Full time directional versus user selectable microphone modes in hearing aids

OBJECTIVE: The purpose of this experiment was to systematically examine hearing aid benefit as measured by speech recognition and self-assessment methods across omnidirectional and directional hearing aid modes. These data were used to compare directional benefit as measured by speech recognition in the laboratory to hearing aid wearer's perceptions of benefit in everyday environments across full-time directional, full-time omnidirectional, and user selectable directional fittings. Identification of possible listening situations that resulted in different self reported hearing aid benefit as a function of microphone type was a secondary objective of this experiment. DESIGN: Fifteen adults with symmetrical, sloping sensorineural hearing loss were fitted bilaterally with in-the-ear (ITE) directional hearing aids. Measures of hearing aid benefit included the Profile of Hearing Aid Benefit (PHAB), the Connected Sentence Test (CST), the Hearing in Noise Test (HINT), and a daily use log. Additionally, two new subscales were developed for administration with the PHAB. These subscales were developed to specifically address situations in which directional hearing aids may provide different degrees of benefit than omnidirectional hearing aids. Participants completed these measures in three conditions: omnidirectional only (O), directional only with low-frequency gain compensation (D), and user-selectable directional/omnidirectional (DO). RESULTS: Results from the speech intelligibility in noise testing indicated significantly more hearing aid benefit in directional modes than omnidirectional. PHAB results indicated more benefit on the background noise subscale (BN) in the DO condition than in the O condition; however, this directional advantage was not present for the D condition. Although the reliability of the newly proposed subscales is as yet unknown, the data were interpreted as revealing a directional advantage in situations where the signal of interest was in front of the participant and a directional disadvantage in situations where the signal of interest was behind the listener or localization was required. CONCLUSIONS: Laboratory directional benefit is reflected in self-assessment measures that focus on listening in noise when the sound source of interest is in front of the listener. The use of a directional hearing aid mode; however, may have either a positive, a neutral, or a negative impact on hearing aid benefit measured in noisy situations, depending on the specific listening situation.     

Distance and reverberation effects on directional benefit

OBJECTIVE: Understanding the potential benefits and limitations of directional hearing aids across a wide range of listening environments is important when counseling persons with hearing loss regarding realistic expectations for these devices. The purpose of this study was to examine the impact of speaker-to-listener distance on directional benefit in two reverberant environments, in which the dominate noise sources were placed close to the hearing aid wearer. In addition, speech transmission index (STI) measures made in the test environments were compared to measured sentence recognition to determine if performance was predictable across changes in distance, reverberation and microphone mode. DESIGN: The aided sentence recognition, in noise, for fourteen adult participants with symmetrical sensorineural hearing impairment was measured in six environmental conditions in both directional and omnidirectional modes. A single room, containing four uncorrelated noise sources served as the test environment. The room was modified to exhibit either low (RT60 = 0.3 sec) or moderate (RT60 = 0.9 sec) levels of reverberation. Sentence recognition was measured in both reverberant environments at three different speech loudspeaker-to-listener distances (1.2 m, 2.4 m, and 4.8 m). STI measures also were made in each of the 12 listening conditions (2 microphone modes x 3 distances x 2 reverberation environments). RESULTS: A decrease in directional benefit was measured with increasing distance in the moderate reverberation condition. Although reduced, directional benefit was still present in the moderately reverberant environment at the farthest speech speaker-to-listener distance tested in this experiment. A similar decrease with increasing speaker-to-listener distance was not measured in the low reverberation condition. The pattern of average sentence recognition results across varying distances and two different reverberation times agreed with the pattern of STI values measured under the same conditions. CONCLUSIONS: Although these data support increased directional benefit in noise for reduced speaker-to-listener distance, some benefit was still obtained by listeners when listening beyond "effective" critical distance under conditions of low (300 msec) to moderate (900 msec) reverberation. It is assumed that the directional benefit was due to the reduction of the direct sound energy from the noise sources near the listener. The use of aided STI values for the prediction of average word recognition across listening conditions that differ in reverberation, microphone directivity, and speaker-to-listener distance also was supported.     

Low-frequency gain compensation in directional hearing aids

Hearing aids currently available on the market with both omnidirectional and directional microphone modes often have reduced amplification in the low frequencies when in directional microphone mode due to better phase matching. The effects of this low-frequency gain reduction for individuals with hearing loss in the low frequencies was of primary interest. Changes in sound quality for quiet listening environments following gain compensation in the low frequencies was of secondary interest. Thirty participants were fit with bilateral in-the-ear hearing aids, which were programmed in three ways while in directional microphone mode: no-gain compensation, adaptive-gain compensation, and full-gain compensation. All participants were tested with speech in noise tasks. Participants also made sound quality judgments based on monaural recordings made from the hearing aid. Results support a need for gain compensation for individuals with low-frequency hearing loss of greater than 40 dB HL.     

