Noise reduction results of an adaptive filtering technique for dual-microphone behind-the-ear hearing aids

OBJECTIVE: The performance of an adaptive beam-former in a 2-microphone, behind-the-ear hearing aid for speech understanding in noisy environments was evaluated. Physical and perceptual evaluations were carried out. This was the first large-scale test of a wearable real-time implementation of this algorithm. The main perceptual research questions of this study were related to the influence on the noise reduction performance of (1) the spectro-temporal character of the jammer sound, (2) the jammer sound scene, (3) hearing impairment, and (4) the basic microphone configuration in the hearing aid. Four different speech materials were used for the perceptual evaluations. All tests were carried out in an acoustical environment comparable to living room reverberation. DESIGN: The adaptive beamformer was implemented in Audallion, a small, body-worn processor, linked to a Danasound 2-microphone behind-the-ear aid. The strategy was evaluated physically in different acoustical environments. Using speech reception threshold (SRT) measurements, the processing was evaluated perceptually and the different research questions addressed with three groups of subjects. Groups I, II, and III consisted of 10 normal-hearing, 5 hearing-impaired, and 7 normal-hearing persons, respectively. The tests were carried out in three spectro-temporally different jammer sounds (unmodulated and modulated speech weighted noise, multitalker babble) and in three different noise scenarios (single noise source at 90 degrees, noise sources at 90 degrees and 270 degrees relative to speaker position, diffuse noise scene). Two microphone configurations were compared: a device equipped with two omnidirectional microphones and a device equipped with one hardware directional and one omnidirectional microphone. In each of these conditions, the adaptive beamformer and the directional and omnidirectional microphone configurations were tested. RESULTS: The improvement in signal-to-noise ratio from the use of the adaptive beamformer did not depend on the spectro-temporal character of the jammer sounds and the speech materials used, although the absolute levels of the SRTs varied appreciably for different speech-noise combinations. The performance of the adaptive noise reduction depended on the jammer sound scene. CONCLUSIONS: No difference in signal-to-noise ratio improvement was observed between hearing-impaired and normal-hearing listeners, although individual SRT levels may differ. On average, an SRT improvement of 7.7 and 3.9 dB for a single noise source at 90 degrees and 5.9 and 3.4 dB for two noise sources at 90 degrees and 270 degrees was obtained for both normal-hearing and hearing-impaired listeners, using the adaptive beamformer and the directional microphone, respectively, relative to the omnidirectional microphone signal. In diffuse noise, only small improvements were obtained.     

Speech intelligibility in noisy environments with one- and two-microphone hearing aids

In this study speech intelligibility in background noise was evaluated with 10 binaural hearing-aid users for hearing aids with one omnidirectional microphone and a hearing aid with a two-microphone configuration (enabling an omnidirectional as well as a directional mode). Signal-to-noise ratio (SNR) measurements were carried out for three different types of background noise (speech-weighted noise, traffic noise and restaurant noise) and two kinds of speech material (bisyllabic word lists and sentences). The average SNR improvement of the directional microphone configuration relative to the omnidirectional one was 3.4 dB for noise presented from 90 degrees azimuth. This improvement was independent of the specific type of noise and speech material, indicating that one speech-in-noise condition may yield enough relevant information in the evaluation of directional microphones and speech understanding in noise.     

Speech-clarity judgments of hearing-aid-processed speech in noise: Differing polar patterns and acoustic environments

This investigation assessed the extent to which listeners’ preferences for hearing aid microphone polar patterns vary across listening environments, and whether normal-hearing and inexperienced and experienced hearing-impaired listeners differ in such preferences. Paired-comparison judgments of speech clarity (i.e. subjective speech intelligibility) were made monaurally for recordings of speech in noise processed by a commercially available hearing aid programmed with an omnidirectional and two directional polar patterns (cardioid and hypercardioid). Testing environments included a sound-treated room, a living room, and a classroom. Polar-pattern preferences were highly reliable and agreed closely across all three groups of listeners. All groups preferred listening in the sound-treated room over listening in the living room, and preferred listening in the living room over listening in the classroom. Each group preferred the directional patterns to the omnidirectional pattern in all room conditions. We observed no differences in preference judgments between the two directional patterns or between hearing-impaired listeners’ extent of amplification experience. Overall, findings indicate that listeners perceived qualitative benefits from microphones having directional polar patterns.     

