Research Article

Aural/oral performance in children with bimodal stimulation or unilateral cochlear implant


Background and Aim: Sound processors in cochlear implant (CI) cannot encode low frequency information and discard much of the temporal fine structure required to perceive fundamental frequency. Hearing aids can transmit low frequency information, which is important for pitch perception and provides many advantages for the users. This study aimed to compare aural/oral performance of bimodal cochlear implants with unilateral ones in children using parents' evaluation of aural/oral performance of children (PEACH) questionnaire.
Methods: Twenty children with unilateral cochlear implant and 20 ones with bimodal cochlear implants were selected for this study. Of them, 23 had cochlear devices, 10 possessed Med-El ones, and 7 wore advanced bionics ones. Bimodal group had at least 7 months of hearing experience with digital hearing aid in non-implanted ear. In order to compare the aural/oral performance in these groups, we used the PEACH questionnaire.
Results: In unilateral and bimodal groups, age of implantation and age of testing and hearing experience before CI use were not significantly different. However, there was a significant difference in quiet score, noise score, and total score between unilateral and bimodal groups (p<0.05).
Conclusion: In bimodal group, aural/oral performance was significantly improved in quiet and noise situations in comparison with unilateral group. This improvement is due to the advantage of binaural processing and low frequency information provided by the hearing aid.