Effects of noise source configuration on directional benefit using symmetric and asymmetric directional hearing aid fittings

OBJECTIVE: The benefits of directional processing in hearing aids are well documented in laboratory settings. Likewise, substantial research has shown that speech understanding is optimized in many settings when listening binaurally. Although these findings suggest that speech understanding would be optimized by using bilateral directional technology (e.g., a symmetric directional fitting), recent research suggests similar performance with an asymmetrical fitting (directional in one ear and omnidirectional in the other). The purpose of this study was to explore the benefits of using bilateral directional processing, as opposed to an asymmetric fitting, in environments where the primary speech and noise sources come from different directions. DESIGN: Sixteen older adults with mild-to-severe sensorineural hearing loss (SNHL) were recruited for the study. Aided sentence recognition using the Hearing in Noise Test (HINT) was assessed in a moderately reverberant room, in three different speech and noise conditions in which the locations of the speech and noise sources were varied. In each speech and noise condition, speech understanding was assessed in four different microphone modes (bilateral omnidirectional mode; bilateral directional mode; directional mode left and omnidirectional mode right; omnidirectional mode left and directional mode right). The benefits and limitations of bilateral directional processing were assessed by comparing HINT thresholds across the various symmetric and asymmetric microphone processing conditions. RESULTS: Study results revealed directional benefit varied based on microphone mode symmetry (i.e., symmetric versus asymmetric directional processing) and the specific speech and noise configuration. In noise configurations in which the speech was located in the front of the listener and the noise was located to the side or surrounded the listener, maximum directional benefit (approximately 3.3 dB) was observed with the symmetric directional fitting. HINT thresholds obtained when using bilateral directional processing were approximately 1.4 dB better than when an asymmetric fitting (directional processing in only one ear) was used. When speech was located on the side of the listener, the use of directional processing on the ear near the speech significantly reduced speech understanding. CONCLUSIONS: Although directional benefit is present in asymmetric fittings, the use of bilateral directional processing optimizes speech understanding in noise conditions in which the speech comes from in front of the listener and the noise sources are located to the side of or surround the listener. In situations in which the speech is located to the side of the listener, the use of directional processing on the ear adjacent to the speaker is likely to reduce speech audibility and thus degrade speech understanding.     

Evaluation of an adaptive,directional-microphone hearing aid

The effectiveness of adaptive directional processing for improvement of speech recognition in comparison to non-adaptive directional and omni-directional processing was examined across four listening environments intended to simulate those found in the real world. The test environment was a single, moderately reverberant room with four loudspeaker configurations: three with fixed discrete noise source positions and one with a single panning noise source. Sentence materials from the Hearing in Noise Test (HINT) and Connected Speech Test (CST) were selected as test materials. Speech recognition across all listening conditions was evaluated for 20 listeners fitted binaurally with Phonak Claro behind-the-ear (BTE) style hearing aids. Results indicated improved speech recognition performance with adaptive and non-adaptive directional processing over that measured with the omnidirectional processing across all four listening conditions. While the magnitudes of directional benefit provided to subjects listening in adaptive and fixed directional modes were similar in some listening environments, a significant speech recognition advantage was measured for the adaptive mode in specific conditions. The advantage for adaptive over fixed directional processing was most prominent when a competing noise was presented from the listener's sides (both fixed and panning noise conditions), and was partially predictable from electroacoustically measured directional pattern data.     

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.     

Effect of low-frequency gain and venting effects on the benefit derived from directionality and noise reduction in hearing aids

When the frequency range over which vent-transmitted sound dominates amplification increases, the potential benefit from directional microphones and noise reduction decreases. Fitted with clinically appropriate vent sizes, 23 aided listeners with varying low-frequency hearing thresholds evaluated six schemes comprising three levels of gain at 250 Hz (0, 6, and 12 dB) combined with two features (directional microphone and noise reduction) enabled or disabled in the field. The low-frequency gain was 0 dB for vent-dominated sound, while the higher gains were achieved by amplifier-dominated sounds. A majority of listeners preferred 0-dB gain at 250 Hz and the features enabled. While the amount of low-frequency gain had no significant effect on speech recognition in noise or horizontal localization, speech recognition and front/back discrimination were significantly improved when the features were enabled, even when vent-transmitted sound dominated the low frequencies. The clinical implication is that there is no need to increase low-frequency gain to compensate for vent effects to achieve benefit from directionality and noise reduction over a wider frequency range.     