Speech-clarity judgments of hearing-aid-processed speech in noise: differing polar patterns and acoustic environments

This investigation assessed the extent to which listeners' preferences for hearing aid microphone polar patterns vary across listening environments, and whether normal-hearing and inexperienced and experienced hearing-impaired listeners differ in such preferences. Paired-comparison judgments of speech clarity (i.e. subjective speech intelligibility) were made monaurally for recordings of speech in noise processed by a commercially available hearing aid programmed with an omnidirectional and two directional polar patterns (cardioid and hypercardioid). Testing environments included a sound-treated room, a living room, and a classroom. Polar-pattern preferences were highly reliable and agreed closely across all three groups of listeners. All groups preferred listening in the sound-treated room over listening in the living room, and preferred listening in the living room over listening in the classroom. Each group preferred the directional patterns to the omnidirectional pattern in all room conditions. We observed no differences in preference judgments between the two directional patterns or between hearing-impaired listeners' extent of amplification experience. Overall, findings indicate that listeners perceived qualitative benefits from microphones having directional polar patterns.     

Effect of signal-to-noise ratio on directional microphone benefit and preference

This study examined speech intelligibility and preferences for omnidirectional and directional microphone hearing aid processing across a range of signal-to-noise ratios (SNRs). A primary motivation for the study was to determine whether SNR might be used to represent distance between talker and listener in automatic directionality algorithms based on scene analysis. Participants were current hearing aid users who either had experience with omnidirectional microphone hearing aids only or with manually switchable omnidirectional/directional hearing aids. Using IEEE/Harvard sentences from a front loudspeaker and speech-shaped noise from three loudspeakers located behind and to the sides of the listener, the directional advantage (DA) was obtained at 11 SNRs ranging from -15 dB to +15 dB in 3 dB steps. Preferences for the two microphone modes at each of the 11 SNRs were also obtained using concatenated IEEE sentences presented in the speech-shaped noise. Results revealed that a DA was observed across a broad range of SNRs, although directional processing provided the greatest benefit within a narrower range of SNRs. Mean data suggested that microphone preferences were determined largely by the DA, such that the greater the benefit to speech intelligibility provided by the directional microphones, the more likely the listeners were to prefer that processing mode. However, inspection of the individual data revealed that highly predictive relationships did not exist for most individual participants. Few preferences for omnidirectional processing were observed. Overall, the results did not support the use of SNR to estimate the effects of distance between talker and listener in automatic directionality algorithms.     

正常听力受试者佩戴不同组合全向性与方向性麦克风的效果比较

目的 比较噪声环境下全向性麦克风与自适应方向性麦克风的不同组合佩戴方式对听力正常成年人言语识别率的影响,从而选择最佳的组合佩戴方式.方法 选择20例(40耳)听力正常青年人(男、女各10例)分别按照双耳全向性麦克风模式(组合1),双耳自适应方向性麦克风模式(组合2),一耳全向性麦克风、一耳自适应麦克风模式(组合3)3种方式,在信噪比变化的漫射声场中进行言语识别率测试,从而进行助听效果的评估.结果 组合1、2、3三种方式测出的L50值(50%言语识别率的信噪比)分别为-3.55±2.37 dB,-7.15±2.18 dB,-5.40±2.35 dB,三者之间两两比较差异均有显著统计学意义(P<0.05).结论 噪声环境下无论双耳佩戴自适应方向性麦克风模式还是一耳佩戴自适应方向性麦克风、另一耳佩戴全向性麦克风,其言语识别能力均高于双耳佩戴全向性麦克风模式,且双耳佩戴自适应方向性麦克风模式的言语识别率高于一耳自适应麦克风、一耳全向性麦克风模式.     

