Impact of Stimulus Delivery Method on Music Enjoyment in Cochlear Implant Users

Previous work has shown that music re-engineering can enhance music enjoyment in cochlear implant (CI) recipients. In this study, we investigate the impact of the mechanism of stimulus delivery on music enjoyment by comparing direct streaming (DS) with external audio (EA).

Prospective cohort study.

Academic cochlear implant center.

Eligibility criteria included (1) age 18 years or above, (2) unilateral or bilateral CI, (3) at least 3 months' status post cochlear implantation, and (4) English-speaking.

Patients were assigned to listen to music excerpts through DS or external audio (EA). A retest with the opposite stimulus modality was requested 2 weeks after the initial visit.

Patients rated music excerpts from various genres on 3 metrics: musicality, naturalness, and pleasantness. These scores were combined to create a total enjoyment score.

Thirty-six subjects with a mean age of 63 years (SD 16.23, range 20 to 86) participated in the study. Twenty-four returned for retesting with the opposite stimulus delivery. Across all tests, there was a preference for EA over DS (mean difference +0.81, P <0.0001). Within the unilaterally implanted subjects, CI + deaf ear group scored EA significantly lower than both the CI + NH and CI + HA/impaired hearing groups ( P <0.0001). There was no difference between EA and DS in bilaterally implanted users. In total, 83.3% of subjects reported that utilization of the audio mixer increased music enjoyment, and 77.8% of subjects expressed a desire to use it on music of their own choosing.

Subjects with unilateral CI demonstrated a preference for EA over DS, which was consistent after retest with randomization. In CI-only conditions (bilateral CI or CI + deaf), subjects had a slight preference for DS or no difference. EA and DS should not be considered equivalent methods of stimulus delivery in the assessment of music enjoyment in unilateral CI recipients.