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There are two types of speech processors used in CI devices: behind-the-ear (BTE) and off-the-ear (OTE). This study aimed to investigate the characteristics of patients and revision cases in relation to the type of speech processors. A retrospective review of 452 ears that underwent CI was performed. Children with severe inner ear anomalies (91.7%) more frequently preferred BTE speech processors than those without severe inner ear anomalies (p =.000). The magnet strength used in OTE speech processor users was significantly higher than in BTE speech processor users (p =.002). In cochlear implantees who underwent surgery before 12 months of age, the magnet strength in the revision group was greater than in the non-revision group (p =.025). Overall, our findings suggest factors to consider when choosing the type of speech processor and modifying the magnet strength of the implant device. The choice between BTE and OTE speech processors led to different required magnet strengths, contributing to the occurrence of skin flap inflammation. [ABSTRACT FROM AUTHOR]

BACKGROUND: RONDO 2 is a lightweight, compact, wirelessly charged, and fully integrated single-unit speech processor. Single-unit processors provide an effective and convenient alternative to behind-the-ear processors for adults. Therefore, the aim of this study was to investigate if RONDO 2 is suitable for and did not compromise the hearing performance of young children in everyday life. METHODS: Thirteen children aged <4 years were fitted with the RONDO 2 speech processor at the first activation of the cochlear implant. They were evaluated with the LittlEARS® Auditory Questionnaire, LittlEARS® Early Speech Production Questionnaire, and the Speech, Spatial, and Qualities of Hearing Scale 12 pre-implantation. In addition to these measures, they were evaluated with the Audio Processor Satisfaction Questionnaire post-implantation. Duration of daily use and troubleshooting data were acquired. Evaluation occurred at 4 time points: before implantation and 1, 3, and 12 months post-initial activation. RESULTS: Ten out of 13 children continued using RONDO 2 after the study. Twelve months after implantation, they used it on average 11.6 hours per day and had an average Audio Processor Satisfaction Questionnaire score of 9.1 out of 10. Average hearing performance scores continuously improved throughout the follow-up period across measures. Twelve months after implantation, the mean scores were 30.1 out of 35 for the LittlEARS® Auditory Questionnaire, 19.9 out of 27 for the LittlEARS® Early Speech Production Questionnaire, and 7.4 out of 10 for the Speech, Spatial, and Qualities of Hearing Scale 12. CONCLUSION: Participants demonstrated high levels of satisfaction and good hearing performance with RONDO 2, which indicates that this single-unit processor could be a viable and comfortable alternative to behind-the-ear processors in young children, although larger controlled experiments are warranted. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Generally, cochlear implant system consists of one or more electrodes which directly activate the auditory nerve. The microphone transforms external speech processor input into stimuli for each electrode and transcutaneous the connection between the electrodes and processor. As a result, cochlear implants continue to improve the performance of speech processor. After the implantation, preservation gains importance in acoustic hearing to prevent the neural degradation from the loss of cells. Eventually, the possibility of preserving low-frequency and high-frequency hearing using modified surgical technique has been explored for hearing in cochlear implantation. The primary focus on the architecture is to reduce the major potential thread performance and power trade-off. So, frequency mapping function with modified FIR filter has been proposed. For this implementation, the values relative to the frequency range defines upper and lower stimulus limits of each electrode. The proposed FIR filter is designed with distributed arithmetic function where the reconfigurable FIR filter can change the filter input coefficients. By scaling both the frequency ranges and by assessing the deriving frequency parameters, the mapping function will be yielded. Mapping function is manipulated to rectify any mapping deviations. This results in favor of the development of frequency specific mapping function with flexible system. From the proposed results, it is evident that the speech recognition performance is improved significantly by better minimization of overall energy consumption based on effective and pipelined FFT architecture. This implementation also reduces the power and improves the accuracy by 90% and above for different frequency ranges. [ABSTRACT FROM AUTHOR]