Noise reduction technologies implemented in head-worn preprocessors for improving cochlear implant performance in reverberant noise fields

The purpose of this study was to investigate whether a multichannel adaptive directional microphone and a modulation-based noise reduction algorithm could enhance cochlear implant performance in reverberant noise fields. A hearing aid was modified to output electrical signals (ePreprocessor) and a cochlear implant speech processor was modified to receive electrical signals (eProcessor). The ePreprocessor was programmed to flat frequency response and linear amplification. Cochlear implant listeners wore the ePreprocessor-eProcessor system in three reverberant noise fields: 1) one noise source with variable locations; 2) three noise sources with variable locations; and 3) eight evenly spaced noise sources from 0° to 360°. Listeners' speech recognition scores were tested when the ePreprocessor was programmed to omnidirectional microphone (OMNI), omnidirectional microphone plus noise reduction algorithm (OMNI?+?NR), and adaptive directional microphone plus noise reduction algorithm (ADM?+?NR). They were also tested with their own cochlear implant speech processor (CI_OMNI) in the three noise fields. Additionally, listeners rated overall sound quality preferences on recordings made in the noise fields. Results indicated that ADM+NR produced the highest speech recognition scores and the most preferable rating in all noise fields. Factors requiring attention in the hearing aid-cochlear implant integration process are discussed.     

Advantages of directional hearing aid microphones related to room acoustics.

In this study, two types of hearing aids were used. Both aids had the same frequency characteristics for frontal sound, but one employed an omnidirectional microphone and the other a directional microphone. The frequency characteristics of both hearing aids were measured for five azimuths on KEMAR and in situ in 12 normal-hearing subjects. For these subjects we also determined the speech reception threshold (SRT) with background noise in two rooms with different reverberation times. The direction of the speech stimuli was always frontal; the direction of the noise was varied. Additionally, directional hearing was measured with short noise bursts from eight loudspeakers surrounding the subject. In the less reverberant room, sounds coming from behind were less amplified by the hearing aid with the directional microphone than by the one with the omnidirectional microphone. In this room the monaural SRT values were largely determined by the level of the background noise. For the directional hearing aids there was an extra binaural advantage which depended on the direction of the background noise. Only for low-frequency noise bursts was directional hearing better with directional hearing aids. In the more reverberant room, no distinct differences between the frequency characteristics of the two hearing aid types were measured. However, a systematic difference between monaural SRT values measured through the two hearing aids was found. This difference was independent of noise azimuth. In conclusion, hearing aid(s) with a directional microphone showed no disadvantages and clear advantages under specific conditions.     

The impact of head angle on monaural and binaural performance with directional and omnidirectional hearing aids

OBJECTIVE: To evaluate the impact of head turn and monaural and binaural fittings on the sentence reception thresholds of hearing-impaired listeners wearing directional and omnidirectional hearing aids. DESIGN: Sentence reception thresholds were measured for 20 listeners fit monaurally and binaurally with behind-the-ear hearing aids set in both directional and omnidirectional modes. All listeners exhibited symmetrical, sloping, sensorineural hearing loss. The aided performance across these four fittings was evaluated for three different head and body angles. The three angles reflected body turns of 0 degrees, 15 degrees, and 30 degrees as measured relative to the primary sound source, with 0 degrees denoting the listener directly facing the sound source. Listeners were instructed to keep their heads in a fixed horizontal position and turn their heads and bodies to face visual targets at the three test angles. Sentences from the Hearing in Noise Test presented with a background of five, spatially separated, uncorrelated samples of cafeteria noise served as test material. All testing was performed in a moderately reverberant (Rt = 631 msec) "living room" environment. RESULTS: Participants generally performed significantly better when fit with directional versus omnidirectional hearing aids, and when fit binaurally versus monaurally across test conditions. The measured "binaural advantage" was reduced with increasing head angle. Participants performed significantly better with a 30 degree head angle than when directly facing the primary speaker. This "head turn advantage" was most prominent for monaural (versus binaural) conditions. Binaural and head turn advantages were not significantly different across directional and omnidirectional modes. CONCLUSIONS: These data provide additional support for the use of directional hearing aids and binaural amplification to improve speech intelligibility in noisy environments. The magnitude of these advantages was similar to that reported in previous investigations. The data also showed that hearing aid wearers achieved significantly better speech intelligibility in noise by turning their heads and bodies to a position in which they were not directly facing the sound source. This head turn advantage was in good agreement with the increase in Directivity Index with head turn and reflected the fact that hearing aids are generally most sensitive to sounds arriving from angles other than directly in front of the hearing aid wearer. Although these data suggest that many monaural hearing aid wearers may significantly improve speech intelligibility in noise through the use of head turn, the interaction between this advantage and the potential loss of visual cues with head turn is unknown.     

