Hearing Loss Clinical Trial
Official title:
Assessment of the Contribution of Combined Acoustic Hearing Via a Hearing Aid and Electric Hearing Via a Cochlear Implant in Adult Bimodal Users Following Using a HA With a Dedicated Bimodal Fitting Formula
Introduction: Bilateral-bimodal users may benefit from bilateral-binaural and a bimodal
effect . The two modes of stimulation complement each other and may overcome the limitation
of electric hearing alone. However, alongside the expected benefits of having two hearing
systems in bilateral bimodal hearing, there are several inherent mismatches in combing two
different stimulation methods, which may negatively impact the processing of the binaural
cues.
Aim: To determine whether bimodal listening with a hearing aid programmed using a dedicated
bimodal fitting formula, which aligns the frequency response, loudness growth functions, and
automatic gain control (AGC) characteristics between the cochlear implant speech processor
and the hearing aid brings additional benefit over bimodal listening with the subject's
clinical hearing instrument via the use of using a comprehensive battery of speech
perception tests aimed at different aspects of binaural hearing as well as the contribution
of the unique bimodal complementary effect. A secondary goal is to identify the tests that
are best suited to predicting and evaluating bimodal benefit.
Method: The study will include 20 Hebrew and 20 Arabic speakers' adult bilateral-bimodal
users that their audiometric thresholds in the non implanted ear will be no worse than 75 dB
HL at 250 and 85 dB HL at 500 Hz, who use their hearing aids for at least 75% of their
waking hours. The added benefit of the hearing aid programmed using a dedicated bimodal
fitting formula will be evaluated using six task-specific tests designed to sensitively
assess the bilateral-binaural and bimodal complementary effects using roving speech and
noise and different types of background noises (maskers), pitch-related task and subjective
questionnaire. Participants will be tested twice in quick succession, at two-weekly
intervals, in establishing a baseline score with their clinical HAs. Then participants will
be tested again twice in quick succession, at two-weekly intervals following three month
experience with the HA fitted with the bimodal fitting formula. All tests will be
administered the CI/HA listening condition.
Introduction: Bilateral-bimodal hearing, cochlear implant on one ear and hearing aid on the
other ear (CI/HA) may benefit from bilateral-binaural effects as a result of using two
hearing systems, and a bimodal effect as a result of using two modes of stimulation, namely
acoustic via a HA and electrical via a CI. The two modes of stimulation complement each
other and may overcome the limitation of electric hearing alone. However, alongside the
expected benefits of having two hearing systems in bilateral bimodal hearing, there are
several inherent mismatches in combing two different stimulation methods, which may
negatively impact the processing of the binaural cues. These mismatches include mismatch in
the incoming speech signal timing; mismatch in pitch balance between two devices, mismatch
in the frequency range conferred, and mismatch in the frequency range conveyed to a specific
location in the cochlea by the cochlear implant and to a different location in the
contra-lateral cochlea by the hearing aid.
Aim: To determine whether bimodal listening with a hearing aid programmed using a dedicated
bimodal fitting formula, which aligns the frequency response, loudness growth functions, and
automatic gain control (AGC) characteristics between the cochlear implant speech processor
and the hearing aid brings additional benefit over bimodal listening with the subject's
clinical hearing instrument via the use of using a comprehensive battery of speech
perception tests aimed at different aspects of binaural hearing as well as the contribution
of the unique bimodal complementary effect. A secondary goal is to identify the tests that
are best suited to predicting and evaluating bimodal benefit.
Method: The study will include 20 Hebrew and 20 Arabic speakers' adult bilateral-bimodal
users that their audiometric thresholds in the non implanted ear will be no worse than 75 dB
HL at 250 and 85 dB HL at 500 Hz, who use their hearing aids for at least 75% of their
waking hours. The added benefit of the hearing aid programmed using a dedicated bimodal
fitting formula will be evaluated using six task-specific tests designed to sensitively
assess the bilateral-binaural and bimodal complementary effects using roving speech and
noise and different types of background noises (maskers), pitch-related task and subjective
questionnaire. Participants will be tested twice in quick succession, at two-weekly
intervals, in establishing a baseline score with their clinical HAs. Then participants will
be tested again twice in quick succession, at two-weekly intervals following three month
experience with the HA fitted with the bimodal fitting formula. All tests will be
administered the CI/HA listening condition.
Data analysis: Speech perception test results and self-rating questionnaire scores will be
analyzed by repeated measure analysis of variance. The difference between the two moods of
bimodal listening (clinical HA versus HA fitted by the bimodal formula) will be evaluated.
Correlation between audiological variables aided and unaided hearing thresholds in the
non-implanted ear and the bilateral-bimodal benefit will be examined as well.
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