterally deaf individuals after CI but with nonindividualized frequency-to-electrode allocations may therefore have underestimated the potential benefits of providing binaural hearing. However, it remains unclear whether the size and nature of the potential incremental benefits from individualized allocations are sufficient to justify the time and resources required to derive them based on cochlear imaging or pitch-matching tasks.

Localization performance correlates with binaural fusion for interaurally mismatched vocoded speech

Bilateral cochlear implant users often have difficulty fusing sounds from the two ears into a single percept. However, measuring fusion can be difficult, particularly with cochlear implant users who may have no reference for a fully fused percept. As a first step to address this, this study examined how localization performance of normal hearing subjects relates to binaural fusion. The stimuli were vocoded speech tokens with various interaural mismatches. The results reveal that the percentage of stimuli perceived as fused was correlated with localization performance, suggesting that changes in localization performance can serve as an indicator for binaural fusion changes.

Determining the minimum number of electrodes that need to be pitch matched to accurately estimate pitch matches across the array

OBJECTIVE

With bilateral cochlear implant (CI) users there is typically a place mismatch between the locations stimulated by the left and right electrode arrays. This mismatch can affect performance, potentially limiting binaural benefits. One way to address this is by perceptually realigning the arrays such that a given frequency in the input stimulates perceptually matched locations in the two ears. A clinically feasible technique is needed that can determine the appropriate perceptual alignment. A pitch matching task can potentially be used for this, but only if it can be performed in a clinically feasible amount of time. The objective of this study was to determine the minimal number of electrodes that need to be pitch matched to accurately determine pitch matches across the entire array.

DESIGN

A retrospective analysis of pitch matching data was conducted. Subsets of pitch matches were selected and the predicted pitch matching across the array was compared to that predicted by the full dataset.

STUDY SAMPLE

16 bilateral CI users.

RESULTS

The results indicated that nine pitch matches are sufficient, which can typically be obtained in approximately 7 min.

CONCLUSION

The results reveal a clinically feasible method for determining pitch matches across the array.

Clinically Paired Electrodes Are Often Not Perceived as Pitch Matched

For bilateral cochlear implant (CI) patients, electrodes that receive the same frequency allocation often stimulate locations in the left and right ear that do not yield the same perceived pitch, resulting in a pitch mismatch. This pitch mismatch may be related to degraded binaural abilities. Pitch mismatches have been found for some bilateral CI users and the goal of this study was to determine whether pitch mismatches are prevalent in bilateral CI patients, including those with extensive experience with bilateral CIs. To investigate this possibility, pitch matching was conducted with 16 bilateral CI patients. For 14 of the 16 participants, there was a significant difference between those electrodes in the left and right ear that yielded the same pitch and those that received the same frequency allocation in the participant’s clinical map. The results suggest that pitch mismatches are prevalent with bilateral CI users. The results also indicated that pitch mismatches persist even with extended bilateral CI experience. Such mismatches may reduce the benefits patients receive from bilateral CIs.

Effects of insertion depth on spatial speech perception in noise for simulations of cochlear implants and single-sided deafness

OBJECTIVE

This study evaluated the effects of insertion depth on spatial speech perception in noise for simulations of cochlear implants (CI) and single-sided deafness (SSD).

DESIGN

Mandarin speech recognition thresholds were adaptively measured in five listening conditions and four spatial configurations. The original signal was delivered to the left ear. The right ear received either no input, one of three CI simulations in which the insertion depth was varied, or the original signal. Speech and noise were presented at either front, left, or right.

STUDY SAMPLE

Ten Mandarin-speaking NH listeners with pure-tone thresholds less than 20 dB HL.

RESULTS

Relative to no input in the right ear, the CI simulations provided significant improvements in head shadow benefit for all insertion depths, as well as better spatial release of masking (SRM) for the deepest simulated insertion. There were no significant improvements in summation or squelch for any of the CI simulations.

CONCLUSIONS

The benefits of cochlear implantation were largely limited to head shadow, with some benefit for SRM. The greatest benefits were observed for the deepest simulated CI insertion, suggesting that reducing mismatch between acoustic and electric hearing may increase the benefit of cochlear implantation.

Perceptually aligning apical frequency regions leads to more binaural fusion of speech in a cochlear implant simulation

For bilateral cochlear implant users, the left and right arrays are typically not physically aligned, resulting in a degradation of binaural fusion, which can be detrimental to binaural abilities. Perceptually aligning the two arrays can be accomplished by disabling electrodes in one ear that do not have a perceptually corresponding electrode in the other side. However, disabling electrodes at the edges of the array will cause compression of the input frequency range into a smaller cochlear extent, which may result in reduced spectral resolution. An alternative approach to overcome this mismatch would be to only align one edge of the array. By aligning either only the apical or basal end of the arrays, fewer electrodes would be disabled, potentially causing less reduction in spectral resolution. The goal of this study was to determine the relative effect of aligning either the basal or apical end of the electrode with regards to binaural fusion. A vocoder was used to simulate cochlear implant listening conditions in normal hearing listeners. Speech signals were vocoded such that the two ears were either predominantly aligned at only the basal or apical end of the simulated arrays. The experiment was then repeated with a spectrally inverted vocoder to determine whether the detrimental effects on fusion were related to the spectral-temporal characteristics of the stimuli or the location in the cochlea where the misalignment occurred. In Experiment 1, aligning the basal portion of the simulated arrays led to significantly less binaural fusion than aligning the apical portions of the simulated array. However, when the input was spectrally inverted, aligning the apical portion of the simulated array led to significantly less binaural fusion than aligning the basal portions of the simulated arrays. These results suggest that, for speech, with its predominantly low frequency spectral-temporal modulations, it is more important to perceptually align the apical portion of the array to better preserve binaural fusion. By partially aligning these arrays, cochlear implant users could potentially increase their ability to fuse speech sounds presented to the two ears while maximizing spectral resolution.