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Research Article

A meta-analysis to compare speech recognition in noise with bilateral cochlear implants and bimodal stimulation

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Pages 871-880 | Received 28 Sep 2010, Accepted 02 May 2011, Published online: 21 Nov 2011
 

Abstract

Abstract

Objective: This investigation quantified the relative benefits of binaural CI arrangements (i.e., bilateral, bimodal) for three binaural phenomena (i.e., binaural squelch, binaural summation, head-shadow effect) and sensitivity of two speech-recognition test paradigms (i.e., adaptive and fixed). Design: A repeated-measures meta-analytical approach was used to compare effect sizes between binaural CI arrangements for each of the three binaural-listening phenomena and between the two test paradigms. Study sample: A total of 95 effect sizes were calculated and analyzed from 42 peer-reviewed studies published between January 2000 and April 2011. Results: Findings revealed significant effect sizes for both CI arrangements for the binaural phenomena of summation and head-shadow effect. A significant effect size for binaural squelch was determined only for bilateral CI users. Further, the two paradigms resulted in similar effect sizes for bilateral and bimodal users, with the exception of binaural squelch. Here, significant effect sizes were significant only in the fixed-testing paradigm. Conclusions: The average user of binaural CI arrangements realizes the binaural phenomena of summation and the head-shadow effect, but only the bilateral CI arrangement is afforded the advantage of binaural squelch. Statistically, listeners fit with bilateral CIs have a slight advantage in binaural performance over those using bimodal stimulation.

Sumario

Objetivo: Esta investigación cuantifica los beneficios relativos de las adaptaciones binaurales de IC (p.e., bilaterales, bimodales) en cuanto a tres fenómenos binaurales (p.e., chapoteo binaural, sumación binaural, efecto de sombra de la cabeza) y la sensibilidad de dos paradigmas de prueba para el reconocimiento del lenguaje. Diseño: Se utilizó un enfoque meta-analítico de medidas repetidas para comparar el grado del efecto en las adaptaciones binaurales de CI para cada uno de los tres fenómenos de audición binaural y entre los dos paradigmas de prueba. Muestra Del Estudio: Se calculó y se analizó un total de 95 efectos en 42 estudios con revisión editorial, publicados entre enero del 2000 y abril del 2011. Resultados: Los hallazgos revelaron grados significativos de efecto para ambas adaptaciones de CI, tanto para el fenómeno de sumación como para el de efectos sombra de la cabeza. Se determinó un grado significativo de efecto para el chapoteo binaural sólo para los usuarios de CI bilaterales. Más aún, los dos paradigmas rindieron resultados de grado similar para usuarios bilaterales y bimodales, con la excepción del chapoteo binaural. Aquí, los grados de efecto fueron significativos solamente para el paradigma de prueba fija. Conclusiones: El usuario promedio con adaptación binaurales de CI se da cuenta del fenómeno binaural de sumación y el efecto de sombra de la cabeza, pero solo al arreglo de CI bilateral le da la ventaja del chapoteo binaural. Estadísticamente, los sujetos adaptados con CI bilaterales tienen una ligera ventaja en el desempeño binaural sobre aquellos que utilizan estimulación bimodal.

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