Effect of low-frequency gain and venting effects on the benefit derived from directionality and noise reduction in hearing aids

When the frequency range over which vent-transmitted sound dominates amplification increases, the potential benefit from directional microphones and noise reduction decreases. Fitted with clinically appropriate vent sizes, 23 aided listeners with varying low-frequency hearing thresholds evaluated six schemes comprising three levels of gain at 250 Hz (0, 6, and 12 dB) combined with two features (directional microphone and noise reduction) enabled or disabled in the field. The low-frequency gain was 0 dB for vent-dominated sound, while the higher gains were achieved by amplifier-dominated sounds. A majority of listeners preferred 0-dB gain at 250 Hz and the features enabled. While the amount of low-frequency gain had no significant effect on speech recognition in noise or horizontal localization, speech recognition and front/back discrimination were significantly improved when the features were enabled, even when vent-transmitted sound dominated the low frequencies. The clinical implication is that there is no need to increase low-frequency gain to compensate for vent effects to achieve benefit from directionality and noise reduction over a wider frequency range.     

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.     

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.     

A directional remote-microphone for bimodal cochlear implant recipients

Abstract

To evaluate whether speech recognition in noise differs according to whether a wireless remote microphone is connected to just the cochlear implant (CI) or to both the CI and to the hearing aid (HA) in bimodal CI users. The second aim was to evaluate the additional benefit of the directional microphone mode compared with the omnidirectional microphone mode of the wireless microphone. This prospective study measured Speech Recognition Thresholds (SRT) in babble noise in a ‘within-subjects repeated measures design’ for different listening conditions. Eighteen postlingually deafened adult bimodal CI users. No difference in speech recognition in noise in the bimodal listening condition was found between the wireless microphone connected to the CI only and to both the CI and the HA. An improvement of 4.1?dB was found for switching from the omnidirectional microphone mode to the directional mode in the CI only condition. The use of a wireless microphone improved speech recognition in noise for bimodal CI users. The use of the directional microphone mode led to a substantial additional improvement of speech perception in noise for situations with one target signal.     

Directivity quantification in hearing aids: fitting and measurement effects

OBJECTIVE: To evaluate the impact of venting, microphone port orientation, and compression on the electroacoustically measured directivity of directional and omnidirectional behind-the-ear hearing aids. In addition, the average directivity provided across three brands of directional and omnidirectional behind-the-ear hearing aids was compared with that provided by the open ear. DESIGN: Three groups of hearing aids (four instruments in each group) representing three commercial models (a total of 12) were selected for electroacoustic evaluation of directivity. Polar directivity patterns were measured and directivity index was calculated across four different venting configurations, and for five different microphone port angles. All measurements were made for instruments in directional and omnidirectional modes. Single source traditional, and two-source modified front-to-back ratios were also measured with the hearing aids in linear and compression modes. RESULTS: The directivity provided by the open (Knowles Electronics Manikin for Acoustic Research) ear was superior to that of the omnidirectional hearing aids in this study. Although the directivity measured for directional hearing aids was significantly better than that of omnidirectional models, significant variability was measured both within and across the tested models both on average and at specific test frequencies. Both venting and microphone port orientation affected the measured directivity. Although compression reduced the magnitude of traditionally measured front-to-back ratios, no difference from linear amplification was noted using a modified methodology. CONCLUSIONS: The variation in the measured directivity both within and across the directional microphone hearing aid brands suggests that manufacturer's specification of directivity may not provide an accurate index of the actual performance of all individual instruments. The significant impact of venting and microphone port orientation on directivity indicate that these variables must be addressed when fitting directional hearing aids on hearing-impaired listeners. Modified front-to-back ratio results suggest that compression does not affect the directivity of hearing aids, if it is assumed that the signal of interest from one azimuth, and the competing signal from a different azimuth, occur at the same time.     

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.     

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.     

Predicting hearing aid microphone preference in everyday listening

Seventeen hearing-impaired adults were fit with omnidirectional/directional hearing aids, which they wore during a four-week trial. For each listening situation encountered in daily living during a total of seven days, participants selected the preferred microphone mode and described the listening situation in terms of five environmental variables, using a paper and pencil form. Results indicated that hearing-impaired adults typically spend the majority of their active listening time in situations with background noise present and surrounding the listener, and the signal source located in front and relatively near. Microphone preferences were fairly evenly distributed across listening situations but differed depending on the characteristics of the listening environment. The omnidirectional mode tended to be preferred in relatively quiet listening situations or, in the presence of background noise, when the signal source was relatively far away. The directional mode tended to be preferred when background noise was present and the signal source was located in front of and relatively near the listener. Results suggest that knowing only signal location and distance and whether background noise is present or absent, omnidirectional/directional hearing aids can be set in the preferred mode in most everyday listening situations. These findings have relevance for counseling patients when to set manually switchable omnidirectional/directional hearing aids in each microphone mode, as well as for the development of automatic algorithms for selecting omnidirectional versus directional microphone processing.     

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.     

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.     

