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Relationship Between Auditory Function of Nonimplanted Ears and Bimodal Benefit

Zhang, Ting1; Spahr, Anthony J.1; Dorman, Michael F.1; Saoji, Aniket2

doi: 10.1097/AUD.0b013e31826709af
Research Articles

Objectives: Patients with a cochlear implant (CI) in one ear and a hearing aid in the other ear commonly achieve the highest speech-understanding scores when they have access to both electrically and acoustically stimulated information. At issue in this study was whether a measure of auditory function in the hearing aided ear would predict the benefit to speech understanding when the information from the aided ear was added to the information from the CI.

Design: The subjects were 22 bimodal listeners with a CI in one ear and low-frequency acoustic hearing in the nonimplanted ear. The subjects were divided into two groups—one with mild-to-moderate low-frequency loss and one with severe-to-profound loss. Measures of auditory function included (1) audiometric thresholds at 750 Hz or lower, (2) speech-understanding scores (words in quiet and sentences in noise), and (3) spectral-modulation detection (SMD) thresholds. In the SMD task, one stimulus was a flat spectrum noise and the other was a noise with sinusoidal modulations at 1.0 peak/octave.

Results: Significant correlations were found among all three measures of auditory function and the benefit to speech understanding when the acoustic and electric stimulation were combined. Benefit was significantly correlated with audiometric thresholds (r = −0.814), acoustic speech understanding (r = 0.635), and SMD thresholds (r = −0.895) in the hearing aided ear. However, only the SMD threshold was significantly correlated with benefit within the group with mild-to-moderate loss (r = −0.828) and within the group with severe-to-profound loss (r = −0.896).

Conclusions: The SMD threshold at 1 cycle/octave has the potential to provide clinicians with information relevant to the question of whether an ear with low-frequency hearing is likely to add to the intelligibility of speech provided by a CI.

It is increasingly common to find cochlear implant users with some degree of hearing in the contralateral ear. Combining the acoustic signal from the nonimplanted ear with the electric signal from the cochlear implant often improves sound quality and speech understanding. However, the degree of auditory function in these nonimplanted ears and the degree of benefit they provide varies considerably across listeners. The authors describe the relationship between benefit and three measures of auditory function: audiometric thresholds, speech understanding, and spectral-envelope perception. Of these measures, the one most closely correlated with benefit was spectral-envelope perception (r = 0.89).

1Department of Speech and Hearing Science, Arizona State University, Tempe, California, USA; and 2Advanced Bionics Corporation, Valencia, California, USA.

ACKNOWLEDGMENTS: The authors thank Louise Loiselle for helping recruit bimodal patients and also thank all the subjects who participated in this research. This research was supported by grants from the National Institute of Deafness and Other Communication Disorders to authors Ting Zhang (F32 DC010937), Anthony J. Spahr (R03 DC011052), and Michael F. Dorman (R01 DC010821) and from Advanced Bionics.

The authors have no conflicts of interest to disclose.

Address for correspondence: Anthony J. Spahr, Arizona State University, Cochlear Implant Research Lab, Lattie F. Coor Hall, Room 3462, Tempe, AZ, 85287, USA. E-mail:

Received July 14, 2011

Accepted June 26, 2012

© 2013 by Lippincott Williams & Wilkins