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Users of a cochlear implant (CI) in one ear, who are provided with a hearing aid (HA) in the contralateral ear, so-called bimodal listeners, are typically affected by a constant and relatively large interaural time delay offset due to differences in signal processing and differences in stimulation. For HA stimulation, the cochlear travelling wave delay is added to the processing delay, while for CI stimulation, the auditory nerve fibers are stimulated directly. In case of MED-EL CI systems in combination with different HA types, the CI stimulation precedes the acoustic HA stimulation by 3 to 10 ms. A self-designed, battery-powered, portable, and programmable delay line was applied to the CI to reduce the device delay mismatch in nine bimodal listeners. We used an A-B-B-A test design and determined if sound source localization improves when the device delay mismatch is reduced by delaying the CI stimulation by the HA processing delay (τ HA ). Results revealed that every subject in our group of nine bimodal listeners benefited from the approach. The root-mean-square error of sound localization improved significantly from 52.6° to 37.9°. The signed bias also improved significantly from 25.2° to 10.5°, with positive values indicating a bias toward the CI. Furthermore, two other delay values (τ HA –1 ms and τ HA +1 ms) were applied, and with the latter value, the signed bias was further reduced in some test subjects. We conclude that sound source localization accuracy in bimodal listeners improves instantaneously and sustainably when the device delay mismatch is reduced.
In bimodal cochlear implant (CI) / hearing aid (HA) users a constant interaural time delay in the order of several milliseconds occurs due to differences in signal processing of the devices. For MED-EL CI systems in combination with different HA types, we have quantified the respective device delay mismatch (Zirn et al. 2015). In the current study, we investigate the effect of the device delay mismatch in simulated and actual bimodal listeners on sound localization accuracy.
To deal with the device delay mismatch in actual bimodal listeners we delayed the CI stimulation according to the measured HA processing delay and two other values. With all delay values highly significant improvements of the rms error in the localization task were observed compared to the test without the delay. The results help to narrow down the optimal patient-specific delay value.
Zeitliche Anpassung führt zu verbesserter Schalllokalisation bei bimodal versorgten CI-/HG-Trägern
(2021)
Bei bimodal versorgten Cochlea-Implantaten (CI) / Hörgerät (HG)-Trägern entsteht durch die unterschiedliche Signalverarbeitung der Geräte eine konstante interaurale Zeitverzögerung in der Größenordnung von mehreren Millisekunden. Für MED-EL CI-Systeme in Kombination mit verschiedenen HG-Typen haben wir den jeweiligen Device-Delay-Mismatch quantifiziert. In der aktuellen Studie untersuchen wir den Einfluss der Device-Delay-Mismatch bei simulierten und tatsächlichen bimodalen Hörern auf die Genauigkeit der Schalllokalisation.
Um den Device-Delay-Mismatch bei bimodal versorgten Patienten zu verringern, haben wir die CI-Stimulation um die gemessene HG-Signallaufzeit und zwei weitere Werte verzögert. Nach einer Angewöhnungsphase war der effektive Winkelfehler bei Verzögerung um die HG-Signallaufzeit hochsignifikant reduziert im Vergleich zu der Testkondition ohne CI-Verzögerung (mittlere Verbesserung: 11 % ; p < .01, Wilcoxon Signed Rank Test). Aber auch mit den beiden weiteren Verzögerungswerten wurden Verbesserungen erreicht. Anhand der Ergebnisse lässt sich der optimale patientenspezifische Verzögerungswert näher eingrenzen.