title: Optimizing the benefit of sound processors coupled to personal FM systems.
abstract: BACKGROUND
  Use of personal frequency modulated (FM) systems significantly improves speech recognition in noise for users of cochlear implants (CI). There are, however, a number of adjustable parameters of the cochlear implant and FM receiver that may affect performance and benefit, and there is limited evidence to guide audiologists in optimizing these parameters.
  
  
  OBJECTIVE
  This study examined the effect of two sound processor audio-mixing ratios (30/70 and 50/50) on speech recognition and functional benefit for adults with CIs using the Advanced Bionics Auria sound processors.
  
  
  METHODS
  Fully-repeated repeated measures experimental design. Each subject participated in every speech-recognition condition in the study, and qualitative data was collected with subject questionnaires.
  
  
  METHODS
  Twelve adults using Advanced Bionics Auria sound processors. Participants had greater than 20% correct speech recognition on consonant-nucleus-consonant (CNC) monosyllabic words in quiet and had used their CIs for at least six months.
  
  
  METHODS
  Performance was assessed at two audio-mixing ratios (30/70 and 50/50). For the 50/50 mixing ratio, equal emphasis is placed on the signals from the sound processor and the FM system. For the 30/70 mixing ratio, the signal from the microphone of the sound processor is attenuated by 10 dB.
  
  
  METHODS
  Speech recognition was assessed at two audio-mixing ratios (30/70 and 50/50) in quiet (35 and 50 dB HL) and in noise (+5 signal-to-noise ratio) with and without the personal FM system. After two weeks of using each audio-mixing ratio, the participants completed subjective questionnaires.
  
  
  RESULTS
  Study results suggested that use of a personal FM system resulted in significant improvements in speech recognition in quiet at low-presentation levels, speech recognition in noise, and perceived benefit in noise. Use of the 30/70 mixing ratio resulted in significantly poorer speech recognition for low-level speech that was not directed to the FM transmitter. There was no significant difference in speech recognition in noise or functional benefit between the two audio-mixing ratios.
  
  
  CONCLUSIONS
  Use of a 50/50 audio-mixing ratio is recommended for optimal performance with an FM system in quiet and noisy listening situations.
authors.affiliation: Hearts for Hearing Foundation, USA. jace.wolfe@heartsforhearing.org
authors.forename: Jace
authors.initials: J
authors.lastname: Wolfe
authors.forename: Erin C
authors.initials: EC
authors.lastname: Schafer