Purpose: Some oldest patients rehabilitated with a cochlear implant more than 20 years ago could still be upgraded with new generations of speech processor (SP). The aim of this study was to show the benefit of a recent generation of SP in this population. Methods: A monocentric prospective study was designed to evaluate the performance of 33 ancient CI22M users implanted between 1989 and 1997 and upgraded with the late compatible sound processor CP900. Performance was evaluated in quiet and noise with Framatix, an automated adaptative test. Results: Performance using Framatix significantly improved with the CP900, with a decrease of the median speech perception threshold of 6 dB in quiet (p < 0.05) and 5,3 dB in noise (p < 0.0005). No subjective benefit using the APHAB questionnaire was observed. Conclusion: Upgrading of cochlear implant recipients who were implanted more than 20 years ago with recent compatible and new technological SP provide benefit in speech recognition in noise. [ABSTRACT FROM AUTHOR]

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article provides arguments for incorporating bottom-up practice activities into listening instruction at university EFL classroom. It begins with a brief overview of the current research into listening, followed by a review of main processing components involved in speech comprehension. Also, the paper discusses Ukrainian pre-service teachers' major listening difficulties and reasons which prevent them from developing listening fluency in English. The role of the speech processor in the process of teaching listening comprehension has been determined. Psycholinguistic peculiarities of its development are discussed. It is proved that a well-developed L2 speech processor will ensure adequate perception of foreign speech and auditory self-control of one's own articulation. Activities for enriching Ukrainian university students' L2 perceptual experience (transcribing, noticing exercises) and training their L2 pronunciation (reading aloud, shadow reading) are suggested. Finally, it is concluded that improvement in speech perception makes listening process increasingly automatic, which in turn makes the development of top-down listening skills more effective. [ABSTRACT FROM AUTHOR]

The objectives of the study were to demonstrate the audiological and subjective benefits of the adaptive UltraZoom beamforming technology available in the Naída CI Q70 sound processor, in cochlear-implanted adults upgraded from a previous generation sound processor. Thirty-four adults aged between 21 and 89 years (mean 53 ± 19) were prospectively included. Nine subjects were unilaterally implanted, 11 bilaterally and 14 were bimodal users. The mean duration of cochlear implant use was 7 years (range 5-15 years). Subjects were tested in quiet with monosyllabic words and in noise with the adaptive French Matrix test in the best-aided conditions. The test setup contained a signal source in front of the subject and three noise sources at +/−90° and 180°. The noise was presented at a fixed level of 65 dB SPL and the level of speech signal was varied to obtain the speech reception threshold (SRT). During the upgrade visit, subjects were tested with the Harmony and with the Naída CI sound processors in omnidirectional microphone configuration. After a take-home phase of 2 months, tests were repeated with the Naída CI processor with and without UltraZoom. Subjective assessment of the sound quality in daily environments was recorded using the APHAB questionnaire. No difference in performance was observed in quiet between the two processors. The Matrix test in noise was possible in the 21 subjects with the better performance. No difference was observed between the two processors for performance in noise when using the omnidirectional microphone. At the follow-up session, the median SRT with the Naída CI processor with UltraZoom was −4 dB compared to −0.45 dB without UltraZoom. The use of UltraZoom improved the median SRT by 3.6 dB ( p < 0.0001, Wilcoxon paired test). When looking at the APHAB outcome, improvement was observed for speech understanding in noisy environments ( p < 0.01) and in aversive situations ( p < 0.05) in the group of 21 subjects who were able to perform the Matrix test in noise and for speech understanding in noise ( p < 0.05) in the group of 13 subjects with the poorest performance, who were not able to perform the Matrix test in noise. The use of UltraZoom beamforming technology, available on the new sound processor Naída CI, improves speech performance in difficult and realistic noisy conditions when the cochlear implant user needs to focus on the person speaking at the front. Using the APHAB questionnaire, a subjective benefit for listening in background noise was also observed in subjects with good performance as well as in those with poor performance. This study highlighted the importance of upgrading CI recipients to new technology and to include assessment in noise and subjective feedback evaluation as part of the process. [ABSTRACT FROM AUTHOR]

