Combining acoustic and electric stimulation to attack the cocktail party problem
Resumé
Residual low-frequency acoustic hearing can provide critical temporal ne structure and pitch cues that are not conveyed by current cochlear implants, while electric hearing can provide high-frequency temporal envelope cues that are not effectively delivered by current hearing aids. Therefore combined acoustic and electric stimulation provides complementary information and may have great potential to improve performance on tasks that require good pitch perception, for example speech recognition in noise, music perception, understanding tonal languages, perceiving tone of voice, and talker identification. These tasks are particularly challenging for current cochlear implant users. Acoustic and electric hear- ing may be combined via electroacoustic stimulation in the same ear (ipsilateral EAS), or via a cochlear implant in one ear and a hearing aid in the other (contralateral EAS). At present, clinical outcomes are encouraging but show large inter-subject variability. Theoretical considerations on the underlying mechanisms and optimal tting are lacking. This paper reviews the difficulties cochlear implant users face on pitch-related tasks, and presents speech recognition results from EAS users and simulation data from normal-hearing controls. In addition, results are presented from a unique subject who has a cochlear implant in one ear, and virtually normal hearing in the other ear; he was implanted due to intractable tinnitus. It is suggested that in some important tasks, the hearing aid and cochlear implant combination may provide a more effective solution than not only each device alone but also than bilateral cochlear implants.
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