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Abstract
Objectives: The controlled clinical test environment is very different from real-life listening situations, where the presence of additional speakers and variations in background noise signals can affect listening performances. The primary objective of this study is to reduce the gap between clinical results and real-life performances that are reported for many hearing implant users.
Methods: Similar to Part I of this study, hearing performance and sound perception are evaluated using the following tests: (i) the Roving Level Test, (ii) the Just Understanding Speech Test, (iii) the Performance Perceptual Test, (iv) the Visual Analogue Scale to evaluate the perceived listening effort required for a range of background noise levels, and (v) the Hearing Implant Sound Quality questionnaire. All subjects recruited for this study used MED-EL hearing implant systems.
Results: Results show that, similar to normal hearing listeners, hearing implant users tend to accurately estimate their hearing abilities, and both listening effort and speech recognition thresholds tend to increase with increasing noise.
Discussion: The proposed test battery for evaluating speech understanding and listening effort were suitable for use in this study as all of the implant users were able to complete the tests. This test battery can be used to provide audiologists with further information relating to real-life listening performances.
Conclusion: Evaluating the self-estimated and verified performance measurements of hearing implant users in real-life listening situations are essential for providing information regarding the discrepancies observed between the objective and subjective reports of hearing difficulties.
Acknowledgements
The authors would like to thank Edda Amann (MED-EL) for her statistical analysis and Laura Kerr (MED-EL) for her medical writing services on a version of this manuscript.
Disclaimer statement
Contributors None.
Funding None.
Conflicts of interest This study was designed by MED-EL GmbH.
Ethics approval None.
Notes on contributors
Dipl. Ing. Timo Bräcker M.Sc. is a Research Engineer at MED-EL's Research Center in Hannover, Germany. After gaining an education at the logopedic school in Oldenburg, Germany and working for half a year at a nursery school for speech impaired children, he studied Hearing Technology and Audiology at the University of Applied Sciences in Oldenburg, and later obtained a Master of Science. Timo joined MED-EL's Headquarters in Innsbruck, Austria as a Research Engineer in 2008 and transferred to MED-EL Germany in 2014. Currently, his research at the MED-EL Research Center in Hannover primarily concentrates on the planning and realization of audiological studies in cooperation with the Medical University of Hannover (MHH), Germany.
Stefan Hellmiss was trained as a radio and television technician in 2001 and started working for PMS-Electronics GmbH in Germany. In 2005, he retrained as a hearing aid acoustician and joined KIND, a hearing aid company in Großburgwedel, Germany. He received his Bachelor's degree in acoustics in 2010 and began working as a clinical engineer at MED-EL Germany. He has been a clinical manager at MED-EL Germany since 2013.
Cornelia Batsoulis holds a Ph.D. Degree in Electrical Engineering. She has worked in the field of hearing research for over 10 years. She started as a research associate for audiological studies at the Medical School Hannover (MHH), Germany. In 2012, Cornelia joined the MED-EL Research Team in Hannover, Germany. She is currently the Head of Research at MED-EL Germany in Hannover. Her team is responsible for research projects and studies, which are conducted in cooperation with MHH.
Tina Petzold trained as a medicaltechnical assistant (MTA) for functional diagnostics between 2006 and 2009 at the Acedemy of Education in Dresden, Germany. Between 2009 and 2011 she worked at the ENT Clinic Friedrichstadt in Dresden with Dr. Deutscher. From 2011 to 2016 and again since 2017 Tina has worked in the ENT clinic at the Medical University of Hannover (MHH), Germany with Prof. Dr. Lenarz. In between, she worked at the International Neuroscience Institute (INI) in Hannover, Germany.
Luisa Gabel Strenger has been employed in the Department of Otolaryngology at the Goethe University Hospital in Frankfurt, Germany. She works as a medical technical assistant for functional diagnostics since 2011. She supervises studies related to all regulatory guidelines of the medical devices act. Additionally, she is responsible for functional diagnostics. Since 2014, she has been training as a clinical study assistant in the test centre.
Alexander Möltner holds a Dipl.-Ing. (FH) degree in Electrical Engineering from the University of Applied Sciences Würzburg/Schweinfurt, Germany. He has been working in the field of cochlear implants for over 19 years. In addition to doing research for studies at MED-EL Germany, his responsibilities include developing and fitting cochlear implants.