The RONDO is a single-unit cochlear implant audio processor, which omits the need for a behind-the-ear (BTE) audio processor. The primary aim was to compare speech perception results in quiet and in noise with the RONDO and the OPUS 2, a BTE audio processor. Secondary aims were to determine subjects' self-assessed levels of sound quality and gather subjective feedback on RONDO use. All speech perception tests were performed with the RONDO and the OPUS 2 behind-the-ear audio processor at 3 test intervals. Subjects were required to use the RONDO between test intervals. Subjects were tested at upgrade from the OPUS 2 to the RONDO and at 1 and 6 months after upgrade. Speech perception was determined using the Freiburg Monosyllables in quiet test and the Oldenburg Sentence Test (OLSA) in noise. Subjective perception was determined using the Hearing Implant Sound Quality Index (HISQUI), and a RONDO device-specific questionnaire. 50 subjects participated in the study. Neither speech perception scores nor self-perceived sound quality scores were significantly different at any interval between the RONDO and the OPUS 2. Subjects reported high levels of satisfaction with the RONDO. The RONDO provides comparable speech perception to the OPUS 2 while providing users with high levels of satisfaction and comfort without increasing health risk. The RONDO is a suitable and safe alternative to traditional BTE audio processors. [ABSTRACT FROM AUTHOR]

Conclusion: The results show that the DUET2 offers users speech perception that is equivalent to or better than the DUET. Moreover, the DUET2 offers subjective benefits above those provided by the DUET. Background: The DUET is a combination of hearing aid and CI in one device for electric acoustic stimulation. Since its introduction: a second generation, the DUET2, has been developed. This study aimed to investigate the benefits of the DUET2 compared to the DUET. Methods: Speech reception was determined in quiet and in noise. The sound quality of speech and music was rated using a visual analogue scale. Test intervals were at upgrade and at 3 and 6 months after upgrade. Results: Speech reception in quiet and in noise was significantly better than with the DUET after 6 months. For sentence reception in quiet, the SRT with the DUET2 did not change significantly between test intervals. Sentence reception in noise with the DUET2 improved significantly between 3 and 6 months and upgrade and 6 months. After 6 months, speech reception in quiet and in noise with the DUET2 was significantly better than with the DUET. Subjects rated the sound quality of speech and of music with the DUET2 significantly better than with the DUET. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether individuals older than 60 years of age suffering from profound, bilateral, sensorineural hearing loss and unable to use hearing aids can benefit from a cochlear implant in order to improve hearing performance. Additionally, to evaluate how they manage the external components of their implanted system. Materials and Methods: The records of 68 cochlear implant users over 60 years of age were reviewed. They had undergone tonal and speech audiometry evaluations of hearing before and after implantation. A subset of 27 elderly patients were asked to respond to a specially designed questionnaire regarding the use of the external components of the implanted system. Results: Patients over 60 years of age benefit from cochlear implants. The earlier the implantation, the better the results tend to be. Certain limitations when using the external components of the implanted system were evident among the elderly. Conclusions: People >60 years of age suffering from profound, bilateral, sensorineural hearing loss show improved hearing performance following cochlear implantation. Using the implanted system includes some limitations that should be studied and overcome. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Objective: It is well known that a proper fitting of the cochlear implant processor is relevant to provide good quality in speech perception. The aim of this study is to extract statistical information to be applied for fitting the processor. Methods: This study is based on the programming maps of 121 patients, aged from 18 months to 68 years at the moment of implantation. All subjects were implanted with the COMBI 40+ cochlear implant at San Cecilio University Hospital, Granada (Spain). The patients were classified into groups based on their age at implantation: younger than 5 years, between 5 and 16 years, and older than 16 years. The patients in each age-based group were divided into two subgroups, considering whether they had recent hearing experience or not. A special group including patients affected by severe damages in the cochlea was also defined. Results: Relationships between the programming parameters and factors like the age at implantation, the hearing experience and the presence of severe cochlear damage were found. The THR levels for patients younger than 5 years were significantly lower than those for patients implanted between 5 and 16 years, and this group presented significantly lower THR levels than adults. The MCL levels were not significantly influenced by the age at implantation. A significant increment was observed for both, MCL and THR levels, when patients were affected by severe cochlear damage. A significant increment in the THR levels were observed for patients with no recent hearing experience, while no significant differences were found for MCL levels. This study also analyzes the distribution along the cochlea of the stimulation levels. In the case of patients not affected by severe cochlear damage, the most basal electrodes presented a significant increment in the stimulation levels with respect to the rest of electrodes. Conclusion: This work provides information of great value for programming the speech processors, particularly when the subjective responses of the patients are not sufficient. The application in our ENT Service has reduced substantially the average time needed to obtain an acceptable fitting of the processor, especially in children. Our study also shows that electrical thresholds are a good indicator of the functionality of the auditory nerve. The analysis of this parameter highlights the importance of an early intervention as well as a deep insertion of the electrode carrier in order to obtain the maximum functionality from the cochlear implant. [Copyright &y& Elsevier]

