Bilateral/Bimodal Hearing

T/F ci recipients experience a significant improvement in speech perception abilities over those achieved with conventional amp

True

T/F our convention assessment tools do always provide enough info about the potentional benefit of pairing a ha with a CI

false, do not always

T/F there is a wide range of performance across users

true

T/F ear selection would not have signficantly affected the outcome (in unilateral CI implantation)

true

bilateral advantage is about ___ percentage points on average on measures of speech perception

10

what improvements can be seen with bilateral CI users compared to unilateral

localization/lateralization

bilateral CI pts may experience improved speech perception and localization from access to

squelch

binaural summation

head shadow effect

cocktail party effect

Squelch

the ability to attend to the ear with a more favorable SNR via central processing of interaural time and intensity cues

binaural summation

the improvement in acuity when listening to the same signal in each ear versus in a monaural listening condition

head shadow effect

when speech is presented to one ear and noise to the other, the skull creates a sound barrier to attenuate the noise known as the head shadow effect

Cocktail Party

the ability to recognize a signal of interest in the presence of ongoing competing noise

which ear advantage has been reported in the auditory processsing literature

right

for children, allowing development of right ear advantage may allow for development for

superior language

learning

communication skills

level differences are largest for ___ frequencies

high

time differences are largest for ____ frequencies

low

head shadow effect is more seen with ____ frequencies

high

Why do CI users not have the ability to perceive timing differences (ITDs)

largely use envelop extraction, a lot of tfs is not perserved

CI users do not localize well due to the lack of sensitivity of timing differences above

300 pps

CI users do not localize well due to the lack of ______ in pulse presentations at like positions across the two sides

synchronization

CI listeners do not localize well due to lack of matches places of stimulation across the ___ sides

2

improvement provided by binaural CI is most likely due to

ILDs

____months of bilateral CI use is needed to develop spatial hearing ablities

3-12

T/F persons with bilateral CIs are often able to localize soun more effectively than bimodal users

True

Standard commericial insurance ____ approve CIs

may

Will medicare cover CIs?

genrally not covered

will medicaid cover CIs?

children, often yes

adults, if in a study or impaired vision

T/F there is not a similar complication rates between simultaneous vs sequential CI

false, there is similiar

T/F Simultaneous CI exposes the recepient to two cycyles of anesthersia and intubation cycles

False, sequential

According to William house bilateral CI =

standard of care

William House believes 2 CIs are better than 1 because

speech recognition in quiet and in noise

localization

safety

T/F bimodal stimulation may offer CI pts an improvement even when the residual hearing in the contralateral ear is limited

True

T/F the addition of even a minimum amount of high frequency acoustic information has been shown to provide an improvement in speech perception abilities for listeners of bimodal stimulation

false, low frequency

Some ways to evaluate bimodal benefit

verify fit w/ behavioral measures

aided SF thresholds using warble tones

aided Ling 6 detection/descrimination thresholds

aided speech percep testing in quiet

aided speech percep in noise

subjective report

what is generalyl recommended for all unilateral CI users

bimodal fitting

what are some additional benefits to bimodal

sound quality

sound awareness without device

What may bimodal hearing do that bilteral CIs may not

may provide TFS and access to pitch and muisc melody which is more difficult with electrical sitmulation

Deciding between bimodal/bilateral CI in adults

evaluation the overall needs to the unilateral pt to determine whether the pt is more likely to benefit from bimodal or biltaeral CI

test in noise

T/F bilateral CI provides better speech recognition in noise and localization for children with bilateral prgound HL

true