Speech Recognition and Subjective Hearing Abilities for Electric-Acoustic Stimulation Users With Unilateral Hearing Loss

Objective Some cochlear implant (CI) recipients with unilateral hearing loss (UHL) have functional acoustic hearing in the implanted ear, warranting the fitting of an ipsilateral electric-acoustic stimulation (EAS) device. The present study assessed speech recognition and subjective hearing abilities over time for EAS users with UHL. Study Design Prospective, repeated-measures. Setting Tertiary referral center. Patients Adult CI recipients with normal-to-moderate low-frequency acoustic thresholds in the implanted ear and a contralateral pure-tone average (0.5, 1, and 2 kHz) <= 25 dB HL. Main Outcome Measures Participants were evaluated preoperatively and at 1, 3, and 6 months post-activation. Speech recognition for the affected ear was evaluated with CNC words in quiet. Masked speech recognition in the bilateral condition was evaluated with AzBio sentences in a 10-talker masker (0 dB SNR) for three spatial configurations: target from the front and masker either colocated with the target or presented 90 degrees toward the affected or contralateral ear. Responses to the Speech, Spatial, and Qualities of Hearing Scale subscales were used to assess subjective hearing abilities. Results Participants experienced significant improvements in CNC scores (F-(3,F-13) = 14.90, p < 0.001), and masked speech recognition in the colocated (F-(3,F-11) = 3.79, p = 0.043) and masker toward the contralateral ear (F-(3,F-11) = 4.75, p = 0.023) configurations. They also reported significantly better abilities on the Speech Hearing (F-(3,F-13) = 5.19, p = 0.014) and Spatial Hearing (F-(3,F-13) = 10.22, p = 0.001) subscales. ConclusionsAdults with UHL and functional acoustic hearing in the implanted ear experience significant improvements in speech recognition and subjective hearing abilities within the initial months of EAS use as compared with preoperative performance and perceptions.