Page 59 - Spring 2019
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‘'00 Azaio in Quiet Axfiin uoua sun AzBlo +5 :13 sup:
mo ¢ ma up «no ¢
91: 9a  in
6 5“ g 6 W 3 1: 5" ..
8°  L1   I3   I3 
5 5 it  E if.‘ ;.~_'. 5 33 
gee fizz E2: 
0 .3 1:  .3 ,3.-
E an cl «.4 ci an cl
5 4o . . . . . .
E Figure 4. Recognition by subjects with normal hearing (NH;
black circles) and CI (blue circles) subjects ofAzBio sentences
20 _g_ Mung5Y||ab|c ,,,oms_ Hams 9,51" 1997 presented in an otherwise quiet condition (lefi) or in compe-
—o—HsM It 1 .Hi 1/.1997 -- - - - - -
4_ M°"°:;|f:;‘l:':::,:IF;;‘a:z:$:"l fats 5 tition with environmental noise at the speech-to-noise ratios
-0- A13” SEW‘-"Desi Vaflflemifl -1313 (SNRs) of +10 dB (center) and +5 dB (right). Horizontal lines,
0 means of the scores for each test and set of subjects. From Wil-
0‘1 1 lo 100 son and Dorman (2018b), with permission; data courtesy of
Months after initial fitting Dr. Rene’ Giflord.
Figure 3. Means and SEMs for recognition of monosyllabic
wuhds (solid circles) ‘ma sentences ("P B" #731“) by implant An additional aspect of performance with the present-day
subjects. The sentences included the 112310 sentences (green unilateral C15 is seen in Figure 4) which shows the effects
circle’ '""'l lines) and the Hochmm-r's£h“ltz'M05e' (HSM) of noise interference on performance These data also are
sentences in Gennan or their equivalents in other languages from VUMC and again kindly Provided by Dr Gifford The
(blue circles and lines). See text for additional details about subjects include 82 adults with normal hearing (NH) and
the tests “_m1 5m"f“_ Bf dam‘ From Wilson and Dmmm‘ 60 adult users of unilateral Cls from the same corpus men-
aolgb)’ Wlth P"m’55“m' tioned previously or implanted later at the VUMC. The A2-
  Bio sentences were used and were presented in an otherwise
interval for the two monosyllabic word tests; and (5) lower quiet mndmo_n (figure 4’ left) or m_C°mP_etm°n wlth envi-
ronmental noise at the speech-to-noise ratios (SNRs) of +10
scores for the word tests than for the sentence tests. , , ‘
(Figure 4, center) and +5 dB (Figure 4, right). Scores for the
The l-‘T‘P1'°Vement5 0V5’ time indicate 3 P1'i1"CiP31 T019 0f 315 individual subjects are shown along with the mean scores in-
brain in determining outcomes with Cls. In particular, the djcated by thg hm-1zoma1]jne5‘
ti.rne course of the improvements is consistent with changes in _
b . . . . . The scores for the NH subjects are at or near 100% correct
rain function in adapting to a novel input (Moore and Shan- _ _ _
. . . for the quiet and +10 dB conditions and above 80% correct
non, 2009) but not consistent with changes at the periphery _ _

. . . . for the +5 dB condition. In contrast, scores for the C1 sub-
such as reductions in electrode impedances that occur during _ _ _

. . jects are much lower for all conditions and do not overlap
the first days, not months, of unplant use. The brain makes _ _

. . . . . the NH scores for the +10 and +5 dB conditions. Thus, the
sense of the input initially and makes progressively better _ _ _ _
sense of it over time, out to 3-12 months and perhaps even be- Present-day urfflateral €115 do not Provide NH’ especially m

. . . adverse acoustic conditions such as the ones shown and such
yond 12 months. (Note that the acute comparisons in Figure _ _ H _ t t 1 H th
2 did not capture the improvements over time that might have as m typlca _y noisy res aura“ S or_ wofkp ace?‘ owéver’ C

. . . . Cls do provide highly useful hearing in relatively quiet (and
resulted with substitution of the new processing strategy on a _ _ _ _ .
1 . reverberation-free) conditions, as shown by the data in Fig-
ong-term basis; also 566 Tyler et all) 1986') ure 4 lefi and by the sentence scores in Figure 3
The results from the monosyllabic word tests also indicate
that the performance of unilateral Cls has not changed much, Adiunctiva Stimulation
if at all, since the early 1990s, when the new processing strat- Although the performance of unilateral Cls has been rela-
egies became available for clinical use (also see Wilson, 2015, tively constant for the past 2+ decades, another way has been
for additional data in this regard). These tests are particularly found to increase performance and that is to present stimuli
good fiducial markers because the scores for the individual in addition to the stimuli presented by a unilateral CI. As
sub'ects do not encounter ceilin or floor effects for an of noted in A Sna shot of the Hjstor , this additional or ad-
the modern Cls and processing strategies tested to date. junctive) stimulation can be provided with a second CI on the
Spring 2019 | Annusizlcl Tnduy | 57

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