The Benefits of Bimodal Aiding on Extended Dimensions of Speech Perception: Intelligibility, Listening Effort, and Sound Quality.
Elke M J Devocht, A Miranda L Janssen, Josef Chalupper and 2 others
PMID 28874096WHAT IT FOUND
Adding a hearing aid to a cochlear implant improved speech understanding in quiet and noise, reduced listening effort at the most favorable tested level, and made sound fuller and less tinny in 15 adult bimodal users.
Key findings
01The primary bimodal benefit, comparing the cochlear implant and hearing aid together with the cochlear implant alone, was significant with a mean improvement of 14.6 ± 4.1 percentage points.
02When speech and noise came from the front, adding the hearing aid improved the speech reception threshold by 4.2 ± 0.9 dB SNR.
03At the most favorable tested level, bimodal hearing reduced listening effort by 1.4 ± 0.3 points on a 0 to 12 scale, and bimodal sound was rated 3.0 points less tinny than cochlear implant alone.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 15 participants were enrolled, and 4 could not be analysed for spatial speech in noise, so the noise results apply to a smaller subset. The hearing aid alone condition was not tested for speech in noise or listening effort, so the study cannot separate the hearing aid's independent contribution from its effect when added to the implant. The test order was fixed across participants, so practice or fatigue effects may have influenced some ratings. Listening effort and sound quality were subjective ratings, not performance measures. Correlation analyses were exploratory and not corrected for multiple comparisons. The sample had aidable residual hearing up to 1000 Hz and already used the hearing aid regularly, so results may not apply to cochlear implant users with little residual hearing or inconsistent hearing-aid use.
Declared interests
The supplied text does not report a funding source or author conflict-of-interest declaration. Participants received a modest participation fee and travel compensation.
The easy way to misread this
Do not assume every cochlear implant user should add a hearing aid. This was a small study of 15 Dutch-speaking adults who already used a contralateral hearing aid for at least 50% of the day, and 4 participants could not be analysed for spatial speech in noise.