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Related Concept Videos

The Cochlea01:13

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The cochlea is a coiled structure in the inner ear that contains hair cells—the sensory receptors of the auditory system. Sound waves are transmitted to the cochlea by small bones attached to the eardrum called the ossicles, which vibrate the oval window that leads to the inner ear. This causes fluid in the chambers of the cochlea to move, vibrating the basilar membrane.
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The human brain perceives pitch through two primary mechanisms reflected in place theory and frequency theory. Each mechanism describes how sound waves are interpreted as specific pitches by the brain, offering insights into the intricate processes of auditory perception.
Place theory, or place coding, suggests that different pitches are heard because various sound waves activate specific locations along the cochlea's basilar membrane. The brain determines the pitch of a sound by...
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Frequency-dependent loudness balancing in bimodal cochlear implant users.

Lidwien C E Veugen1, Josef Chalupper2, Ad F M Snik3

  • 1a Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour , Radboud University Nijmegen , Nijmegen , the Netherlands ;

Acta Oto-Laryngologica
|March 18, 2016
PubMed
Summary

Frequency-dependent loudness balancing for cochlear implant (CI) and hearing aid (HA) users did not improve speech understanding on average. However, some individuals benefited from specific fittings, suggesting personalized approaches are key for bimodal stimulation.

Keywords:
Bimodal stimulationcochlear implantshearing aidsloudness balancingspeech perception

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Area of Science:

  • Audiology
  • Neuroscience
  • Biomedical Engineering

Background:

  • Bimodal stimulation, using a cochlear implant (CI) and a hearing aid (HA) in opposite ears, can yield significant benefits for hearing.
  • Individual variability in speech understanding outcomes is substantial among bimodal users.
  • Suboptimal device fitting and loudness mismatches are potential contributors to this variability.

Purpose of the Study:

  • To compare the effectiveness of frequency-dependent loudness balancing versus broadband balancing for bimodal hearing aid users.
  • To investigate if tailored loudness adjustments improve speech understanding in quiet and noise.
  • To explore factors contributing to individual differences in bimodal fitting outcomes.

Main Methods:

  • A cross-over study design with 15 participants using a CI and HA in contralateral ears.
  • Hearing aid gain was adjusted in three frequency bands (0-548 Hz, 548-1000 Hz, >1000 Hz) for soft and loud sounds to match CI loudness.
  • This was compared to a standard broadband loudness balancing procedure.
  • Speech understanding was assessed in quiet and noise, and subjective benefit was measured via questionnaires.

Main Results:

  • Both loudness balancing methods yielded similar hearing aid gains.
  • No significant difference in speech understanding was observed between the two balancing procedures in quiet or noise.
  • A marginal average bimodal benefit of 0.3 ± 4 dB was found for speech in noise, with considerable inter-subject variability.

Conclusions:

  • Frequency-dependent loudness balancing, on average, did not outperform broadband balancing for bimodal users.
  • Despite average results, a subset of participants (9 out of 15) demonstrated significantly improved speech understanding with one of the tested fittings.
  • The findings highlight the presence of significant individual differences and the potential need for personalized fitting strategies in bimodal stimulation.