Sousa Rhonda, Nair Erika, Wannagot Shannon
Soundbridge, Wethersfield, CT.
University of Connecticut, Mansfield, CT.
J Am Acad Audiol. 2019 Mar;30(3):198-207. doi: 10.3766/jaaa.17072. Epub 2018 Jan 30.
Guidelines established by the American Academy of Audiology (AAA) currently recommend behavioral testing when fitting frequency-modulated (FM) systems to individuals with cochlear implants (CIs). A protocol for completing electroacoustic measures on CI sound processors has not yet been established or validated when fitting either FM or digital-modulated (DM) systems, mini microphones, or mini microphones coupled to DM systems. In response, professionals have used or altered the AAA (2008) electroacoustic verification steps for fitting FM systems to hearing aids when fitting FM/DM systems, mini microphones, or mini microphones coupled to FM/DM systems to CI sound processors.
The purpose of this research is to determine if the electroacoustic verification guidelines established by AAA (2008) for fitting FM systems to hearing aids are feasible and verifiable when fitting mini microphones and mini microphones coupled to DM systems to CI sound processors.
Electroacoustic measures were conducted on 51 Cochlear Nucleus 6/CP910 sound processors, one Cochlear Wireless Mini Microphone 2+ (MM2+), and one Phonak DM System (one Roger Inspiro transmitter and one Roger X receiver) using an adapted AAA (2008) protocol (Nair et al, 2017). Phonak's recommended default receiver gain setting was used with the Roger X receiver and adjusted if necessary to achieve transparency. Transparency refers to when the signal output of the device is the same when coupled and when not coupled to remote microphone technology.
Electroacoustic measures were conducted on 51 Cochlear Nucleus 6/CP910 sound processors. In this study, the 51 Cochlear Nucleus 6/CP910 sound processors were either streaming to the Cochlear MM2+ or streaming to the MM2+ coupled to a Phonak DM system.
In a clinical setting, using the AAA (2008) protocol for electroacoustic measurements when fitting FM systems to hearing aids, electroacoustic measurements using various equipment (MM2+ and Phonak DM system) were performed on 51 Cochlear Nucleus 6/CP910 sound processors using the Audioscan Verifit to determine transparency and verify DM advantage, comparing speech inputs (65 dB SPL) in an effort to achieve equal outputs. If transparency was not achieved when the CI sound processor was streaming to the MM2+ coupled to the Phonak DM system at the default receiver gain, adjustments were made to the Roger X receiver's gain. The integrity of the signal was monitored with the manufacturer's monitor earphones.
Using the AAA (2008) hearing aid protocol, when the Cochlear Nucleus 6/CP910 sound processor was streaming to the Cochlear MM2+, transparency was achieved for 50 of 51 CI sound processors. Again, using the AAA (2008) protocol when the Cochlear Nucleus 6/CP910 sound processor was streaming to the Cochlear MM2+ coupled to the Phonak DM system at Phonak's recommended default receiver gain, 28 sound processors achieved transparency. After the receiver gain was adjusted, the remaining 23 sound processors met transparency.
Electroacoustic measurements and transparency can be achieved for CI sound processors coupled to either a MM2+ only or to a MM2+ and a DM system by adapting the AAA (2008) guidelines.
美国听力学学会(AAA)制定的指南目前建议,在为人工耳蜗(CI)使用者适配调频(FM)系统时进行行为测试。在适配FM或数字调制(DM)系统、迷你麦克风或与DM系统耦合的迷你麦克风时,尚未建立或验证针对CI声音处理器完成电声测量的方案。作为回应,专业人员在为CI声音处理器适配FM/DM系统、迷你麦克风或与FM/DM系统耦合的迷你麦克风时,采用或修改了AAA(2008年)用于为助听器适配FM系统的电声验证步骤。
本研究的目的是确定AAA(2008年)制定的用于为助听器适配FM系统的电声验证指南,在为CI声音处理器适配迷你麦克风以及与DM系统耦合的迷你麦克风时是否可行且可验证。
使用经过修改的AAA(2008年)方案(Nair等人,2017年),对51个科利耳Nucleus 6/CP910声音处理器、1个科利耳无线迷你麦克风2+(MM2+)以及1个峰力DM系统(1个Roger Inspiro发射器和1个Roger X接收器)进行电声测量。峰力推荐的默认接收器增益设置用于Roger X接收器,并在必要时进行调整以实现透明度。透明度是指设备在与远程麦克风技术耦合和未耦合时信号输出相同的情况。
对51个科利耳Nucleus 6/CP910声音处理器进行电声测量。在本研究中,这51个科利耳Nucleus 6/CP910声音处理器要么流式传输到科利耳MM2+,要么流式传输到与峰力DM系统耦合的MM2+。
在临床环境中,当为助听器适配FM系统时使用AAA(2008年)电声测量方案,使用Audioscan Verifit对51个科利耳Nucleus 6/CP910声音处理器使用各种设备(MM2+和峰力DM系统)进行电声测量,以确定透明度并验证DM优势,比较语音输入(65 dB SPL)以实现相等的输出。如果CI声音处理器在默认接收器增益下流式传输到与峰力DM系统耦合的MM2+时未实现透明度,则对Roger X接收器的增益进行调整。使用制造商的监听耳机监测信号的完整性。
使用AAA(2008年)助听器方案,当科利耳Nucleus 6/CP910声音处理器流式传输到科利耳MM2+时,51个CI声音处理器中有50个实现了透明度。同样,当科利耳Nucleus 6/CP910声音处理器在峰力推荐的默认接收器增益下流式传输到与峰力DM系统耦合的科利耳MM时,使用AAA(2008年)方案,28个声音处理器实现了透明度。在调整接收器增益后,其余23个声音处理器达到了透明度。
通过采用AAA(2008年)指南,可以为仅与MM2+耦合或与MM2+和DM系统耦合的CI声音处理器实现电声测量和透明度。