Predicting directional hearing aid benefit for individual listeners

The fitting of directional microphone hearing aids is becoming increasingly more routine, and this fitting option has proven to be a successful method to improve speech intelligibility in many noisy listening environments. Data suggest, however, that some hearing-impaired listeners receive significantly more directional benefit than others. It is of interest, therefore, to determine if directional benefit is predictable from identifiable audiologic factors. In this report, we examined whether the slope of audiometric configuration, amount of high-frequency hearing loss, and/or the aided omnidirectional performance for a speech-in-noise intelligibility task could be used to predict the magnitude of directional hearing aid benefit. Overall results obtained from three separate investigations revealed no significant correlation between the slope of audiometric configuration or amount of high-frequency hearing loss and the benefit obtained from directional microphone hearing instruments. Although there was a significant, negative relationship between aided omnidirectional performance and the directional benefit obtained in one study, there was considerable variability among individual participants, and nearly all of the listeners with the best omnidirectional hearing aid performance still received significant additional benefit from directional amplification. These results suggest that audiologists should consider the use of directional amplification for patients regardless of audiogram slope, high-frequency hearing loss, or omnidirectional speech intelligibility score.     

Improving speech intelligibility in background noise with an adaptive directional microphone

Omnidirectional, supercardioid, and adaptive directional microphones (ADM) were evaluated in combination with the ADRO amplification scheme for eight participants with moderate sloping hearing losses. The ADM produced better speech perception scores than the other two microphones in all noise conditions. Participants performed the Hearing in Noise Test sentences at -4.5 dB SNR or better, which is similar to the level achievable with normal hearing. The Speech, Spatial and Qualities of Hearing Scale indicated no disadvantages of using the ADM relative to the omnidirectional microphone in real-life situations. The ADM was preferred over the omnidirectional microphone in 54% of situations, compared to 17% preferences for the omnidirectional microphone, and 29% no preference. The combination of the ADM to improve SNR, and ADRO to keep the signal output comfortable and audible provided near-normal hearing performance for people with moderate hearing loss. The ADM is the recommended microphone configuration for ADRO hearing aids.     

Use of a digital hearing aid with directional microphones in school-aged children

The efficacy of a digital hearing aid with a directional microphone was examined in a school-aged population. Twenty children (9 with a mild-to-moderately-severe hearing loss and 11 with a moderate-to-severe hearing loss) between 7 1/2 and 13 2/3 years of age wore the study hearing aids binaurally for 30 days prior to the evaluation. The testing protocol included speech recognition tests using the CID W-22 word lists presented at 72 dB SPL, 65 dB SPL, and 52 dB SPL (at 0 degrees azimuth) in the presence of a 65 dB SPL party noise (180 degrees azimuth). Subjective rating of hearing aid efficacy in the classroom was examined using the Listening Inventory For Education (LIFE) questionnaire. Parental impression on hearing aid efficacy was also collected at the end of the study. The results showed improved speech recognition in noise with the digital directional hearing aid at all presentation levels. Preference for the digital directional hearing aids over the subjects' own omnidirectional analog hearing aids was also seen on the LIFE questionnaire and parental impression. The degree of hearing loss did not seem to have affected the benefits offered by the digital directional hearing aids. These results were compared to results from other studies on the use of directional microphones in hearing aids.     

Auditory localization abilities in bilateral cochlear implant recipients.

