Effects of hearing aid settings for electric-acoustic stimulation

Background: Cochlear implant (CI) recipients with postoperative hearing preservation may utilize an ipsilateral bimodal listening condition known as electric-acoustic stimulation (EAS). Studies on EAS have reported significant improvements in speech perception abilities over CI-alone listening conditions. Adjustments to the hearing aid (HA) settings to match prescription targets routinely used in the programming of conventional amplification may provide additional gains in speech perception abilities. Purpose: Investigate the difference in users' speech perception scores when listening with the recommended HA settings for EAS patients versus HA settings adjusted to match National Acoustic Laboratories' nonlinear fitting procedure version 1 (NAL-NL1) targets. Research Design: Prospective analysis of the influence of HA settings. Study Sample: Nine EAS recipients with greater than 12 mo of listening experience with the DUET speech processor. Intervention: Subjects were tested in the EAS listening condition with two different HA setting configurations. Speech perception materials included consonant-nucleus-consonant (CNC) words in quiet, AzBio sentences in 10-talker speech babble at a signal-to-noise ratio (SNR) of +10, and the Bamford-Kowal-Bench sentences in noise (BKB-SIN) test. Data Collection and Analysis: The speech perception performance on each test measure was compared between the two HA configurations. Results: Subjects experienced a significant improvement in speech perception abilities with the HA settings adjusted to match NAL-NL1 targets over the recommended HA settings. Conclusions: EAS subjects have been shown to experience improvements in speech perception abilities when listening to ipsilateral combined stimulation. This population's abilities may be underestimated with current HA settings. Tailoring the HA output to the patient's individual hearing loss offers improved outcomes on speech perception measures.