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Cochlear Implant (CI) users typically perform poorly on musical tasks, especially those based on pitch ranking and melody recognition. It was hypothesized that CI users would demonstrate deterioration in performance for a pitch ranking and a melody recognition task presented with iterated rippled noise (IRN) in comparison to pure tones (PT). In Addition, it was hypothesized that normal hearing (NH) listeners would show fewer differences in performance between IRN and PT for these two tasks. In this study, the ability of CI users and NH subjects to rank pitches and to identify melodies created with IRN and PT was assessed in free field in a sound-isolated room. CI subjects scored significantly above chance level with PT stimuli in both tasks. With IRN stimuli their performance was around chance level. NH subjects scored significantly above chance level in both tasks and with all stimuli. NH subjects performed significantly better than CI subjects in both tasks. These results illustrate the difficulties of CI subjects to rank pitches and to identify melodies.

The purpose of this study was to (a) apply the musical sound quality assessment method, Cochlear Implant-MUltiple Stimulus with Hidden Reference and Anchor (CI-MUSHRA), to quantify musical sound quality deficits in CI (cochlear implant) users with respect to high-frequency loss, and (b) assess possible correlations between CI-MUSHRA performance and self-reported musical sound quality, as assessed by more traditional rating scales. Five versions of real-world musical stimuli were created: 8-,4-, and 2-kHz low-pass-filtered (LPF) versions with increasing high-frequency removal, a composite stimulus containing a 1-kHz LPF-filtered version and white noise ("anchor"), and an unaltered version ("hidden reference"). Using the CI-MUSHRA methodology, these versions were simultaneously presented to participants in addition to a labeled reference. Participants listened to all versions and provided ratings based on a 100-point scale that reflected perceived sound quality difference among the versions. A total of 25 musical stimuli were tested. As comparison measures, participants completed four Visual Analogue Scales (VAS) to assess musical sound quality. Overall, compared to normal hearing (NH) listeners, CI users demonstrated an impaired ability to discriminate between unaltered and altered musical stimuli with variable amounts of high-frequency information removed. Performance using CI-MUSHRA to evaluate this parameter did not correlate to measurements of musical sound quality, as assessed by VAS. This study identified high-frequency loss as one acoustic parameter contributing to overall CI-mediated musical sound quality limitations. CI-MUSHRA provided a quantitative assessment of musical sound quality. This method offers the potential to quantify CI impairments of many different acoustic parameters related to musical sound quality in the future.

A 9-year old boy with perinatal HIV infection developed meningitis due to nontypeable Haemophilus influenzae. His course was complicated by progressive hearing loss due to labyrinthitis ossificans. Placement of cochlear implant improved hearing thresholds. Nontypeable H. influenzae meningitis and use of cochlear implants have not previously been in HIV-infected children.

Importance: A number of studies have investigated music perception in adult cochlear implant (CI) users. However, little is known about how pediatric CI users perceive and process music, in part because suitable methods for assessing music perception in this population are lacking. Therefore, we developed the Music in Children With Cochlear Implants (MCCI) battery to assess music perception in pediatric CI users younger than 9 years., Objective: To pilot test the MCCI on a group of pediatric CI users to determine its feasibility for measuring music perception and to compare performance of CI users with that of normal-hearing (NH) control participants., Design, Setting, and Participants: The pilot test was conducted in an academic tertiary care center. The MCCI evaluated rhythm, pitch, melody, harmony, and timbre perception. For each section, 10 pediatric CI users and 10 NH controls were presented with a pair of stimuli that possibly varied along a single musical element (eg, rhythm). Participants were required to indicate whether the stimuli in the pair were the same or different., Interventions: Administration of the MCCI., Main Outcomes and Measures: Percentage correct on each section of the MCCI and the aggregate score of all sections by group., Results: The MCCI provided a basic characterization of musical perceptual abilities. In the aggregate, NH controls significantly outperformed CI users in music perception (mean [SD] accuracy for CI users vs NH controls: rhythm, 73% [20%] vs 78% [20%]; pitch, 84% [12%] vs 91% [13%]; melody, 65% [16%] vs 75% [18%]; harmony, 74% [13%] vs 75% [14%]; and timbre, 80% [17%] vs 90% [12%]; repeated-measures analysis of variance, F1,17 = 9.3; P < .01). Despite obtaining lower accuracies than NH controls, however, the CI users achieved above-chance accuracy in all sections of the MCCI (1-sample t test, P < .01), including pitch-based sections that are traditionally difficult for CI users. These results suggest that CI users can make use of temporal and spectral cues to discriminate between musical stimuli, although not to the extent of their NH peers., Conclusions and Relevance: The MCCI provided an efficient and user-friendly assessment of music perception in pediatric CI users. This test battery may serve as a valuable tool to evaluate music perceptual abilities of pediatric CI users and measure the effects of interventions.