Application of frequency importance functions to directivity for prediction of benefit in uniform fields

OBJECTIVE: The purpose of the current investigation was to systematically examine two of the assumptions central to the application of Articulation Index weighted Directivity Index (AI-DI) to the prediction of directional benefit across three groups of listeners differentiated by degree and configuration of hearing loss. Specifically, the assumption that (1) changes in speech recognition performance are predictable from frequency specific changes in calculated audibility after applying directivity index (DI) values and (2) applying appropriate frequency importance functions would increase the accuracy of AI-DI predictions of directional benefit were evaluated. DESIGN: The output of a single hearing aid for a speech in noise input was recorded to produce high and low directivity (directional and omnidirectional microphone modes) segments. These segments were then high-pass and low-pass filtered into low- and high-frequency regions and acoustically mixed to generate the eight frequency-specific directivity combinations. All recordings were made through an acoustic manikin placed in a single room, surrounded by five uncorrelated noise sources. The aided sentence recognition, in noise, for three groups of 12 adult participants with symmetrical sensorineural hearing impairment, was then measured across the eight listening conditions. The three groups were differentiated by degree and type of hearing loss including "sloping," "flat," and "severe" configurations.The frequency-specific DI values for each of the eight listening conditions were applied to the calculation of frequency specific noise levels. These corrected noise levels were then used to calculate an Articulation Index using the Speech Intelligibility Index (SII, ). These SII values were then compared with measured speech recognition under the same eight listening conditions.Directional benefit values were then calculated by subtracting the performance of individual participants on the Connected Speech Test (CST) in omnidirectional mode from performance in all other filter conditions. The changes in average DI and AI-DI (using three different frequency importance functions) that existed between omnidirectional and the other seven filter conditions were then calculated for comparison to directional benefit values. RESULTS: The speech recognition data revealed a complex interaction between filter condition and group. Despite this interaction, highly significant positive correlations were found between participants' speech recognition scores and the corresponding SII calculation for all three hearing loss groups.Individual subjects' measured directional benefit was highly correlated with changes in DI. Similar correlations were found for average DI and all three AI-DI weighting methods. CONCLUSIONS: As expected, performance and calculated SII values were in good agreement across conditions supporting the hypothesis that DI provides a reasonable frequency-specific estimate of signal-to-noise ratio changes in the test environment. The results further support the use of AI-DI or average DI for prediction of directional benefit. The choice of importance weighting across frequency (flat or frequency importance function based), however, did not improve the accuracy of these predictions; therefore, a simple average DI is advocated. Further, the prediction of absolute directional benefit across hearing loss groups from traditional AI-DI calculations may lead to error if the negative effects of hearing loss on speech understanding, and how these effects vary with degree of hearing loss, are not considered as a contributing factor.     

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.     

Initial clinical experience with a totally implantable cochlear implant research device.

OBJECTIVE: To evaluate the effectiveness and issues associated with a research totally implantable cochlear implant (TIKI). STUDY DESIGN: Limited patient trial. SETTING: Tertiary referral center. PATIENTS: Three adult human subjects with severe-to-profound sensorineural hearing loss. INTERVENTIONS: Subjects were implanted with a research TIKI developed by Cochlear Limited and the Co-operative Research Centre for Cochlear Implant and Hearing Aid Innovation. The TIKI has a lithium ion rechargeable battery, a package-mounted internal microphone, and sound-processing electronics that enable the use of "invisible hearing" without the use of an external device. The TIKI also functions with an external ESPrit 3G sound processor as a conventional cochlear implant. The standard surgical technique was modified to accommodate the larger device package. Postoperatively, subjects used TIKI in both invisible hearing and the conventional ESPrit 3G modes. MAIN OUTCOME MEASURES: Device use was recorded in both invisible hearing and ESPrit 3G listening modes. Performance of the internal battery and microphone was assessed over time. Psychophysical MAP data were collected, and speech perception was measured at 1, 3, 6, and 12 months postoperatively in both listening modes. RESULTS: There were no surgical or postoperative complications. All subjects use both invisible hearing and conventional ESPrit 3G modes. Speech perception outcomes for all patients showed improvement from preoperative scores. As a consequence of the reduced sensitivity of the implanted microphone, speech perception results using the invisible hearing mode were significantly lower than the ESPrit 3G mode. Subjects reported some body noise interference that limited use of the invisible hearing mode; however, all continue to use the invisible hearing mode on a limited daily basis. The rechargeable battery functioned well, with a cycle time indicating the low-power implant design is effective and will deliver long battery life. CONCLUSION: This study demonstrates that the challenges in developing a safe and effective TIKI can be overcome. Three subjects implanted with the research TIKI all reported benefit from routine use. For each subject, hearing outcomes using invisible hearing mode were not as good as when using the external ESPrit 3G sound processor in the conventional mode.