Hey Matthias, Böhnke Britta, Mewes Alexander, Munder Patrick, Mauger Stefan J, Hocke Thomas
Audiology, ENT clinic UKSH Kiel Germany.
Cochlear Limited Melbourne Australia.
Laryngoscope Investig Otolaryngol. 2021 Jun 15;6(4):807-815. doi: 10.1002/lio2.564. eCollection 2021 Aug.
In clinical practice, characterization of speech comprehension for cochlear implant (CI) patients is typically administered by a set of suprathreshold measurements in quiet and in noise. This study investigates speech comprehension of the three most recent cochlear implant sound processors; CP810, CP910, and CP1000 (Cochlear Limited). To compare sound processor performance across generations and input dynamic range changes, the state-of-the art signal processing technologies available in each sound processor were enabled. Outcomes will be assessed across a range of stimulation intensities, and finally analyzed with respect to normal hearing listeners.
In a prospective study, 20 experienced postlingually deafened CI patients who received a Nucleus CI in the ENT department of the University Hospital of SH in Kiel were recruited. Speech comprehension was measured in quiet at 40, 50, and 65 dB with monosyllabic words as well as by speech reception threshold for two-digit numbers. In noise, speech reception thresholds were measured with the adaptive German matrix test with speech and noise in front.
We found that high levels of open-set speech comprehension are achieved at suprathreshold presentation levels in quiet. However, results at lower test levels have remained mostly unchanged for tested sound processors with default dynamic range. Expanding the lower limit of the acoustic input dynamic range yields better speech comprehension at lower presentation levels. In noise the application of ForwardFocus improves the speech reception. Overall, a continuous improvement for speech perception across three generations of CI sound processors was found.
Findings motivate further development of signal pre-processing, an additional focus of clinical work on lower stimulation levels, and automation of ForwardFocus.
在临床实践中，通常通过一组在安静和噪声环境下的超阈值测量来评估人工耳蜗（CI）患者的言语理解能力。本研究调查了三款最新的人工耳蜗声音处理器：CP810、CP910和CP1000（科利耳有限公司）的言语理解情况。为了比较不同代声音处理器的性能以及输入动态范围的变化，启用了每个声音处理器中可用的最先进信号处理技术。将在一系列刺激强度下评估结果，并最终与正常听力的听众进行对比分析。
在一项前瞻性研究中，招募了20名在基尔大学医院耳鼻喉科接受了Nucleus CI的有经验的语后聋CI患者。使用单音节词在40、50和65分贝的安静环境下测量言语理解能力，并通过两位数的言语接受阈值进行测量。在噪声环境中，使用自适应德语矩阵测试测量言语接受阈值，测试时言语和噪声位于前方。
我们发现，在安静环境下的超阈值呈现水平时能实现较高水平的开放式言语理解。然而，对于具有默认动态范围的测试声音处理器，较低测试水平的结果大多保持不变。扩展声学输入动态范围的下限可在较低呈现水平时产生更好的言语理解。在噪声环境中，应用ForwardFocus可提高言语接受能力。总体而言，发现三代CI声音处理器的言语感知能力持续提高。
研究结果促使进一步开展信号预处理的研发工作，将临床工作的额外重点放在较低刺激水平上，并实现ForwardFocus的自动化。
2级。
