Relationship Between Speech Recognition in Quiet and Noise and Fitting Parameters, Impedances and ECAP Thresholds in Adult Cochlear Implant Users

Feike de Graaff, Birgit I Lissenberg-Witte, Marre W Kaandorp, Paul Merkus, S Theo Goverts, Sophia E Kramer, Cas Smits, de Graaff F., Lissenberg-Witte B.I., Kaandorp M.W., Merkus P., Goverts S.T., Kramer S.E., Smits C.

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: The objective of this study was to identify parameters which are related to speech recognition in quiet and in noise of cochlear implant (CI) users. These parameters may be important to improve current fitting practices. DESIGN: Adult CI users who visited the Amsterdam UMC, location VUmc, for their annual follow-up between January 2015 and December 2017 were retrospectively identified. After applying inclusion criteria, the final study population consisted of 138 postlingually deaf adult Cochlear CI users. Prediction models were built with speech recognition in quiet and in noise as the outcome measures, and aided sound field thresholds, and parameters related to fitting (i.e., T and C levels, dynamic range [DR]), evoked compound action potential thresholds and impedances as the independent variables. A total of 33 parameters were considered. Separate analyses were performed for postlingually deafened CI users with late onset (LO) and CI users with early onset (EO) of severe hearing impairment. RESULTS: Speech recognition in quiet was not significantly different between the LO and EO groups. Speech recognition in noise was better for the LO group compared with the EO group. For CI users in the LO group, mean aided thresholds, mean electrical DR, and measures to express the impedance profile across the electrode array were identified as predictors of speech recognition in quiet and in noise. For CI users in the EO group, the mean T level appeared to be a significant predictor in the models for speech recognition in quiet and in noise, such that CI users with elevated T levels had worse speech recognition in quiet and in noise. CONCLUSIONS: Significant parameters related to speech recognition in quiet and in noise were identified: aided thresholds, electrical DR, T levels, and impedance profiles. The results of this study are consistent with previous study findings and may guide audiologists in their fitting practices to improve the performance of CI users. The best performance was found for CI users with aided thresholds around the target level of 25 dB HL, and an electrical DR between 40 and 60 CL. However, adjustments of T and/or C levels to obtain aided thresholds around the target level and the preferred DR may not always be acceptable for individual CI users. Finally, clinicians should pay attention to profiles of impedances other than a flat profile with mild variations.
Original languageEnglish
JournalEar and Hearing
DOIs
Publication statusPublished - 5 Nov 2019

Cite this

@article{1cf3d986cc1c422694c9eced1f3d5e49,
title = "Relationship Between Speech Recognition in Quiet and Noise and Fitting Parameters, Impedances and ECAP Thresholds in Adult Cochlear Implant Users",
abstract = "OBJECTIVES: The objective of this study was to identify parameters which are related to speech recognition in quiet and in noise of cochlear implant (CI) users. These parameters may be important to improve current fitting practices. DESIGN: Adult CI users who visited the Amsterdam UMC, location VUmc, for their annual follow-up between January 2015 and December 2017 were retrospectively identified. After applying inclusion criteria, the final study population consisted of 138 postlingually deaf adult Cochlear CI users. Prediction models were built with speech recognition in quiet and in noise as the outcome measures, and aided sound field thresholds, and parameters related to fitting (i.e., T and C levels, dynamic range [DR]), evoked compound action potential thresholds and impedances as the independent variables. A total of 33 parameters were considered. Separate analyses were performed for postlingually deafened CI users with late onset (LO) and CI users with early onset (EO) of severe hearing impairment. RESULTS: Speech recognition in quiet was not significantly different between the LO and EO groups. Speech recognition in noise was better for the LO group compared with the EO group. For CI users in the LO group, mean aided thresholds, mean electrical DR, and measures to express the impedance profile across the electrode array were identified as predictors of speech recognition in quiet and in noise. For CI users in the EO group, the mean T level appeared to be a significant predictor in the models for speech recognition in quiet and in noise, such that CI users with elevated T levels had worse speech recognition in quiet and in noise. CONCLUSIONS: Significant parameters related to speech recognition in quiet and in noise were identified: aided thresholds, electrical DR, T levels, and impedance profiles. The results of this study are consistent with previous study findings and may guide audiologists in their fitting practices to improve the performance of CI users. The best performance was found for CI users with aided thresholds around the target level of 25 dB HL, and an electrical DR between 40 and 60 CL. However, adjustments of T and/or C levels to obtain aided thresholds around the target level and the preferred DR may not always be acceptable for individual CI users. Finally, clinicians should pay attention to profiles of impedances other than a flat profile with mild variations.",
keywords = "action potential, adult, article, attention, audiologist, cochlea prosthesis, controlled study, electrode, female, follow up, hearing impairment, human, impedance, independent variable, male, noise, outcome assessment, prediction, retrospective study, speech discrimination",
author = "{de Graaff}, Feike and Lissenberg-Witte, {Birgit I} and Kaandorp, {Marre W} and Paul Merkus and Goverts, {S Theo} and Kramer, {Sophia E} and Cas Smits and F., {de Graaff} and Lissenberg-Witte B.I. and Kaandorp M.W. and Merkus P. and Goverts S.T. and Kramer S.E. and Smits C.",
year = "2019",
month = "11",
day = "5",
doi = "10.1097/AUD.0000000000000814",
language = "English",
journal = "Ear and Hearing",
issn = "0196-0202",
publisher = "LWW",

}

Relationship Between Speech Recognition in Quiet and Noise and Fitting Parameters, Impedances and ECAP Thresholds in Adult Cochlear Implant Users. / de Graaff, Feike; Lissenberg-Witte, Birgit I; Kaandorp, Marre W; Merkus, Paul; Goverts, S Theo; Kramer, Sophia E; Smits, Cas; F., de Graaff; B.I., Lissenberg-Witte; M.W., Kaandorp; P., Merkus; S.T., Goverts; S.E., Kramer; C., Smits.