OBJECTIVE: To quantify binaural advantage for auditory localization in the horizontal plane by bilateral cochlear implant (CI) recipients. Also, to determine whether the use of dual microphones with one implant improves localization. METHODS: Twenty subjects from the UK multicenter trial of bilateral cochlear implantation with Nucleus 24 K/M device were recruited. Sound localization was assessed in an anechoic room with an 11-loudspeaker array under four test conditions: right CI, left CI, binaural CI, and dual microphone. Two runs were undertaken for each of five stimuli (speech, tones, noise, transients, and reverberant speech). Order of conditions was counterbalanced across subjects. RESULTS: Mean localization error with bilateral implants was 24 degrees compared with 67 degrees for monaural implant and dual microphone conditions (chance performance is 65 degrees). Normal controls average 2 to 3 degrees in similar conditions. Binaural performance was significantly better than monaural performance for all subjects, for all stimulus types, and for different sound sources. Only small differences in performance with different stimuli were observed. CONCLUSIONS: Bilateral cochlear implantation with the Nucleus 24 device provides marked improvement in horizontal plane localization abilities compared with unilateral CI use for a range of stimuli having different spectral and temporal characteristics. Benefit was obtained by all subjects, for all stimulus types, and for all sound directions. However, binaural performance was still worse than that obtained by normal hearing listeners and hearing aid users with the same methodology. Monaural localization performance was at chance. There is no benefit for localization with dual microphones.     

Effects of multi-channel compression time constants on subjectively perceived sound quality and speech intelligibility

OBJECTIVE: The purpose of this study was to determine the influence of the compression time constants in a multi-channel compression hearing aid on both subjectively assessed speech intelligibility and sound quality in realistic binaural acoustical situations for normal-hearing and hearing-impaired listeners. DESIGN: A nonlinear hearing aid with 15 independent compression channels of approximated critical bandwidth was simulated on a personal computer. Various everyday life situations containing different sounds such as speech and speech in noise were recorded binaurally through original hearing aid microphones placed in BTE hearing aid cases. Two experiments were run with normal hearing and hearing-impaired subjects. For each subject, hearing thresholds were established using in situ audiometry. The static I/O-curve parameters in all channels of the hearing aid were then adjusted so that normal speech received an insertion gain corresponding to the NAL-R formula (Byrne & Dillon, 1986). The compression ratio was kept constant at 2.1:1. In the first experiment with six normal-hearing and six hearing-impaired subjects, the hearing aid was programmed to four different settings by changing only the compression time constants while all the parameters describing the static nonlinear Input/Output-curve were kept constant. The compression threshold was set to a very low value. In the second experiment with seven normal-hearing and eight hearing-impaired subjects, the hearing aid was programmed to four settings by changing the release time constants and the compression threshold while all other remaining parameters were kept constant. Using a complete A/B pair comparison procedure, subjects were presented binaurally with the amplified sounds and asked to subjectively assess their preference for each hearing aid setting with regards to speech intelligibility and sound quality. RESULTS AND CONCLUSIONS: In Experiment 1, all subjects showed a significant preference for the longest release time (4 sec) over the two shorter release times (400 msec and 40 msec), pertaining to quality and intelligibility. In combination with the long release time, the attack time (1 msec or 100 msec) was of less importance. Larger inter-individual differences were observed among all subjects with regard to the perceived sound quality of musical and nonspeech signals. In Experiment 2 the hearing-impaired subjects showed a significant preference for the hearing aid setting with a long release time (4 sec) and a low compression threshold (20 dB SPL), both with regard to sound quality and speech intelligibility. With a short release time (40 msec), a lower compression threshold (20 dB SPL) was preferred over a higher threshold (50 dB SPL). Among normal-hearing subjects, the same settings were also preferred for speech intelligibility. However, no significant differences were observed in these subjects regarding the assessment of sound quality. Again, more individual variability was found during the assessment of music and nonspeech signals. In sum, the preference of a rather long release time raises the question of whether a compression system with a very short time constant is the optimal means to compensate for the sensory recruitment phenomenon.     

Impact of compression and hearing aid style on directional hearing aid benefit and performance.

