A psychoacoustic application for the adjustment of electrical hearing thresholds in cochlear implant patients
Open Access
- 11 October 2019
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 14 (10), e0223625
- https://doi.org/10.1371/journal.pone.0223625
Abstract
Fitting cochlear implants, especially the precise determination of electrical hearing thresholds, is a time-consuming and complex task for patients as well as audiologists. Aim of the study was to develop a method that enables cochlear implant (CI) patients to determine their electrical hearing thresholds precisely and independently. Applicability and impact of this method on speech perception in noise at soft speech levels were evaluated. An adaptive psychoacoustic procedure for precise hearing threshold determination (precT) was implemented using MatLab (MathWorks) and a graphical user interface was created. Sound signals were calibrated with a CIC4-Implant-Decoder. Study design: A prospective study including 15 experienced adult cochlear implant users was conducted. Electrical hearing thresholds were determined using the automated precT procedure (auto-precT). Speech perception in noise at 50 dB SPL presentation levels was measured for three conditions: (P1) T-levels kept at the previously established T-levels; (P2) T-levels set to the hearing thresholds determined using auto-precT application; (P3) T-levels set 10 cu below the values determined with auto-precT. All subjects were able to perform the auto-precT application independently. T-levels were altered on average by an absolute value of 10.5 cu using auto-precT. Median speech reception thresholds were significantly improved from 2.5 dB SNR (P1) to 1.6 dB SNR (P2, p = 0.02). Speech perception was lowest using the globally lowered T-levels, median 2.9 dB SNR (P3, not significant compared to P1 and P2). The applicability of the developed auto-precT application was confirmed in the present clinical study. Patients benefited from adjusting previously established T-levels to the threshold levels determined by the auto-precT application. The integration of the application in the clinical fitting routine as well as a remote fitting software approach is recommended. Furthermore, future possibilities of auto-precT include the implementation of the application on tablets or smart phones.Funding Information
- Deutsche Forschungsgemeinschaft (STR 1014)
This publication has 12 references indexed in Scilit:
- A method for determining precise electrical hearing thresholds in cochlear implant usersInternational Journal of Audiology, 2018
- Effects of Threshold Adjustment on Speech Perception in Nucleus Cochlear Implant RecipientsEar & Hearing, 2016
- Cochlear Implant Programming: A Global Survey on the State of the ArtThe Scientific World Journal, 2014
- The next generation of Nucleus®fitting: A multiplatform approach towards universal cochlear implant managementInternational Journal of Audiology, 2013
- Optimizing the perception of soft speech and speech in noise with the Advanced Bionics cochlear implant systemInternational Journal of Audiology, 2011
- Comparing Cochlear Implant Users??? Speech Performance with Processor Fittings Based on Conventionally Determined T and C Levels or on Compound Action Potential Thresholds and Live-Voice Speech in a Prospective Balanced Crossover StudyEar & Hearing, 2006
- Evaluation of Streamlined Programming Procedures for the Nucleus Cochlear Implant with the Contour Electrode ArrayEar & Hearing, 2005
- Recognition of Speech Presented at Soft to Loud Levels by Adult Cochlear Implant Recipients of Three Cochlear Implant SystemsEar & Hearing, 2004
- Comparison of Two Methods for Selecting Minimum Stimulation Levels Used in Programming the Nucleus 22 Cochlear ImplantJournal of Speech, Language, and Hearing Research, 1999
- Comparison of Procedures for Obtaining Thresholds and Maximum Acceptable Loudness Levels With the Nucleus Cochlear Implant SystemJournal of Speech, Language, and Hearing Research, 1995