Otolaryngology - Theses
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ItemAn evaluation of speech perception when introducing ADRO to adults who use both a cochlear implant and a contralateral hearing aid( 2011)Speech perception outcomes obtainable with cochlear implants have improved over time, so cochlear implantation is now routinely offered to adults with residual hearing who gain benefit from using a hearing aid in their contralateral ear. To maximize the overall sound perception abilities for these patients, we need to consider optimizing the fittings of both the cochlear implant and the hearing aid. One means of optimizing a person's speech perception is to allow them to trial sound processing schemes and evaluate their effects on speech recognition. Adaptive Dynamic Range Optimization (ADRO) is one such scheme that is available in Cochlear Limited's speech processors and has been shown to offer speech perception benefits for adult and paediatric cochlear implant recipients. More recently, ADRO has been implemented in hearing aids and shown to offer some speech perception benefits over other hearing aid amplification algorithms. The aim of this study is to evaluate the ADRO sound processing scheme when implemented in both a cochlear implant speech processor and a hearing aid in a group of adults who would normally wear both (bimodal) devices. Following a period of take-home experience with all device combinations, speech perception measures using words presented at 50dB SPL and 60dB SPL and sentences presented with competing noise were evaluated for the participants using their devices with and without ADRO activated, and the results compared. Participant preferences for the bimodal device combinations were also obtained using a take-home questionnaire. The results from this study show that adults can obtain significant improvement in speech perception when listening in quiet environments when ADRO is activated in both their hearing aid and cochlear implant. The greatest benefit is seen when listening to softer levels of speech. There is no detrimental effect on speech perception when using ADRO in the bimodal device condition in noisy environments. Whist statistically significant differences in speech perception scores were observed between the bimodal-ADRO and no-ADRO device combinations, the differences were not large. This is reflected in the participants indicating no overall preference for either device combination. The outcomes of this study suggest that adults who routinely use a cochlear implant in one ear and a hearing aid in the other could benefit from having ADRO implemented in both devices.