Background: Cochlear implants provide access to soft intensity sounds and therefore improved audibility for children with severe-to-profound hearing loss. Speech processor programming parameters, such as threshold (or T-level), input dynamic range (IDR), and microphone sensitivity, contribute to the recipient's program and influence audibility. When soundfield thresholds obtained through the speech processor are elevated, programming parameters can be modified to improve soft sound detection. Adult recipients show improved detection for low-level sounds when T-levels are set at raised levels and show better speech understanding in quiet when wider IDRs are used. Little is known about the effects of parameter settings on detection and speech recognition in children using today's cochlear implant technology. Purpose: The overall study aim was to assess optimal T-level, IDR, and sensitivity settings in pediatric recipients of the Advanced Bionics cochlear implant. Research Design: Two experiments were conducted. Experiment 1 examined the effects of two T-level settings on soundfield thresholds and detection of the Ling 6 sounds. One program set T-levels at 10% of most comfortable levels (M-levels) and another at 10 current units (CUs) below the level judged as "soft." Experiment 2 examined the effects of IDR and sensitivity settings on speech recognition in quiet and noise. Study Sample: Participants were 11 children 7-17 yr of age (mean 11.3) implanted with the Advanced Bionics High Resolution 90K or CII cochlear implant system who had speech recognition scores of 20% or greater on a monosyllabic word test. Data Collection and Analysis: Two T-level programs were compared for detection of the Ling sounds and frequency modulated (FM) tones. Differing IDR/sensitivity programs (50/0, 50/10, 70/0, 70/10) were compared using Ling and FM tone detection thresholds, CNC (consonant-vowel nucleus-consonant) words at 50 dB SPL, and Hearing in Noise Test for Children (HINT-C) sentences at 65 dB SPL in the presence of four-talker babble (18 signal-to-noise ratio). Outcomes were analyzed using a paired t-test and a mixed-model repeated measures analysis of variance (ANOVA). Results: T-levels set 10 CUs below "soft" resulted in significantly lower detection thresholds for all six Ling sounds and FM tones at 250, 1000, 3000, 4000, and 6000 Hz. When comparing programs differing by IDR and sensitivity, a 50 dB IDR with a 0 sensitivity setting showed significantly poorer thresholds for low frequency FM tones and voiced Ling sounds. Analysis of group mean scores for CNC words in quiet or HINT-C sentences in noise indicated no significant differences across IDR/sensitivity settings. Individual data, however, showed significant differences between IDR/sensitivity programs in noise; the optimal program differed across participants. Conclusions: In pediatric recipients of the Advanced Bionics cochlear implant device, manually setting T-levels with ascending loudness judgments should be considered when possible or when low-level sounds are inaudible. Study findings confirm the need to determine program settings on an individual basis as well as the importance of speech recognition verification measures in both quiet and noise. Clinical guidelines are suggested for selection of programming parameters in both young and older children. [ABSTRACT FROM AUTHOR]

Aims: This paper uses a new method of speech testing where the hearing aid or cochlear implant (CI) users are tested in a more realistic listening situation. Methods: Groups of 11 subjects matched for performance with 5 different CI systems, for a total of 55 subjects, were tested with an adaptive test regime where the presentation level of the speech signal roved by ±10 or ±15 dB. Results: Speech reception thresholds varied widely between -4.8 and 17.3 dB with the ±15 dB roving condition being more difficult than the ±10 dB roving condition. We also found significant differences in speech reception threshold between groups using different devices. Conclusion: The test method used in our study, which attempts to test CI users in a more realistic listening situation, is sensitive to the effects of various subject-specific and technical parameters on everyday speech perception with CIs. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Conclusion: In contrast to the Tempo+ the new Opus speech processor stimulates with the new fine structure programming (FSP) speech coding strategy and offers an extended frequency spectrum. A significant improvement in speech perception for sentences at 10 dB SNR (signal to noise ratio) was observable. Objectives: The aim of this study was to investigate the long-term effects on speech perception in quiet and in noise with the Opus speech processor using FSP. Subjects and methods: Eight post-lingually deaf patients implanted with Pulsar cochlear implants and fitted with Tempo+ speech processors (both MED-EL) for a minimum of 1 year were tested at baseline with Tempo+ using continuous interleaved sampling (CIS), and at 1 year follow-up with the Opus speech processor using FSP. Monosyllables and sentence tests were performed in quiet, and sentence tests (HSM) in noise with 15, 10 and 5 dB SNR. Results: Mean speech perception scores showed a trend towards improvement for all tests. A statistically significant (p<0.05) improvement was only observed for the sentence test in noise at 10 dB SNR. [ABSTRACT FROM AUTHOR]

