posted on 2022-04-08, 17:11authored byMargaret T. Dillon, Brendan P. O’Connell, Michael W. Canfarotta, Emily Buss, Joseph Hopfinger
Purpose: Cochlear implant (CI) recipients demonstrate variable speech recognition when listening with a CI-alone or electric-acoustic stimulation (EAS) device, which may be due in part to electric frequency-to-place mismatches created by the default mapping procedures. Performance may be improved if the filter frequencies are aligned with the cochlear place frequencies, known as place-based mapping. Performance with default maps versus an experimental place-based map was compared for participants with normal hearing when listening to CI-alone or EAS simulations to observe potential outcomes prior to initiating an investigation with CI recipients.
Method: A noise vocoder simulated CI-alone and EAS devices, mapped with default or place-based procedures. The simulations were based on an actual 24-mm electrode array recipient, whose insertion angles for each electrode contact were used to estimate the respective cochlear place frequency. The default maps used the filter frequencies assigned by the clinical software. The filter frequencies for the place-based maps aligned with the cochlear place frequencies for individual contacts in the low- to mid-frequency cochlear region. For the EAS simulations, low-frequency acoustic information was filtered to simulate aided low-frequency audibility. Performance was evaluated for the AzBio sentences presented in a 10-talker masker at +5 dB signal-to-noise ratio (SNR), +10 dB SNR, and asymptote.
Results: Performance was better with the place-based maps as compared with the default maps for both CI-alone and EAS simulations. For instance, median performance at +10 dB SNR for the CI-alone simulation was 57% correct for the place-based map and 20% for the default map. For the EAS simulation, those values were 59% and 37% correct. Adding acoustic low-frequency information resulted in a similar benefit for both maps.
Conclusions: Reducing frequency-to-place mismatches, such as with the experimental place-based mapping procedure, produces a greater benefit in speech recognition than maximizing bandwidth for CI-alone and EAS simulations. Ongoing work is evaluating the initial and long-term performance benefits in CI-alone and EAS users.
Supplemental Material S1. Regression coefficients for the linear mixed model that compared performance between default and place-based maps that would be used clinically.
Supplemental Material S2. Regression coefficients for the linear mixed model that assessed the benefit of adding acoustic low-frequency information to default maps with spectrally shifted information and place-based maps.
Dillon, M. T., O'Connell, B. P., Canfarotta, M. W., Buss, E., & Hopfinger, J. (2022). Effect of placed-based versus default mapping procedures on masked speech recognition: Simulations of cochlear implant alone and electric-acoustic stimulation. American Journal of Audiology. Advance online publication. https://doi.org/10.1044/2022_AJA-21-00123
M.T.D. and E.B. are supported by a research grant provided to the university from MED-EL Corporation. B.P.O. is a consultant for Advanced Bionics Corporation MED-EL Corporation, and Johnson and Johnson. This work was funded in part by a clinical research grant provided by the Department of Otolaryngology/Head & Neck Surgery at the University of North Carolina at Chapel Hill and by the National Institute on Deafness and Other Communication Disorders under Award Numbers R21DC018389 and T32DC005460.