In: Ear and Hearing, 05.11.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Relationship Between Speech Recognition in Quiet and Noise and Fitting Parameters, Impedances and ECAP Thresholds in Adult Cochlear Implant Users

AU - de Graaff, Feike

AU - Lissenberg-Witte, Birgit I

AU - Kaandorp, Marre W

AU - Merkus, Paul

AU - Goverts, S Theo

AU - Kramer, Sophia E

AU - Smits, Cas

AU - F., de Graaff

AU - B.I., Lissenberg-Witte

AU - M.W., Kaandorp

AU - P., Merkus

AU - S.T., Goverts

AU - S.E., Kramer

AU - C., Smits

PY - 2019/11/5

Y1 - 2019/11/5

N2 - OBJECTIVES: The objective of this study was to identify parameters which are related to speech recognition in quiet and in noise of cochlear implant (CI) users. These parameters may be important to improve current fitting practices. DESIGN: Adult CI users who visited the Amsterdam UMC, location VUmc, for their annual follow-up between January 2015 and December 2017 were retrospectively identified. After applying inclusion criteria, the final study population consisted of 138 postlingually deaf adult Cochlear CI users. Prediction models were built with speech recognition in quiet and in noise as the outcome measures, and aided sound field thresholds, and parameters related to fitting (i.e., T and C levels, dynamic range [DR]), evoked compound action potential thresholds and impedances as the independent variables. A total of 33 parameters were considered. Separate analyses were performed for postlingually deafened CI users with late onset (LO) and CI users with early onset (EO) of severe hearing impairment. RESULTS: Speech recognition in quiet was not significantly different between the LO and EO groups. Speech recognition in noise was better for the LO group compared with the EO group. For CI users in the LO group, mean aided thresholds, mean electrical DR, and measures to express the impedance profile across the electrode array were identified as predictors of speech recognition in quiet and in noise. For CI users in the EO group, the mean T level appeared to be a significant predictor in the models for speech recognition in quiet and in noise, such that CI users with elevated T levels had worse speech recognition in quiet and in noise. CONCLUSIONS: Significant parameters related to speech recognition in quiet and in noise were identified: aided thresholds, electrical DR, T levels, and impedance profiles. The results of this study are consistent with previous study findings and may guide audiologists in their fitting practices to improve the performance of CI users. The best performance was found for CI users with aided thresholds around the target level of 25 dB HL, and an electrical DR between 40 and 60 CL. However, adjustments of T and/or C levels to obtain aided thresholds around the target level and the preferred DR may not always be acceptable for individual CI users. Finally, clinicians should pay attention to profiles of impedances other than a flat profile with mild variations.

AB - OBJECTIVES: The objective of this study was to identify parameters which are related to speech recognition in quiet and in noise of cochlear implant (CI) users. These parameters may be important to improve current fitting practices. DESIGN: Adult CI users who visited the Amsterdam UMC, location VUmc, for their annual follow-up between January 2015 and December 2017 were retrospectively identified. After applying inclusion criteria, the final study population consisted of 138 postlingually deaf adult Cochlear CI users. Prediction models were built with speech recognition in quiet and in noise as the outcome measures, and aided sound field thresholds, and parameters related to fitting (i.e., T and C levels, dynamic range [DR]), evoked compound action potential thresholds and impedances as the independent variables. A total of 33 parameters were considered. Separate analyses were performed for postlingually deafened CI users with late onset (LO) and CI users with early onset (EO) of severe hearing impairment. RESULTS: Speech recognition in quiet was not significantly different between the LO and EO groups. Speech recognition in noise was better for the LO group compared with the EO group. For CI users in the LO group, mean aided thresholds, mean electrical DR, and measures to express the impedance profile across the electrode array were identified as predictors of speech recognition in quiet and in noise. For CI users in the EO group, the mean T level appeared to be a significant predictor in the models for speech recognition in quiet and in noise, such that CI users with elevated T levels had worse speech recognition in quiet and in noise. CONCLUSIONS: Significant parameters related to speech recognition in quiet and in noise were identified: aided thresholds, electrical DR, T levels, and impedance profiles. The results of this study are consistent with previous study findings and may guide audiologists in their fitting practices to improve the performance of CI users. The best performance was found for CI users with aided thresholds around the target level of 25 dB HL, and an electrical DR between 40 and 60 CL. However, adjustments of T and/or C levels to obtain aided thresholds around the target level and the preferred DR may not always be acceptable for individual CI users. Finally, clinicians should pay attention to profiles of impedances other than a flat profile with mild variations.

KW - action potential

KW - adult

KW - article

KW - attention

KW - audiologist

KW - cochlea prosthesis

KW - controlled study

KW - electrode

KW - female

KW - follow up

KW - hearing impairment

KW - human

KW - impedance

KW - independent variable

KW - male

KW - noise

KW - outcome assessment

KW - prediction

KW - retrospective study

KW - speech discrimination

UR - http://www.mendeley.com/research/relationship-between-speech-recognition-quiet-noise-fitting-parameters-impedances-ecap-thresholds-ad

U2 - 10.1097/AUD.0000000000000814

DO - 10.1097/AUD.0000000000000814

M3 - Article

JO - Ear and Hearing

JF - Ear and Hearing

SN - 0196-0202

ER -