1. Sheffield BM, Zeng FG. The relative phonetic con¬tributions of a cochlear implant and residual acoustic hearing to bimodal speech perception. J Acoust Soc Am. 2012;131(1):518-30.doi: 10.1121/1.3662074.
2. Moore BC. Coding of sounds in the auditory system and its relevance to signal processing and coding in cochlear implants. Otol Neurotol. 2003;24(2):243-54. doi: 10.1097/00129492-200303000-00019.
3. Looi V, Radford CJ. A comparison of the speech recognition and pitch ranking abilities of children using a unilateral cochlear implant, bimodal stimulation or bilateral hearing aids. Int J Pediatr Otorhinolaryngol. 2011;75(4):472-82. doi: 10.1016/j.ijporl.2010.12.023.
4. Ching TY, Psarros C, Hill M, Dillon H, Incerti P. Should children who use cochlear implants wear hearing aids in the opposite ear? Ear Hear. 2001;22(5):365-80. doi: 10.1097/00003446-200110000-00002.
5. Chang JE, Bai JY, Zeng FG. Unintelligible low-frequency sound enhances simulated cochlear-implant speech recognition in noise. IEEE Trans Biomed Eng. 2006;53(12 Pt 2):2598-601. doi: 10.1109/tbme.2006.883793.
6. Li N, Loizou PC. A glimpsing account for the benefit of simulated combined acoustic and electric hearing. J Acoust Soc Am. 2008;123(4):2287-94. doi: 10.1121/1.2839013.
7. Ching TY, Incerti P, Hill M, van Wanrooy E. An overview of binaural advantages for children and adults who use binaural/bimodal hearing devices. Audiol Neurootol. 2006;11 Suppl 1:6-11. doi: 10.1159/000095607.
8. Morera C, Manrique M, Ramos A, Garcia-Ibanez L, Cavalle L, Huarte A, et al. Advantages of binaural hea¬ring provided through bimodal stimulation via a cochlear implant and a conventional hearing aid: a 6-month comparative study. Acta Otolaryngol. 2005;125(6):596-606. doi: 10.1080/00016480510027493.
9. Sucher CM, McDermott HJ. Bimodal stimulation: benefits for music perception and sound quality. Cochlear Implants Int. 2009;10 Suppl 1:96-9. doi: 10.1002/cii.398.
10. Potts LG, Skinner MW, Litovsky RA, Strube MJ, Kuk F. Recognition and localization of speech by adult coch¬lear implant recipients wearing a digital hearing aid in the nonimplanted ear (bimodal hearing). J Am Acad Audiol. 2009;20(6):353-73. doi: 10.3766/jaaa.20.6.4.
11. Ching TY, Hill M. The parents' evaluation of aural/oral performance of children (PEACH) scale: normative data. J Am Acad Audiol. 2007;18(3):220-35. doi: 10.3766/jaaa.18.3.4.
12. Naghibirad F, Fatahi J, Hajiabolhassan F, Faghihzadeh E, Emamdjomeh H. Cultural adaptation and determination of validity and reliability of the Persian version of the parents’ evaluation of aural/oral performance of children. Aud Ves Res. 2016;25(2):111-18.
13. Brännström KJ, Ludvigsson J, Morris D, Ibertsson T. Clinical note: clinical note: validation of the Swedish version of the parents’ evaluation of aural/oral performance of Children (PEACH) rating scale for normal hearing infants and children. Hearing Balance Commun. 2014;12(2):88-93. doi: 10.3109/21695717.2014.903030.
14. Cullington HE, Zeng FG. Comparison of bimodal and bilateral cochlear implant users on speech recognition with competing talker, music perception, affective pro¬sody discrimination, and talker identification. Ear Hear. 2011;32(1):16-30. doi: 10.1097/aud.0b013e3181edfbd2.
15. Firszt JB, Reeder RM, Skinner MW. Restoring hearing symmetry with two cochlear implants or one cochlear implant and a contralateral hearing aid. J Rehabil Res Dev. 2008;45(5):749-67. doi: 10.1682/jrrd.2007.08.0120.
16. Spitzer S, Liss J, Spahr T, Dorman M, Lansford K. The use of fundamental frequency for lexical segmentation in listeners with cochlear implants. J Acoust Soc Am. 2009;125(6):EL236-41. doi: 10.1121/1.3129304.
17. Assmann PF, Summerfield Q. Modeling the perception of concurrent vowels: vowels with different fundamental frequencies. J Acoust Soc Am. 1990;88(2):680-97. doi: 10.1121/1.399772.
18. Kong Y-Y, Carlyon RP. Improved speech recognition in noise in simulated binaurally combined acoustic and electric stimulation. J Acoust Soc Am. 2007;121(6):3717-27. doi: 10.1121/1.2717408.
19. Brown CA, Bacon SP. Low-frequency speech cues and simulated electric-acoustic hearing. J Acoust Soc Am. 2009;125(3):1658-65. doi: 10.1121/1.3068441.
20. Dorman MF, Loizou P, Wang S, Zhang T, Spahr A, Loiselle L, et al. Bimodal cochlear implants: the role of acoustic signal level in determining speech perception benefit. Audiol Neurootol. 2014;19(4):234-8. doi: 10.1159/000360070.
21. Ching TY, Day J, Van Buynder P, Hou S, Zhang V, Seeto M, et al. Language and speech perception of young children with bimodal fitting or bilateral cochlear implants. Cochlear Implants Int. 2014;15 Suppl 1:S43-6. doi: 10.1179/1467010014z.000000000168.
22. Rader T, Fastl H, Baumann U. Speech perception with combined electric-acoustic stimulation and bilateral cochlear implants in a multisource noise field. Ear Hear. 2013;34(3):324-32. doi: 10.1097/aud.0b013e318272f189.
23. Farid MN, Arifianto D. Speech segregation based-on binaural cue: interaural time difference (itd) and interaural level difference (ild). J. Phys.: Conf. Ser. 2016;776(1);1-6.
24. Ching TY, van Wanrooy E, Hill M, Dillon H. [Binaural redundancy and inter-aural time difference cues for patients wearing a cochlear implant and a hearing aid in opposite ears]. Int J Audiol. 2005;44(9):513-21. Spanish. doi: 10.1080/14992020500190003.
25. Schleich P, Nopp P, D'Haese P. Head shadow, squelch, and summation effects in bilateral users of the MED-EL COMBI 40/40+ cochlear implant. Ear Hear. 2004;25(3):197-204. doi: 10.1097/01.aud.0000130792.43315.97.
IssueVol 26 No 3 (2017) QRcode
SectionResearch Article(s)
Bimodal stimulation unilateral cochlear implant aural/oral performance

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Garousi F, Zarrinkoob H, Moradi V, Emamdjomeh H, Akbarzadeh Baghban A. Aural/oral performance in children with bimodal stimulation or unilateral cochlear implant. Aud Vestib Res. 2017;26(3):138-144.