The impact of cochlear implant microphone settings on the binaural hearing of experienced cochlear implant users with si

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The impact of cochlear implant microphone settings on the binaural hearing of experienced cochlear implant users with single‑sided deafness Anja Kurz1   · Maren Zanzinger1 · Rudolf Hagen1 · Kristen Rak1 Received: 28 July 2020 / Accepted: 20 October 2020 © The Author(s) 2020

Abstract Objective  Cochlear implantation has become a well-accepted treatment option for people with single-sided deafness (SSD) and has become a clinical standard in many countries. A cochlear implant (CI) is the only device which restores binaural hearing. The effect of microphone directionality (MD) settings has been investigated in other CI indication groups, but its impact on speech perception in noise has not been established in CI users with SSD. The focus of this investigation was, therefore, to assess binaural hearing effects using different MD settings in CI users with SSD. Methods  Twenty-nine experienced CI users with SSD were recruited to determine speech reception thresholds with varying target and noise sources to define binaural effects (head shadow, squelch, summation, and spatial release from masking), sound localization, and sound quality using the SSQ12 and H ­ ISQUI19 questionnaires. Outcome measures included the MD settings “natural”, “adaptive”, and “omnidirectional”. Results  The 29 participants involved in the study were divided into two groups: 11 SONNET users and 18 OPUS 2/RONDO users. In both groups, a significant head shadow effect of 7.4–9.2 dB was achieved with the CI. The MD setting “adaptive” provided a significant head shadow effect of 9.2 dB, a squelch effect of 0.9 dB, and spatial release from masking of 7.6 dB in the SONNET group. No significant summation effect could be determined in either group with CI. Outcomes with the omnidirectional setting were not significantly different between groups. For both groups, localization improved significantly when the CI was activated and was best when the omnidirectional setting was used. The groups’ sound quality scores did not significantly differ. Conclusions  Adaptive directional microphone settings improve speech perception and binaural hearing abilities in CI users with SSD. Binaural effect measures are valuable to quantify the benefit of CI use, especially in this indication group. Keywords  Single-sided deafness · Cochlear implant · Adaptive directional microphone setting · Questionnaire

Introduction Cochlear implant (CI) provision is now an accepted treatment in Europe for many people with single-sided deafness (SSD). The reported benefits of CI use include significantly better speech understanding in noise, improved localization abilities, reduction of tinnitus, improved self-esteem, and less fatigue [1–7]. The challenge in this patient group is the * Anja Kurz [email protected] 1



Department of Oto‑Rhino‑Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080 Würzburg, Germany

integration of electric input (from the CI) with acoustic