Audiology - Communication Research
https://www.audiolcommres.org.br/article/doi/10.1590/2317-6431-2023-2778pt
Audiology - Communication Research
Artigo Original

Tecnologia auditiva assistiva em usuários de implante coclear em ambientes reverberantes com múltiplas fontes de ruído

Assistive listening technology in cochlear implant users in reverberant environments with multiple noise sources

Agustina Echegoyen; Maria Valeria Schmidt Goffi-Gomez; Robinson Koji Tsuji

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Resumo

Objetivo: Avaliar a contribuição da tecnologia de escuta assistida em usuários de implante coclear (IC) em situações de reverberação e ruído.

Métodos: Estudo transversal prospectivo aprovado pelo Comitê de Ética Institucional (CAAE 8 3031418.4.0000.0068). Foram selecionados adolescentes e adultos usuários de IC com surdez pré ou pós-lingual. Para usuários bilaterais, cada orelha foi avaliada separadamente. O reconhecimento de fala foi avaliado por meio de listas gravadas de palavras dissílabas apresentadas a 65 dBA a 0° azimute com e sem o Mini Microfone2 (Cochlear™) conectado ao processador de fala Nucleus®6. A reverberação da sala foi medida como 550 ms. Para avaliar a contribuição do dispositivo de escuta assistida (DEA) em ambiente reverberante, o reconhecimento de fala foi avaliado no silêncio. Para avaliar a contribuição do DEA em reverberação e ruído, o reconhecimento de fala foi apresentado a 0° azimute com o ruído proveniente de 8 alto-falantes dispostos simetricamente a 2 metros de distância do centro com ruído de múltiplos falantes usando relação sinal-ruído de +10dB. Para evitar viés de aprendizado ou fadiga, a ordem dos testes foi randomizada. A comparação das médias foi analisada pelo teste t para amostras pareadas, adotando-se nível de significância de p<0,005.

Resultados: Dezessete pacientes com idade média de 40 anos foram convidados e concordaram em participar, sendo 2 participantes bilaterais, totalizando 19 orelhas. Houve contribuição positiva significante do Mini Mic2 na reverberação e ruído+reverberação (p<0,001).

Conclusão: DEA foi capaz de melhorar o reconhecimento de fala de usuários de IC tanto em situações de reverberação quanto ruidosas.

Palavras-chave

Surdez; Implante coclear; Reconhecimento de fala; Tecnologia assistiva; Reverberação; Acústica dos ambientes; Ruído

Abstract

Purpose:This study aimed to evaluate the contribution of assistive listening technology with wireless connectivity in cochlear implant (CI) users in reverberating and noise situations.

Methods: Prospective cross-sectional study approved by the Institutional Ethics Committee (CAAE 8 3031418.4.0000.0068). Adolescents and adults CI users with pre- or post-lingual deafness were selected. For bilateral users, each ear was assessed separately. Speech recognition was assessed using recorded lists of disyllabic words presented at 65 dBA at 0° azimuth with and without the Wireless Mini Microphone 2 (Cochlear™) connected to the Nucleus®6 speech processor. Room reverberation was measured as 550 ms. To assess the contribution of the assistive listening device (ALD) in a reverberating environment, speech recognition was assessed in quiet. To assess the contribution of the ALD in reverberation and noise, speech recognition was presented at 0° azimuth along with the noise coming from 8 loudspeakers symmetrically arranged 2 meters away from the center with multi-talker babble noise using signal to noise ratio of +10dB. To avoid learning bias or fatigue, the order of the tests was randomized. Comparison of means was analyzed by t test for paired samples, adopting significance level of p <0.005.

Results: Seventeen patients with a mean age of 40 years were invited and agreed to participate, with 2 bilateral participants, totaling 19 ears assessed. There was a significant positive contribution from the Mini Mic2 in reverberation, and noise+reverberation (p <0.001).

Conclusion: ALD was able to improve speech recognition of CI users in both reverberation and noisy situations.

Keywords

Hearing loss; Cochlear implantation; Speech perception; Assistive technology; Reverberation; Room acoustics; Noise

Referências

1 WHO: World Health Organization. World report on hearing [Internet]. Genebra: WHO; 2021 [citado em 2023 Nov 1]. Disponível em: https://www.who.int/publications/i/item/world-report-on-hearing

2 Niparko JK, Tobey EA, Thal DJ, Eisenberg LS, Wang NY, Quittner AL, et al. Spoken language development in children following cochlear implantation. JAMA. 2010;303(15):1498-506. http://dx.doi.org/10.1001/jama.2010.451. PMid:20407059.

