Horizontal-plane localization of noise and speech signals by postlingually deafened adults fitted with bilateral cochlear implants

Objectives: The main purpose of the study was to assess the ability of adults with bilateral cochlear implants to localize noise and speech signals in the horizontal plane. A second objective was to measure the change in localization performance in these adults between approximately 5 and 15 mo after activation. A third objective was to evaluate the relative roles of interaural level difference (ILD) and interaural temporal difference (ITD) cues in localization by these subjects. Design: Twenty-two adults, all postlingually deafened and all bilaterally fitted with MED-EL COMBI 40+ cochlear implants, were tested in a modified source identification task. Subjects were tested individually in an anechoic chamber, which contained an array of 43 numbered loudspeakers extending from -90 degrees to +90 degrees azimuth. On each trial, a 200-msec signal (either a noise burst or a speech sample) was presented from one of 17 active loudspeakers (span: +/- 80 degrees and the subject had to identify which source from the 43 loudspeakers in the array produced the signal. Subjects were tested in three conditions: left device only active, right device only active, and both devices active. Twelve of the 22 subjects were retested approximately 10 mo after their first test. In Experiment 2, the spectral content and rise-decay time of the noise stimulus were manipulated. Results: The relationship between source azimuth and response azimuth was characterized in terms of the adjusted constant error (0). (1) With both devices active, 0 for the noise stimulus varied from 8.1 degrees to 43.4 degrees (mean: 24.0. By comparison, 0 for a group of listeners with normal hearing ranged from 3.5 degrees to 7.8 degrees (mean: 5.6 degrees). When subjects listened in unilateral mode (with one device turned off), ( was at or near chance (50.5 degrees) in all cases. However, when consider- ing unilateral performance on each subject's better side, average ( for the speech stimulus was 47.9 degrees, which was significantly (but only slightly) better than chance. (2) When listening bilaterally, error score was significantly lower for the speech stimulus (mean ( = 21.5 degrees) than for the noise stimulus (mean 0 = 24.1 degrees). (3) As a group, the 12 subjects who were retested 10 mo after their first visit showed no significant improvement in localization performance during the intervening time. However, two subjects who performed very poorly during their first visit showed dramatic improvement (error scores were halved) over the intervening time. In Experiment 2, removing the high-frequency content of noise signals resulted in significantly poorer performance, but removing the low-frequency content or increasing the rise-decay time did not have an effect. Conclusions: In agreement with previously reported data, subjects with bilateral cochlear implants localized sounds in the horizontal plane remarkably well when using both of their devices, but they generally could not localize sounds when either device was deactivated. They could localize the speech signal with slightly, but significantly better accuracy than the noise, possibly due to spectral differences in the signals, to the availability of envelope ITD cues with the speech but not the noise signal, or to more central factors related to the social salience of speech signals. For most subjects the remarkable ability to localize sounds has stabilized by 5 mo after activation. However, for some subjects who perform poorly initially, there can be substantial improvement past 5 mo. Results from Experiment 2 suggest that ILD cues underlie localization ability for noise signals, and that ITD cues do not contribute.