OBJECTIVE: To evaluate the impact of low-threshold compression and hearing aid style (in-the-ear [ITE] versus behind-the-ear [BTE]) on the directional benefit and performance of commercially available directional hearing aids. DESIGN: Forty-seven adult listeners with mild-to-moderate sensorineural hearing loss were fit bilaterally with one BTE and four different ITE hearing aids. Speech recognition performance was measured through the Connected Speech Test (CST) and Hearing in Noise Test (HINT) for a simulated noisy restaurant environment. RESULTS: For both the HINT and CST, speech recognition performance was significantly greater for subjects fit with directional in comparison with omnidirectional microphone hearing aids. Performance was significantly poorer for the BTE instrument in comparison with the ITE hearing aids when using omnidirectional microphones. No differences were found for directional benefit between compression and linear fitting schemes. CONCLUSIONS: No systematic relationship was found between the relative directional benefit and hearing aid style; however, the speech recognition performance of the subjects was somewhat predictable based on Directivity Index measures of the individual hearing aid models. The fact that compression did not interact significantly with microphone type agrees well with previously reported electroacoustic data.     

Relationship between laboratory measures of directional advantage and everyday success with directional microphone hearing aids

The improvement in speech recognition in noise obtained with directional microphones compared to omnidirectional microphones is referred to as the directional advantage. Laboratory studies have revealed substantial differences in the magnitude of the directional advantage across hearing-impaired listeners. This investigation examined whether persons who were successful users of directional microphone hearing aids in everyday living tended to obtain a larger directional advantage in the test booth than persons who were unsuccessful users. Results revealed that the mean directional advantage did not differ significantly between patients who used the directional mode regularly and those who reported little or no benefit from directional microphones in daily living and, therefore, tended to leave their hearing aids set in the default omnidirectional mode. Success with directional microphone hearing aids in everyday living, therefore, cannot be reliably predicted by the magnitude of the directional advantage obtained in the clinic.     

Speech recognition and comfort using hearing instruments with adaptive directional characteristics in asymmetric listening conditions

OBJECTIVE: Hearing instruments with adaptive directional microphone systems attempt to maximize speech-to-noise ratio (SNR) and thereby improve speech recognition in noisy backgrounds. When instruments with adaptive systems are fitted bilaterally, there is the potential for adverse effects as they operate independently and may give confusing cues or disturbing effects. The present study compared speech recognition performance in 16 listeners fitted bilaterally with the Phonak Claro hearing instrument using omni-directional, fixed directional, and adaptive directional microphone settings as well as mixed microphone settings (an omni-directional microphone on one side and an adaptive directional microphone on the other). DESIGN: Under anechoic conditions, speech was always presented from a loudspeaker directly in front of the listener (0 degree azimuth) whereas noise was presented from one or two loudspeakers arranged either symmetrically (0, 180, 90 + 270 degrees) or asymmetrically (170 + 240 degrees and 120 + 190 degrees) in the horizontal plane. Adaptive sentence recognition in noise measurement was supplemented by quality ratings. RESULTS: With symmetrical omni-directional settings (Omni/Omni), performance was poorer than a control group of 14 listeners with normal hearing tested unaided: Aided listeners required 4.3 dB more favorable SNR for criterion performance. In all loudspeaker arrangements in which directional characteristics could be exploited, performance with symmetrical adaptive microphones (Adapt/Adapt) was similar to the control group. The mixed microphone settings did not appear to confer any particular disadvantage for speech recognition from their asymmetric nature, always giving scores significantly better than Omni/Omni. Quality rating scores were consistent with speech recognition performance, showing benefits in terms of clarity and comfort for the Adapt/Adapt and Fixed/Fixed microphone conditions over the Omni/Omni and mixed microphone conditions wherever directional characteristics could be used. Similarly, the mixed microphone conditions were rated more comfortable and quieter for the noise than Omni/Omni. CONCLUSIONS: It is concluded that bilateral hearing instruments with adaptive directional microphones confer benefits in terms of speech recognition in noise and sound quality. Independence of the two adaptive control systems does not appear to cause untoward effects.     

