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DOI: 10.3766/jaaa.308ceu
JAAA CEU Program
Volume 30, Number 8 (September 2019)Publikationsverlauf
Publikationsdatum:
25. Mai 2020 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00046128/201908/lookinside/thumbnails/10-3766-jaaa-308ceu_00736-1.jpg)
Questions refer to Zaleski-King et al, “Bimodal Cochlear Implant Listeners’ Ability to Perceive Minimal Audible Angle Differences,” 659–671.
Learner Outcomes:
Readers of this article should be able to:
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Summarize the literature describing bimodal access to interaural level and interaural timing difference cues.
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Discuss the limitations adversely affecting bimodal binaural integration.
CEU Questions:
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The literature has shown that some bimodal listeners can take advantage of interaural cues when speech sources are spatially separated, based on:
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the head shadow effect
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binaural summation
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interaural time difference (ITD) integration
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Many of the documented binaural benefits of bimodal stimulation have been demonstrated in:
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environments providing opportunities for “dip listening” during fluctuations in noise
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optimized, directly controlled laboratory conditions
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in comparison to patients with bilateral hearing aids
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As high-frequency content increases, interaural level differences (ILDs) are:
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more salient
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less salient
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unchanged
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Hearing aid processing produces a(n) _______ timing delay in comparison to cochlear implant (CI) processors, resulting in ________.
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smaller, difficulty for computation of neural cues
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larger, difficulty for computation of neural cues
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equivalent, optimized binaural computation
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A broadband stimulus was used in the study to:
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optimize ILD cues
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improve access to overall loudness cues
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provide an opportunity for acoustic and electric stimulation overlap
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The interdevice delay (IDD) was used in this study to represent:
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the difference in delay required for lateralization of the broadband stimulus
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the delay between the hearing aid (HA) and CI processors required for the listener to achieve a percept of a centered, single stimulus
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the loudness difference required for equal between-ear intensity percept
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The results of this study generally showed that:
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providing ITD access to bimodal listeners can be achieved through determining the IDD
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providing localization information to bimodal listeners necessitates more substantial changes to device speech-processing algorithms and fitting procedures
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providing access to ILDs requires monaural listening for bimodal patients
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The authors hypothesized the Listener B6 demonstrated greater difficulty establishing differences in loudness cues because:
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this listener could not identify ITDs
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this listener had the most pronounced low-frequency hearing loss in the hearing aid ear
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this listener had the least experience listening bimodally
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One limitation identified by the authors that might have contributed to the variability in interaural loudness perception:
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differences in compression ratios
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differences in age of participants
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differences in hearing aid manufacturer/model
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In conclusion, the high variability and the general difficulty demonstrated in tasks requiring binaural comparisons supports the idea that:
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CIs best preserve ILD cues used for the head shadow effect
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listeners likely extracted monaural loudness cues to complete the task
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listening experience determines the ability to compute binaural cues
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