Conclusion. The results indicate that the need for upgrading the processor and/or speech coding strategy should be considered individually, if the processor and coding strategy are functioning properly and a good level of speech perception has been achieved. Objectives. Our aim was to study the intra-individual differences of the body-worn CIS-PRO+ and the behind-the-ear-worn TEMPO+ cochlear implant systems used in the MED-EL Combi40/Combi40+ implants. Subjects and methods. The hearing level, sentence, word and phoneme recognition of eight adult subjects were determined in an ABA study design. Additionally, a self-assessment questionnaire was used. Mean scores and 95% confidence intervals, and individual scores were analysed. Results. The subjects tended to score slightly better on word and phoneme recognition with CIS-PRO+ and CIS strategy than with TEMPO+ and CIS+, but there were no statistically significant differences. Subjectively the participants ranked speech perception and discussion in noise to be slightly easier with TEMPO+ and CIS+. Six of the eight subjects preferred TEMPO+ and CIS+ and two of eight preferred CIS-PRO+ with CIS or number-of-maxima. [ABSTRACT FROM AUTHOR]

Over the years, numerous technological advances have taken place in regard to the internal and external components of cochlear implant systems. Such advances include improvements in receiver and electrode design and placement, improvements in external component technology that have brought about downsizing and increased efficiency of externally worn speech processors, and improvements in surgical techniques that have resulted in decreased damage to the cochlea following electrode insertion. These advances have resulted in changes in candidacy criteria over time and improved outcomes for adults and children who receive cochlear implants. This article will provide a brief overview of some of the changes and technological advances that have taken place in the field of cochlear implants since they were first introduced. [ABSTRACT FROM AUTHOR]

The cochlear implant is the most successful of all neural prostheses developed to date. It is the most effective prosthesis in terms of restoration of function, and the people who have received a cochlear implant outnumber the recipients of other types of neural prostheses by orders of magnitude. The primary purpose of this article is to provide an overview of contemporary cochlear implants from the perspective of two designers of implant systems. That perspective includes the anatomical situation presented by the deaf cochlea and how the different parts of an implant system (including the user's brain) must work together to produce the best results. In particular, we present the design considerations just mentioned and then describe in detail how the current levels of performance have been achieved. We also describe two recent advances in implant design and performance. In concluding sections, we first present strengths and limitations of present systems and then offer some possibilities for further improvements in this technology. In all, remarkable progress has been made in the development of cochlear implants but much room still remains for improvements, especially for patients presently at the low end of the performance spectrum. [ABSTRACT FROM AUTHOR]

Categorical loudness scaling of electric and acoustic stimuli was performed in cochlear implant (CI) recipients equipped with Nucleus™ systems in order to achieve a normal loudness perception in the whole dynamic range of acoustic input. For each electrode, the lower and upper limits of electric stimulus were defined by the values corresponding to “very soft” and “too loud”. Within this dynamic range, the stimulus strength intervals associated to the verbal categories “soft”, “medium”, “loud” and “very loud” were determined. The same loudness categories were used for the scaling of acoustic stimuli. From both scaling experiments, the transduction of the CI system can be assessed and the parameters of the individual mapping function yielding a normal loudness growth can be derived. Deviations from optimum mapping can be corrected at least partially by manipulating the parameters of the mapping function. In many cases, however, one mapping function is not sufficient for all channels. The results argue in favour of the development of flexible and channel-specific mapping function parameters in future CI systems. [ABSTRACT FROM AUTHOR]