Impact of low-frequency hearing.

Today, cochlear implantation is the treatment of choice in the case of severe to profound hearing loss, but the speech perception abilities of many recipients in noisy conditions are still poor and the overall sound quality and ease of listening still require improvement. Residual low-frequency hearing has been associated with improved hearing performance in cochlear implant patients, especially in difficult listening environments (i.e. cocktail party effect). It seems that low-frequency information can enhance the segregation of competing voices, which leads to better speech understanding in noise. We investigated the effect of low-frequency hearing on speech perception performance in a group of subjects being implanted with the Nucleus Hybrid-L device. The Hybrid-L device is a modified Nucleus Freedom implant, which instead of the standard electrode carries a very delicate electrode array that allows preservation of residual hearing to a great extent. Sentence test results from 22 subjects are presented here. Additionally, for 8 subjects, the acoustically presented frequency range was limited to 300, 500 and 700 Hz, and speech perception tests with a single competing talker were conducted. The Hybrid-L study group achieved a speech reception threshold of 15.9 dB in the hearing aid alone condition, 10.8 dB in the cochlear implant alone condition, and 3.9 dB when using the combination of cochlear implant and hearing aid. Differences between the 3 conditions are statistically significant. Results from the additional experiment on the acoustically presented frequency range suggest that very limited residual hearing below 500 Hz is already sufficient to produce a significant improvement in speech perception performance in conjunction with a cochlear implant.