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)
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Study Section
Auditory System Study Section (AUD)
Program Officer
Donahue, Amy
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Vanderbilt University Medical Center
Schools of Medicine
United States
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Gifford, René H; Loiselle, Louise; Natale, Sarah et al. (2018) Speech Understanding in Noise for Adults With Cochlear Implants: Effects of Hearing Configuration, Source Location Certainty, and Head Movement. J Speech Lang Hear Res 61:1306-1321
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Wanna, George B; O'Connell, Brendan P; Francis, David O et al. (2018) Predictive factors for short- and long-term hearing preservation in cochlear implantation with conventional-length electrodes. Laryngoscope 128:482-489
Gifford, René H; Dorman, Michael F (2018) Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient. Ear Hear :
Davis, Timothy J; Gifford, René H (2018) Spatial Release From Masking in Adults With Bilateral Cochlear Implants: Effects of Distracter Azimuth and Microphone Location. J Speech Lang Hear Res 61:752-761
O'Connell, Brendan P; Holder, Jourdan T; Dwyer, Robert T et al. (2017) Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation. Front Neurosci 11:291
Dorman, Michael F; Gifford, Rene H (2017) Speech Understanding in Complex Listening Environments by Listeners Fit With Cochlear Implants. J Speech Lang Hear Res 60:3019-3026
Gifford, René H; Davis, Timothy J; Sunderhaus, Linsey W et al. (2017) Combined Electric and Acoustic Stimulation With Hearing Preservation: Effect of Cochlear Implant Low-Frequency Cutoff on Speech Understanding and Perceived Listening Difficulty. Ear Hear 38:539-553
Loiselle, Louise H; Dorman, Michael F; Yost, William A et al. (2016) Using ILD or ITD Cues for Sound Source Localization and Speech Understanding in a Complex Listening Environment by Listeners With Bilateral and With Hearing-Preservation Cochlear Implants. J Speech Lang Hear Res 59:810-8
Sheffield, Sterling W; Simha, Michelle; Jahn, Kelly N et al. (2016) The Effects of Acoustic Bandwidth on Simulated Bimodal Benefit in Children and Adults with Normal Hearing. Ear Hear 37:282-8

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