3 Lazard DS, Vincent C, Venail F, Van de Heyning P, Truy E, Sterkers O, et al. Pre-, per- and postoperative factors affecting performance of postlinguistically deaf adults using cochlear implants: a new conceptual model over time. PLoS One. 2012;7(11):e48739. http://dx.doi.org/10.1371/journal.pone.0048739. PMid:23152797.

4 Bento RF, Lima LRP Jr, Tsuji RK, Goffi-Gomez MVS, Lima DVSP, Brito R No. Tratado de implante coclear e próteses auditivas implantáveis. Rio de Janeiro: Thieme; 2015.

5 Eisenberg LS, Fisher LM, Johnson KC, Ganguly DH, Grace T, Niparko JK. Sentence recognition in quiet and noise by pediatric cochlear implant users: relationships to spoken language. Otol Neurotol. 2016;37(2):e75-81. http://dx.doi.org/10.1097/MAO.0000000000000910. PMid:26756159.

6 Firszt JB, Holden LK, Skinner MW, Tobey EA, Peterson A, Gaggl W, et al. Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems. Ear Hear. 2004;25(4):375-87. http://dx.doi.org/10.1097/01.AUD.0000134552.22205.EE. PMid:15292777.

7 Nascimento LT, Bevilacqua MC. Evaluation of speech perception in noise in cochlear implanted adults. Braz J Otorhinolaryngol. 2005;71(4):432-8. http://dx.doi.org/10.1016/S1808-8694(15)31195-2. PMid:16446956.

8 Fitzpatrick EM, Séguin C, Schramm DR, Armstrong S, Chénier J. The benefits of remote microphone technology for adults with cochlear implants. Ear Hear. 2009;30(5):590-9. http://dx.doi.org/10.1097/AUD.0b013e3181acfb70. PMid:19561509.

9 Hazrati O, Loizou PC. The combined effects of reverberation and noise on speech intelligibility by cochlear implant listeners. Int J Audiol. 2012;51(6):437-43. http://dx.doi.org/10.3109/14992027.2012.658972. PMid:22356300.

10 Reinhart PN, Souza PE. Intelligibility and clarity of reverberant speech: effects of wide dynamic range compression release time and working memory. J Speech Lang Hear Res. 2016;59(6):1543-54. http://dx.doi.org/10.1044/2016_JSLHR-H-15-0371. PMid:27997667.

11 Kressner AA, Westermann A, Buchholz JM. The impact of reverberation on speech intelligibility in cochlear implant recipients. J Acoust Soc Am. 2018;144(2):1113-22. http://dx.doi.org/10.1121/1.5051640. PMid:30180700.

12 Wolfe J, Morais M, Schafer E. Improving hearing performance for cochlear implant recipients with use of a digital, wireless, remote-microphone, audio-streaming accessory. J Am Acad Audiol. 2015;26(6):532-9. http://dx.doi.org/10.3766/jaaa.15005. PMid:26134720.

13 Wolfe J, Schafer EC. Optimizing the benefit of sound processors coupled to personal FM systems. J Am Acad Audiol. 2008;19(8):585-94. http://dx.doi.org/10.3766/jaaa.19.8.2. PMid:19323350.

14 Schafer EC, Wolfe J, Lawless T, Stout B. Effects of FM-receiver gain on speech-recognition performance of adults with cochlear implants. Int J Audiol. 2009;48(4):196-203. http://dx.doi.org/10.1080/14992020802572635. PMid:19363720.

15 De Ceulaer G, Swinnen F, Pascoal D, Philips B, Killian M, James C, et al. Conversion of adult Nucleus® 5 cochlear implant users to the Nucleus® 6 system. Cochlear Implants Int. 2015;16(4):222-32. http://dx.doi.org/10.1179/1754762814Y.0000000097. PMid:25284643.

16 Vroegop JL, Dingemanse JG, Homans NC, Goedegebure A. Evaluation of a wireless remote microphone in bimodal cochlear implant recipients. Int J Audiol. 2017;56(9):643-9. http://dx.doi.org/10.1080/14992027.2017.1308565. PMid:28395552.

17 Harris RW, Goffi MVS, Pedalini MEB, Merrill A, Gygi MA. Psychometrically equivalent Brazilian Portuguese bisyllabic word recognition spoken by male and female talkers. Pro Fono. 2001;13(2):249-62.

