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Evaluation of Fine Structure Coding Strategies in Cochlear Implants Douglas P. Sladen, PhD1, Ann Peterson, MA1, & Chang Liu, PhD2. 1Mayo Clinic, Rochester, MN 2University of Texas at Austin, Austin, TX

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Disclaimer

I declare that I have no proprietary interest in any product, instrument, device, service, or material related to this

presentation

I have previously served on the international audiology advisory board for Med El

Funding for this study was provided by Med El

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Background – temporal cues

•  Temporal cues •  Envelope cues provide information at the supra segmental and

segmental levels •  Temporal fine structure provides information at the sub

segmental level

•  Fine structure influences music perception, voice pitch, quality, and clarity, and also enables listeners to attend to a speech source when there are competing noise sources

•  Age related loss of temporal synchrony is likely to play a role in the difficulties older adults experience in understanding speech in noise

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Specific aims and hypotheses • To determine if older age is a contraindication to

using fine structure processing

• Comparison of HDCIS to fine structure processing

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A-B crossover design Participants used strategy A (HDCIS) for 3 mos, strategy B (Fine Structure) for three mos

•  Thresholds locked to 10% of comfort

•  Frequency boundaries 100-8500 Hz

•  Maplaw 500

•  Sensitivity 75%

Fine Structure

•  Thresholds locked to 10% of comfort

•  Frequency boundaries 100-8500 Hz

•  Maplaw 500

•  Sensitivity 75%

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HDCIS

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Methods – endpoint testing

Endpoint Testing

• Questionnaires •  Speech Spatial & Qualities of Hearing Questionnaire

(SSQ) (Gatehouse & Noble, 2004) •  Temporal Modulation Detection (TMDT) (Jin et al.,

2015)

•  Speech Recognition

•  Consonant Recognition – iCast (Fu et al., 2005)

•  HINT sentences (Nilsson et al., 1998) in an R-SPACE 8-speaker array

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Participant Age Ear Internal CNC word score

HDCIS Fine Structure

1 80 Le& ConcertFlex28 35 X X

2 25 Le& ConcertFlex28 62 X X

3 79 Le& Sonata8100Med 81 X X

4 80 Le& ConcertFlex24 74 X X

5 50 Le& Sonata8100standard 72 X X

6 68 Le& Sonata8100standard 78 X X

7 56 Right ConcertFlex24 23 X X

8 62 Le& SynchronyFlex24 68 X X

9 78 Right ConcertFlex24 86 X X

10 43 Right ConcertFlex28 80 X X

11 63 Le& Concert8100standard 59 X

12 67 Right ConcertFlex28 64

13 62 Le& ConcertFlex28 16

14 80 Right ConcertFlex24 68

14 60 Right ConcertFlex28 81

15 57 Right ConcertFlex28 70

16 84 Right ConcertFlex24 63

17 68 Right ConcertFlex24 71

8 Right 9 Left

25- 84 yrs Mean 63.5

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Mean 69% Stdev 19%

24% Attrition

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Results - SSQ

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0

1

2

3

4

5

6

7

8

9

10

HDCIS Fine Structure HDCIS Fine Structure HDCIS Fine Structure

Aver

age

Tota

l Sco

re

62

56

68

25

50

78

43

80

80

79

Speech Spatial Qualities

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Results – consonant recognition

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0

10

20

30

40

50

60

70

80

90

100

OverallPercentCorrect VoicingRIT MannerRIT PlaceRIT

Percen

t(%)C

orrect/RIT

ConsonantRecogni8onHDCIS FSP

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Results – consonant recognition

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0

10

20

30

40

50

60

70

80

90

100

HDCIS Fine Structure HDCIS Fine Structure HDCIS Fine Structure

Rel

ativ

e In

form

atio

n Tr

ansf

erre

d (R

IT)

80

25

79

80

50

68

56

62

68

78

43

84

63

Voicing Manner Place

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Voicing – HDCIS and TFS

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0

10

20

30

40

50

60

70

80

90

100

HDCIS Fine Structure

Perc

ent (

%) C

orre

ct

Male

80

25

79

80

50

68

56

62

68

78

43

0

10

20

30

40

50

60

70

80

90

100

HDCIS FineStructure

Percen

t(%)C

orrect

Female

80

25

79

80

50

68

56

62

68

78

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Results – speech recognition in diffuse noise, CI only

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0

5

10

15

20

25

HDCIS Fine Structure

dB S

NR

80

25

79

80

50

68

56

62

68

78

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Participant Age Ear Internal CNC word score

HDCIS Fine Structure Preferred Strategy

1 80 Le& ConcertFlex28 35 X X HDCIS

2 25 Le& ConcertFlex28 62 X X HDCIS

3 79 Le& Sonata8100Med 81 X X FS4p

4 80 Le& ConcertFlex24 74 X X FS4p

5 50 Le& Sonata8100standard 72 X X FS4p

6 68 Le& Sonata8100standard 78 X X FS4p

7 56 Right ConcertFlex24 23 X X FS4p

8 62 Le& SynchronyFlex24 68 X X FS4p

9 78 Right ConcertFlex24 86 X X FS4p

10 43 Right ConcertFlex28 80 X X FS4p

11 63 Le& Concert8100standard 59 X

12 67 Right ConcertFlex28 64 X

13 62 Le& ConcertFlex28 16

14 80 Right ConcertFlex24 68

14 60 Right ConcertFlex28 81 FS4p

15 57 Right ConcertFlex28 70 FS4p

16 84 Right ConcertFlex24 63 FS4p

17 68 Right ConcertFlex24 71 FS4p

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Summary •  Older adults are able make use of fine structure cues, and in some cases

show distinct benefit for understanding speech in diffuse noise

•  Current results are limited by the time frame; it may take up to year to realize benefits of fine structure processing (Kleine et al., 2014)

•  Extending the low frequency boundary to 70 Hz may influence access to low frequency temporal cues

•  Follow up: •  Depth of insertion and placement of electrodes in apex of cochlea •  Advanced programming

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Acknowledgements

Chang Liu, Ph.D.

Ann Peterson, M.A.

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Questions & Discussion

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