Suitability of auditory speech sound evaluation (A§E®) in German cochlear implant patients

A§E® is an audiological evaluation tool based on speech sounds as stimuli and was developed by The Eargroup, Antwerp. It consists of three levels: detection, discrimination and identification of phonemes and is a sufficient tool to measure supraliminal auditory capacities in Flemish language of children 10 months and older as well as adults. The aim of this study was to test the suitability of patients for cochlear implant in Germany, using 245 consecutive measurements (141 adults, 79 children, 25 controls) in a standard test protocol for phoneme detection and discrimination, Mainzer and Göttinger in children and Freiburger in adults pre-, 3 and 6 months and 1 year after implantation. Results in detection and discrimination regarding frequency spectrum and fitting parameters were evaluated using the following statistical methods: t test and correlation analysis. Detection improves first, followed by numbers, phoneme discrimination and monosyllables. Test results compared pre- to 3, 6 months and later, postoperatively, differ significantly (p < 0.05). A "ceiling-effect" is obtained between 6 months and 1 year (reproduction in A§E® >90%). Development of detection and discrimination correlates directly with results in numbers and monosyllables (r = 0.92). Non-German speaking patients cope better with A§E® than with numbers and monosyllables. Evaluation of phoneme discrimination enables better frequency specific fitting. Results indicated that A§E® is a valuable diagnostic supplement in fitting and therapy of cochlear implant patients regardless of cognitive level, age and language. Important information on frequency-resolving power of cochlear nerve after implantation is gained. Use of A§E® enables comparability and evaluation of study results in different countries.