18 Research Randomizer [Internet]. Middletown: Social Psychology Network; c1997-2024 [citado em 2023 Nov 1]. Disponível em: https://randomizer.org/

19 Goffi-Gomez MVS, Muniz L, Wiemes G, Onuki LC, Calonga L, Osterne FJ, et al. Contribution of noise reduction pre-processing and microphone directionality strategies in the speech recognition in noise in adult cochlear implant users. Eur Arch Otorhinolaryngol. 2021;278(8):2823-8. http://dx.doi.org/10.1007/s00405-020-06372-2. PMid:32948894.

20 Hu Y, Kokkinakis K. Effects of early and late reflections on intelligibility of reverberated speech by cochlear implant listeners. J Acoust Soc Am. 2014;135(1):EL22-8. http://dx.doi.org/10.1121/1.4834455. PMid:24437852.

21 De Ceulaer G, Bestel J, Mülder HE, Goldbeck F, De Varebeke SP, Govaerts PJ. Speech understanding in noise with the Roger Pen, Naida CI Q70 processor, and integrated Roger 17 receiver in a multi-talker network. Eur Arch Otorhinolaryngol. 2016;273(5):1107-14. http://dx.doi.org/10.1007/s00405-015-3643-4. PMid:25983309.

22 Jacob RTS, Alves TKM, Moret ALM, Morettin M, Santos LG, Mondelli MFCG. Participation in regular classroom of student with hearing loss: frequency modulation system use. CoDAS. 2014;26(4):308-14. http://dx.doi.org/10.1590/2317-1782/201420130027. PMid:25211690.

23 Miranda-Gonsalez EC, Almeida K. Cross-cultural adaptation of the Speech, Spatial and Qualities of Hearing Scale (SSQ) to Brazilian Portuguese. Audiol Commun Res. 2015;20(3):215-24. http://dx.doi.org/10.1590/S2317-64312015000300001572.

24 Mehrkian S, Bayat Z, Javanbakht J, Emamdjomeh H, Bakhshi E. Effect of wireless remote microphone application on speech discrimination in noise in children with cochlear implants. Int J Pediatr Otorhinolaryngol. 2019;125:192-5. http://dx.doi.org/10.1016/j.ijporl.2019.07.007. PMid:31369931.

25 Ng EHN, Rudner M, Lunner T, Pedersen MS, Rönnberg J. Effects of noise and working memory capacity on memory processing of speech for hearing-aid users. Int J Audiol. 2013;52(7):433-41. http://dx.doi.org/10.3109/14992027.2013.776181. PMid:23550584.

26 Razza S, Zaccone M, Meli A, Cristofari E. Evaluation of speech reception threshold in noise in young Cochlear™ Nucleus (®) system 6 implant recipients using two different digital remote microphone technologies and a speech enhancement sound processing algorithm. Int J Pediatr Otorhinolaryngol. 2017;103:71-5. http://dx.doi.org/10.1016/j.ijporl.2017.10.002. PMid:29224769.

27 Reinhart PN, Souza PE. Listener factors associated with individual susceptibility to reverberation. J Am Acad Audiol. 2018;29(1):73-82. http://dx.doi.org/10.3766/jaaa.16168. PMid:29309025.

28 Benítez-Barrera CR, Thompson EC, Angley GP, Woynaroski T, Tharpe AM. Remote microphone system use at home: impact on child-directed speech. J Speech Lang Hear Res. 2019;62(6):2002-8. http://dx.doi.org/10.1044/2019_JSLHR-H-18-0325. PMid:31112670.

29 Curran M, Walker EA, Roush P, Spratford M. Using propensity score matching to address clinical questions: the impact of remote microphone systems on language outcomes in children who are hard of hearing. J Speech Lang Hear Res. 2019;62(3):564-76. http://dx.doi.org/10.1044/2018_JSLHR-L-ASTM-18-0238. PMid:30950736.

30 Picou EM, Gordon J, Ricketts TA. The effects of noise and reverberation on listening effort in adults with normal hearing. Ear Hear. 2016;37(1):1-13. http://dx.doi.org/10.1097/AUD.0000000000000222. PMid:26372266.

31 Schepker H, Haeder K, Rennies J, Holube I. Perceived listening effort and speech intelligibility in reverberation and noise for hearing-impaired listeners. Int J Audiol. 2016;55(12):738-47. http://dx.doi.org/10.1080/14992027.2016.1219774. PMid:27627181.
 


Submetido em:
29/03/2023

Aceito em:
01/11/2023

6993aeb5a9539563fc11ebe5 acr Articles
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