Prof. Dr. med. Timo Stöver studied medicine at the Hannover Medical School, Germany. He has been the Head of the Department of Oto-Rhino-Laryngology, Head and Neck Surgery at University Hospital Frankfurt in Germany since 2010. His treatment focuses on hearing disorders with surgical and non-surgical approaches, with the use of implantable hearing devices on the surgical side. His main research interests include the effect of neurotrophic factors on inner ear function and regeneration, tissue/material surface interaction, development of local drug delivery devices for the inner ear, and gene expression of the inner ear.
Prof. Dr. Robert Mlynski is Head of the Department of Oto-Rhino-Laryngology (ORL), Head and Neck Surgery ‘Otto Koerner’ at the University Medical Center Rostock, Germany. The ‘Otto Koerner’ clinic is the oldest University Department of ORL in Northern and Central Europe and was established in 1899. His clinical focus is on middle ear and skull base diseases with particular interest in cholesteatoma, middle ear and skull base surgery, including cochlear implantation and active middle ear implants. Prof. Dr. Mlynski graduated at the Universities of Rostock and Würzburg (Germany) and Aberdeen (Scotland). He completed his residency and fellow training in otology and head and neck surgery at the University ENT Clinic in Würzburg under Prof. Dr. Jan Helms and Prof. Dr. Rudolf Hagen. His scientific focus lies on active and passive implantable hearing systems as well as inner ear and stem cell biology of the auditory pathway. He is an invited guest surgeon and teacher at several international otosurgical courses and is a member of the international network of comprehensive hearing implant centers (HEARRING). He is also the Vice Dean of the Medical Faculty of Rostock University, Germany.
Prof. Dr. Thomas Lenarz studied medicine and biochemistry at the universities of Tübingen, Erlangen, Heidelberg, and London between 1975 and 1981 and received his doctoral degree in medicine. He received a Ph.D. in pharmacology of the auditory system in 1987. He worked as a postdoctoral research fellow at the University of California in San Francisco in 1989. He became the Chairman and a Professor at the Department of Otolaryngology, Hannover Medical School, Germany in 1993. He is the coordinator of the Collaborative Research Program (SFB 599) ‘Sustainable Bioresorbable and Permanent Implants of Metallic and Ceramic Materials’ and co-director of the Cluster of Excellence Hearing4All Hannover-Oldenburg. He is also the Director of the German Hearing Centre and the Research Institute of Audio- and Neurotechnology in Hannover, Germany. Prof. Lenarz is a member of the German National Academy of Sciences (Leopoldina) and the German Academy Technology (acatech). He is the current President of the German Society of Biomedical Technology. His research interests include auditory implants, biomaterials for medical implants, audiology, and neurotology.
Prof. Dr. Andreas Büchner received his Master's degree in informatics at the University of Hildesheim, Germany in 1995. After developing signal processing and pattern recognition algorithms for medical imaging systems at the University of Hildesheim, he became a Research Scientist in the field of audiology at the Department of Otolaryngology at the Medical University of Hannover (MHH), Germany. He received a Ph.D. in human biology at MHH in 2002. Since 2003, he has been the Scientific Director of the Hannover Hearing Center, a subsidiary of the Department of Otolaryngology, MHH. In 2011, he became an Assistant Professor of Audiology at MHH. In 2012, he received the W2-position (full professorship) for Auditory Implants. He has recently led several clinical studies in the field of cochlear implants. He is the Head of several working groups in the field of objective audiometry, clinical study design, and signal processing for cochlear implants and hearing instruments at MHH and has been a member of the Executive Committee of the Cluster of Excellence ‘Hearing4all’ funded by the German Research Foundation since 2012. He has authored and co-authored over 150 research articles, book chapters, and conference communications. His main research areas of interest include cochlear implants and hearing aids, the development of signal processing strategies and the introduction of these strategies into the clinic, clinical research on patient outcomes, the combination of acoustic and electric hearing (Electro-Acoustic Stimulation), and the evaluation and interpretation of electrically evoked action potentials of the hearing nerve.