The Use of an Integrated Electric- Acous7c Sound Processor in Children with Low-Frequency Residual Hearing. Sara Neumann, AuD Jace Wolfe, PhD

Transcription

1 The Use of an Integrated Electric- Acous7c Sound Processor in Children with Low-Frequency Residual Hearing Sara Neumann, AuD Jace Wolfe, PhD

2 Disclosures This research was par7ally funded by a grant from Cochlear Americas

3 The Hearts for Hearing Team Audiologists Addi+onal Team Members Jace Wolfe, Ph.D., CCC-A Kris Hopper Kerri Brumley Pa7 Burns Krystal Hudgens, AuD Sherry Edwards Susan LaFleur Rocio Por7llo Megan Marsh, AuD Reyna Romero Kris7 Murphy Chris7an Boone Sara Neumann, AuD Dianne Ward Kelsey Kuehn Verneda Osborne Mila Duke, AuD Jackie Keathly Sabrina Calise Rachel Odor Elizabeth Musgrave, AuD Julie Serven Rachel Magann-Faivre, AuD Johnna Wallace, AuD Sarah Cain, AuD Emily Mills, B.S., AuD Student Speech-Language Pathologists Joanna T. Smith, M.S., CCC-SLP, LSLS Cert. AVT Tamara Elder, M.S. CCC-SLP, LSLS Cert. AVT Darcy Stowe, M.S. CCC-SLP, LSLS Cert. AVT Lindsay Hanna, M.S., CCC-SLP, LSLS Cert. AVT Carly Graham, M.S., CCC-SLP, LSLS Cert. AVT Casey Banks, M.S., CCC-SLP Jenn Bryngelson, CCC-SLP, LSLS Cert. AVT Tessa Hixon, M.S., CCC-SLP Parker Wilson, M.S., CCC-SLP

4 EAS in Children Hearts for Hearing 12 Children with electric-acous7c s7mula7on A variety of electrode arrays Nucleus Hybrid (L24) Nucleus CI422 (Slim Straight) Nucleus Freedom Contour Advance acous+c amplifica+on devices Phonak BTE Hearing Aids Nucleus 6 Acous+c Component A variety of s7mula7on modes between ears Bilateral EAS EAS one ear with electric on opposite ear EAS one ear with acous+c on opposite ear

5 Repor7ng on 7 children fized with the Nucleus 6 electric-acous7c processor

6 Repor7ng on 5 adults for whom EAS alloca7on se]ngs were adjusted within their Nucleus 6 electric-acous7c processor

7 Pediatric Recipients Age range: 7 yrs, 6 mo to 16 yrs, 7 mo Length of CI use: 5 months to 7 years 2 males, 5 females

8 Recipients Technology Recipient LeN Ear Right Ear SP Nucleus CI 512 Nucleus CI 512 AA Phonak Naida SP V CI24RE Contour Advance JM CI24RE Contour Advance Phonak Naida SP V AP Nucleus CI 422 Nucleus CI 422 JF Phonak Naida Q70-RIC Nucleus Hybrid (L24) BJ Nucleus CI 422 Nucleus CI 422 HA Nucleus CI 422 CI24RE Contour Advance All seven of these recipients used the Nucleus 6 EAS processor for their implanted ear(s)

9 Mean Pre-CI Audiogram db HL Frequency (Hz) Leh Right

10 Pre- and Post-op Audiometric Results Frequency (Hz) db HL Pre-CI Post-CI

11 Assessment BabyBio Sentences (Spahr et al., 2014) Quiet at 60 dba Noise +10 db SNR +5 db SNR 0 db SNR Different condi7ons Electric only Acous7c Only Bimodal EAS

12 Bilateral EAS Acoustic Electric EAS Acoustic Electric EAS %Correct n=3

13 Bimodal vs. Combined Electric Acoustic EAS Acoustic %Correct n=3

14 Best EAS %Correct n=7

15 Preliminary Report Evalua7on of EAS Performance with Different Acous7c/ Frequency Alloca7ons

16 EAS Fi]ng Acoustic and electric allocation based on the meet protocol Acoustic component fitted to NAL-NL2 Target

17 Programming EAS 188 Hz The Wideband Overlap Approach Acoustic Overlap Electric 438 Hz Acoustic Overlap The F1 438 Hz Approach Electric The Cochlear Default (> 70 db HL) Approach Acoustic Overlap Electric The Meet Approach Acoustic Acoustic 1-OctaveGap Electric The Gap Approach Electric Low Frequency High

18 Programming EAS Acous7c component output set to NAL-NL2 target for 65 db SPL speech Electric alloca7on set to: Wideband: 188 Hz Cochlear Default: The lowest frequency at which the par7cipant s air conduc7on threshold exceeded 70 db HL F1: 438 Hz (comprehensive inclusion of F1) Meet Approach: The highest air conduc7on frequency at which sufficient audibility was provided by the acous7c component (defined as the highest frequency at which the NAL-NL2 target was met or the highest frequency without a cochlear dead region) Gap Approach: One octave above the highest air conduc7on frequency at which sufficient audibility was provided by the acous7c component

19 Study Design Par7cipants used each of the acous7c/frequency alloca7ons for at least 2-4 weeks Phase 1: Two programs with different acous7c/frequency alloca7ons Switch between the two Phase 2: Two programs with different acous7c/frequency alloca7ons Switch between the two Phase 3: One program with different acous7c/frequency alloca7ons Aher each phase, assessment was completed CNC Word Recogni7on (50 dba) (Peterson & Lehiste, 1962) AzBio Sentence Recogni7on (0, +5, and +10 db SNR) (Spahr et al., 2012) Speech Intelligibility Ra7ng Index (SIRI) (Cox & McDaniel, 1989) Abbreviated Profile of Hearing Aid Benefit (APHAB) (Cox & Alexander, 1995) Speech, Spa7al, Quali7es of Hearing Scale (SSQ) (Gatehouse, 2004) Data collec7on is ongoing with 15 adults and 10 children with EAS

20 CNC Word Recogni7on Adults n = 5

21 AzBio Sentence Recogni7on Adults n = 5

22 Speech Intelligibility Ra7ng Index Adults n = 5

23 APHAB and SSQ Similar group scores were obtained across condi7ons except for the Gap approach, which was perceived to provide significantly poorer hearing performance

24 Summary EAS with the Nucleus 6 sound processor allows for bezer word recogni7on and sentence recogni7on in noise for children with residual acous7c hearing preserva7on aher cochlear implanta7on These children reported bezer sound quality and subjec7ve hearing performance with the use of EAS over acous7c- and electric-only hearing The Cochlear Hybrid default strategy for acous7c/electric alloca7on appears to be effec7ve for the selec7on of EAS crossover parameters The Gap alloca7on approach results in poorer speech recogni7on and subjec7ve hearing performance/sound quality

25 Summary EAS with the Nucleus 6 sound processor provided bezer word recogni7on and sentence recogni7on in noise for children with residual acous7c hearing preserva7on Children using EAS reported bezer sound quality and subjec7ve hearing performance compared to performance with acous7c- and electric-only hearing The Cochlear Hybrid default strategy for acous7c/electric alloca7on appears to be effec7ve for the selec7on of EAS crossover parameters The Gap alloca7on approach results in poorer speech recogni7on and subjec7ve hearing performance/sound quality

26 Thank you for your aren+on