Evaluation of an adaptive directional system in a DSP hearing aid

The effectiveness of an adaptive directional microphone design, as implemented in the Phonak Claro behind-the-ear hearing aid, is evaluated. Participants were fit bilaterally and tested in 2 environments, an anechoic chamber and a moderately reverberant classroom, with the microphones in the fixed (cardioid) setting and the adaptive setting. Five speakers were placed between 110 degrees and 250 degrees azimuth around the listener. Speech-weighted noise was presented from those speakers at an overall level (OAL) of 65 dB (A). Noise was increased by 8 dB from 1 speaker at a time, using 2-s modulation and random assignment, while the output from the other speakers was reduced to maintain the constant OAL. Results of 2 speech perception tasks used as outcome measures indicated that the adaptive system was not able to follow the dominant noise source in the presence of lower level noise sources. Self-report measures obtained after blinded home trials were consistent with laboratory findings that the participants did not perceive this adaptive microphone design to be more effective than the default fixed-microphone option.     

Effect of type of noise and loudspeaker array on the performance of omnidirectional and directional microphones

Differences in performance between omnidirectional and directional microphones were evaluated between two loudspeaker conditions (single loudspeaker at 180 degrees; diffuse using eight loudspeakers set 45 degrees apart) and two types of noise (steady-state HINT noise; R-Space restaurant noise). Twenty-five participants were fit bilaterally with Phonak Perseo hearing aids using the manufacturer's recommended procedure. After wearing the hearing aids for one week, the parameters were fine-tuned based on subjective comments. Four weeks later, differences in performance between omnidirectional and directional microphones were assessed using HINT sentences presented at 0 degrees with the two types of background noise held constant at 65 dBA and under the two loudspeaker conditions. Results revealed significant differences in Reception Thresholds for Sentences (RTS in dB) where directional performance was significantly better than omnidirectional. Performance in the 180 degrees condition was significantly better than the diffuse condition, and performance was significantly better using the HINT noise in comparison to the R-Space restaurant noise. In addition, results revealed that within each loudspeaker array, performance was significantly better for the directional microphone. Looking across loudspeaker arrays, however, significant differences were not present in omnidirectional performance, but directional performance was significantly better in the 180 degrees condition when compared to the diffuse condition. These findings are discussed in terms of results reported in the past and counseling patients on the potential advantages of directional microphones as the listening situation and type of noise changes.     

Evaluation of the benefit for cochlear implantees of two assistive directional microphone systems in an artificial diffuse noise situation

OBJECTIVE: People with cochlear implants have severe problems with speech understanding in noisy surroundings. This study evaluates and quantifies the effect of two assistive directional microphone systems compared to the standard headpiece microphone on speech perception in quiet surroundings and in background noise, in a laboratory setting developed to reflect a situation whereby the listener is disturbed by a noise with a mainly diffuse character due to many sources in a reverberant room. DESIGN: Thirteen postlingually deafened patients, implanted in the Leiden University Medical Centre with the Clarion CII device, participated in the study. An experimental set-up with 8 uncorrelated steady-state noise sources was used to test speech perception on monosyllabic words. Each subject was tested with a standard headpiece microphone, and the two assistive directional microphones, TX3 Handymic by Phonak and the Linkit array microphone by Etymotic Research. Testing was done in quiet at a level of 65 dB SPL and with decreasing signal-to-noise ratios (SNR) down to -15 dB. RESULTS: Using the assistive directional microphones, speech recognition in background noise improved substantially and was not affected in quiet. At an SNR of 0 dB, the average CVC scores improved from 45% for the headpiece microphone to 67% and 62% for the TX3 Handymic and the Linkit respectively. Compared to the headpiece, the Speech Reception Threshold (SRT) improved by 8.2 dB SNR and 5.9 dB SNR for the TX3 Handymic and the Linkit respectively. The gain in SRT for TX3 Handymic and Linkit was neither correlated to the SRT score with headpiece nor the duration of CI-use. CONCLUSION: The speech recognition test in background noise showed a clear benefit from the assistive directional microphones for cochlear implantees compared to the standard microphone. In a noisy environment, the significant benefit from these assistive device microphones may allow understanding of speech with greater ease.