In one of the newest applications of cochlear implants, individuals with bilateral low-frequency hearing receive a short electrode array in one cochlea with the aim of preserving hearing in that ear. A successful surgical outcome allows patients to combine electrical (E) stimulation from the implanted ear and acoustic stimulation (S) from both ears or EAS. The long-term goal of this research is to quantify the benefit of acoustic hearing from two partially hearing ears vs. one partially hearing ear - as in the case of bimodal hearing. Previous research has failed to demonstrate significant benefit to speech perception for EAS with two partially hearing ears vs. one partially hearing ear. The standard clinical measures that have been used to assess benefit, however, have not been designed to assess binaural listening. Thus the proposed research will test two groups of patients including (1) EAS recipients, and (2) patients with a conventional electrode array in one ear and low-frequency hearing in the other ear (i.e., bimodal). Experimentation will include complex listening environments which are thought to be sensitive to the use of binaural cues including the spatial separation of speech and noise, reverberation, and localization. The clinical application of this proposal is substantial. Neither audiologists nor otologists are certain how to counsel EAS-qualifying patients about treatment options. This project will provide the necessary information to allow for data-driven counseling.

Public Health Relevance

Combined electric and acoustic stimulation (EAS) with a short electrode array offers a viable treatment option for individuals who do not receive benefit from hearing aids and may not qualify for a cochlear implant due to residual low-frequency hearing. It is critical, however, that both patients and professionals understand the benefits of preserving hearing in the implanted ear as well as the relative benefits of EAS (cochlear implant + binaural acoustic hearing) vs. bimodal hearing (cochlear implant + contralateral acoustic hearing). The current proposal aims to develop this information and, as a consequence, will enable appropriate informed consent for a treatment option that could become a standard surgical tool in the effort to restore hearing to the partially deaf.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Project (R01)
Project #
Application #
Study Section
Auditory System Study Section (AUD)
Program Officer
Donahue, Amy
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Vanderbilt University Medical Center
Schools of Medicine
United States
Zip Code
Noble, Jack H; Gifford, René H; Hedley-Williams, Andrea J et al. (2014) Clinical evaluation of an image-guided cochlear implant programming strategy. Audiol Neurootol 19:400-11
Gifford, Rene H; Dorman, Michael F; Sheffield, Sterling W et al. (2014) Availability of binaural cues for bilateral implant recipients and bimodal listeners with and without preserved hearing in the implanted ear. Audiol Neurootol 19:57-71
Gifford, René H; Grantham, D Wesley; Sheffield, Sterling W et al. (2014) Localization and interaural time difference (ITD) thresholds for cochlear implant recipients with preserved acoustic hearing in the implanted ear. Hear Res 312:28-37
Zhang, Ting; Dorman, Michael F; Gifford, Rene et al. (2014) Cochlear dead regions constrain the benefit of combining acoustic stimulation with electric stimulation. Ear Hear 35:410-7
Wanna, George B; Noble, Jack H; Carlson, Matthew L et al. (2014) Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes. Laryngoscope 124 Suppl 6:S1-7
Sheffield, Sterling W; Gifford, René H (2014) The benefits of bimodal hearing: effect of frequency region and acoustic bandwidth. Audiol Neurootol 19:151-63
Noble, Jack H; Labadie, Robert F; Gifford, Rene H et al. (2013) Image-guidance enables new methods for customizing cochlear implant stimulation strategies. IEEE Trans Neural Syst Rehabil Eng 21:820-9
Gifford, Rene H; Dorman, Michael F; Skarzynski, Henryk et al. (2013) Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments. Ear Hear 34:413-25
Dorman, Michael F; Gifford, Rene H (2010) Combining acoustic and electric stimulation in the service of speech recognition. Int J Audiol 49:912-9