Objective: This study compared speech perception benefits in adults implanted with the HiResolutionTM (HiRes) Bionic Ear who used both conventional and HiRes sound processing. A battery of speech tests was used to determine which formats were most appropriate for documenting the wide range of benefit experienced by cochlear-implant users. Study Design: A repeated-measures design was used to assess postimplantation speech perception in adults who received the HiResolution Bionic Ear in a recent clinical trial. Patients were fit first with conventional strategies and assessed after 3 months of use. Patients were then switched to HiRes sound processing and assessed again after 3 months of use. To assess the immediate effect of HiRes sound processing on speech perception performance, consonant recognition testing was performed in a subset of patients after 3 days of HiRes use and compared with their 3-month performance with conventional processing. Setting: Subjects were implanted and evaluated at 19 cochlear implant programs in the USA and Canada affiliated primarily with tertiary medical centers. Patients: Patients were 51 postlinguistically deafened adults. Main Outcome Measures: Speech perception was assessed using CNC monosyllabic words, CID sentences and HINT sentences in quiet and noise. Consonant recognition testing was also administered to a subset of patients (n = 30) using the Iowa Consonant Test presented in quiet and noise. All patients completed a strategy preference questionnaire after 6 months of device use. Results: Consonant identification in quiet and noise improved significantly after only 3 days of HiRes use. The mean improvement from conventional to HiRes processing was significant on all speech perception tests. The largest differences occurred for the HINT sentences in noise. Ninety-six percent of the patients preferred HiRes to conventional sound processing. Ceiling effects occurred for both sentence tests in quiet. Conclusions: Although most patients improved after switching to HiRes sound processing, the greatest differences were seen in the ‘poor’ performers because ‘good’ performers often reached ceiling performance, especially on tests in quiet. Future evaluations of cochlear-implant benefit should make use of more difficult measures, especially for ‘good’ users. Nonetheless, a range of difficulty must remain in test materials to document benefit in the entire population of implant recipients.

1.
Dorman M: Speech perception by adults; in Waltzman SB, Cohen NL (eds): Cochlear Implants. New York, Thieme, 2000, pp 317–329.
2.
Nilsson M, McCaw V, Soli S: Minimum Speech Test Battery for Adult Cochlear Implant Patients: User Manual. Los Angeles, House Ear Institute, 1996.
3.
Kessler DK: The Clarion Multi-Strategy cochlear implant. Ann Otol Rhinol Laryngol 1999;108(suppl 177):8–16.
4.
Tyler R, Preece J, Lowder M: Iowa Cochlear Implant Tests. Iowa City, Department of Otolaryngology, Head and Neck Surgery, 1983.
5.
Peterson GE, Lehiste I: Revised CNC lists for auditory tests. J Speech Hear Dis 1962;27:62–70.
6.
Davis H, Silverman SR: Hearing and Deafness, ed 4. New York, Holt, Rinehart & Winston, 1978.
7.
Miller GA, Nicely PE: An analysis of perceptual confusions among some English consonants. J Acoust Soc Am 1955;27:338–352.
8.
Thornton A, Raffin M: Speech-discrimination scores modeled as a binomial variable. J Speech Hear Res 1978;21:507–518.
9.
Skinner MW, Holden LK, Whitford LA, et al: Speech recognition with the Nucleus 24 SPEAK, ACE and CIS speech coding strategies in newly implanted adults. Ear Hear 2002;23:207–223.
10.
Gstoettner WK, Hamzavi J, Baumgartner WD: Speech discrimination scores of postlingually deaf adults implanted with the Combi 40 cochlear implant. Adv Otorhinolaryngol 2000;57:323–326.
11.
Zwolan T, Kileny P, Smith S, Mills D, Koch D, Osberger MJ: Adult cochlear implant patient performance with evolving electrode technology. Otol Neurotol 2001;22:844–849.
12.
Loizou PC, Poroy O, Dorman M: The effect of parametric variations of cochlear implant processors on speech understanding. J Acoust Soc Am 2000;108:790–802.
13.
Dorman MF, Loizou PC, Fitzke J, Tu Z: The recognition of sentences in noise by normal-hearing listeners using simulation of cochlear-implant signal processors with 6–20 channels. J Acoust Soc Am 1998;104:3583–3585.
14.
Friesen LM, Shannon RV, Baskent D, Wang X: Speech recognition in noise as a function of number of spectral channels: Comparison of acoustic hearing and cochlear implants. J Acoust Soc Am 2001;110:1150–1163.
15.
Dorman MF, Spahr TC: New tests of adult patient performance and results for patients fit with different implants. 9th Symposium on Cochlear Implants in Children, Washington, DC, April 2003.
16.
Skinner MW, Holden LK, Demorest ME, Fourakis MS: Speech recognition at simulated soft, conversational, and raised-to-loud vocal efforts by adults with cochlear implants. J Acoust Soc Am 1997;101:3766–3782.
17.
Donaldson GS, Allen S: Effects of presentation level on phoneme and sentence recognition in quiet by cochlear implant listeners. Ear Hear 2003;24:392–405.
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