Background: Difficulty understanding in background noise is a common complaint of cochlear implant
(CI) recipients. Programming options are available to improve speech recognition in
noise for CI users including automatic dynamic range optimization (ADRO), autosensitivity
control (ASC), and a two-stage adaptive beamforming algorithm (BEAM). However, the
processing option that results in the best speech recognition in noise is unknown.
In addition, laboratory measures of these processing options often show greater degrees
of improvement than reported by participants in everyday listening situations. To
address this issue, Compton-Conley and colleagues developed a test system to replicate
a restaurant environment. The R-SPACE™ consists of eight loudspeakers positioned in
a 360 degree arc and utilizes a recording made at a restaurant of background noise.
Purpose: The present study measured speech recognition in the R-SPACE with four processing
options: standard dual-port directional (STD), ADRO, ASC, and BEAM.
Research Design: A repeated-measures, within-subject design was used to evaluate the four different
processing options at two noise levels.
Study Sample: Twenty-seven unilateral and three bilateral adult Nucleus Freedom CI recipients.
Intervention: The participants’ everyday program (with no additional processing) was used as the
STD program. ADRO, ASC, and BEAM were added individually to the STD program to create
a total of four programs.
Data Collection and Analysis: Participants repeated Hearing in Noise Test sentences presented at 0 degrees azimuth
with R-SPACE restaurant noise at two noise levels, 60 and 70 dB SPL. The reception
threshold for sentences (RTS) was obtained for each processing condition and noise
level.
Results: In 60 dB SPL noise, BEAM processing resulted in the best RTS, with a significant
improvement over STD and ADRO processing. In 70 dB SPL noise, ASC and BEAM processing
had significantly better mean RTSs compared to STD and ADRO processing. Comparison
of noise levels showed that STD and BEAM processing resulted in significantly poorer
RTSs in 70 dB SPL noise compared to the performance with these processing conditions
in 60 dB SPL noise. Bilateral participants demonstrated a bilateral improvement compared
to the better monaural condition for both noise levels and all processing conditions,
except ASC in 60 dB SPL noise.
Conclusions: The results of this study suggest that the use of processing options that utilize
noise reduction, like those available in ASC and BEAM, improve a CI recipient's ability
to understand speech in noise in listening situations similar to those experienced
in the real world. The choice of the best processing option is dependent on the noise
level, with BEAM best at moderate noise levels and ASC best at loud noise levels for
unilateral CI recipients. Therefore, multiple noise programs or a combination of processing
options may be necessary to provide CI users with the best performance in a variety
of listening situations.
Key Words
Binaural hearing - cochlear implants - directional microphone - noise reduction -
speech perception
