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Related Experiment Videos

Speech perception in nucleus CI24M cochlear implant users with processor settings based on electrically evoked

Guido F Smoorenburg1, Christina Willeboer, Johannes E van Dijk

  • 1Department of Otorhinolaryngology, University Medical Centre, Utrecht, The Netherlands. g.smoorenburg@kmb.azu.nl

Audiology & Neuro-Otology
|October 29, 2002
PubMed
Summary

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Cochlear implant processor adjustment using electrically evoked compound action potential (ECAP) thresholds showed speech perception is insensitive to threshold settings but sensitive to high-frequency stimulation. ECAP thresholds did not reliably predict optimal settings for better hearing outcomes.

Area of Science:

  • Audiology
  • Biomedical Engineering
  • Neuroscience

Background:

  • Cochlear implant speech processor adjustment is complex and time-consuming.
  • Optimizing processor settings is crucial for effective implant-mediated hearing, especially in pediatric users.
  • Current methods require subjective user feedback, posing challenges for initial device fitting.

Purpose of the Study:

  • To investigate the feasibility of using electrically evoked compound action potential (ECAP) thresholds for cochlear implant speech processor adjustment.
  • To evaluate if ECAP-derived profiles can simplify and improve the initial fitting process.
  • To correlate ECAP measurements with subjective hearing thresholds and loudness levels.

Main Methods:

  • ECAP thresholds were measured across the electrode array to create an adjustment profile.

Related Experiment Videos

  • The profile's overall level was adjusted to hearing and comfortable loudness levels using live voice.
  • Speech perception was assessed using CVC word lists with the new and conventional fitting methods.

    • Main Results:

    • Speech perception scores showed minimal decrease (under 10%) even with doubled dynamic range due to lower ECAP-based threshold settings.
    • Higher high-frequency stimulation settings for basal electrodes negatively impacted speech scores.
    • Correlation between ECAP thresholds and subjective thresholds was weak (r=0.64), but slope correlation was satisfactory (r=0.82).
    • ECAP thresholds poorly predicted maximum stimulation levels and the critical slope of the maximum stimulation curve.

    Conclusions:

    • ECAP thresholds alone are not sufficient for accurate cochlear implant speech processor adjustment.
    • The sensitivity of speech perception to high-frequency stimulation highlights its importance in fitting.
    • While ECAP-based adjustment showed potential for a more user-friendly procedure with minimal impact on speech scores, further refinement is needed to predict critical parameters effectively.