4.5 Article

Is the spread of excitation width correlated to the speech recognition in cochlear implant users?

Journal

EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
Volume 278, Issue 6, Pages 1815-1820

Publisher

SPRINGER
DOI: 10.1007/s00405-020-06260-9

Keywords

Cochlear implant; Speech recognition; Spectral resolution; Spread of excitation; Channel interaction

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The study aimed to assess the impact of spread of excitation (SOE) on speech recognition. The results indicated that in the perimodiolar array, the wider the electrical current dispersion, the poorer the speech recognition, especially in the medial electrode.
Purpose To assess whether there is an interference of the spread of excitation (SOE) on speech recognition. Methods Retrospective cross-sectional study, approved by the institution's ethics committee (CAAE03409212.8.0000.0068). Adult patients with intraoperative neural response telemetry (NRT) performed on electrodes 6, 11 and 16 implanted with Cochlear Ltd (Sydney, Australia) devices were selected. Patients with partial array insertion, pre-lingual hearing loss, deafness etiology due to and CI experience less than 12 months were excluded. SOE was recorded at 10 current units above the NRT threshold (tNRT) and its width in millimeters was collected at point 0.75 of the function. Speech recognition test was 25-recorded monosyllables list, presented at 65 dBHL at 0 degrees azimuth in a sound treated booth. The analysis was divided into groups by electrode array type, regarding the tNRT, SOE width, SOE's peak amplitude and electrode peak. Results A 126 SOE measurements of the 3 tested electrodes were obtained from 43 patients. Patients with straight array had significantly wider SOE, greater peak amplitude at electrode 6 and higher tNRTs. In the perimodiolar array, there was a negative correlation between SOE and monosyllables recognition at electrodes 6 and 11, and in the combined average of the three electrodes, with a significant difference in electrode 11. Sixty-six percent of the SOE measurements had their peak shifted to adjacent electrodes. Conclusion It was observed, in perimodiolar array, the greater the dispersion of electrical current, the worse the speech recognition, especially in the medial electrode.

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