title: The benefits of remote microphone technology for adults with cochlear implants.
abstract: OBJECTIVE
  Cochlear implantation has become a standard practice for adults with severe to profound hearing loss who demonstrate limited benefit from hearing aids. Despite the substantial auditory benefits provided by cochlear implants, many adults experience difficulty understanding speech in noisy environments and in other challenging listening conditions such as television. Remote microphone technology may provide some benefit in these situations; however, little is known about whether these systems are effective in improving speech understanding in difficult acoustic environments for this population. This study was undertaken with adult cochlear implant recipients to assess the potential benefits of remote microphone technology. The objectives were to examine the measurable and perceived benefit of remote microphone devices during television viewing and to assess the benefits of a frequency-modulated system for speech understanding in noise.
  
  
  METHODS
  Fifteen adult unilateral cochlear implant users were fit with remote microphone devices in a clinical environment. The study used a combination of direct measurements and patient perceptions to assess speech understanding with and without remote microphone technology. The direct measures involved a within-subject repeated-measures design. Direct measures of patients' speech understanding during television viewing were collected using their cochlear implant alone and with their implant device coupled to an assistive listening device. Questionnaires were administered to document patients' perceptions of benefits during the television-listening tasks. Speech recognition tests of open-set sentences in noise with and without remote microphone technology were also administered.
  
  
  RESULTS
  Participants showed improved speech understanding for television listening when using remote microphone devices coupled to their cochlear implant compared with a cochlear implant alone. This benefit was documented both when listening to news and talk show recordings. Questionnaire results also showed statistically significant differences between listening with a cochlear implant alone and listening with a remote microphone device. Participants judged that remote microphone technology provided them with better comprehension, more confidence, and greater ease of listening. Use of a frequency-modulated system coupled to a cochlear implant also showed significant improvement over a cochlear implant alone for open-set sentence recognition in +10 and +5 dB signal to noise ratios.
  
  
  CONCLUSIONS
  Benefits were measured during remote microphone use in focused-listening situations in a clinical setting, for both television viewing and speech understanding in noise in the audiometric sound suite. The results suggest that adult cochlear implant users should be counseled regarding the potential for enhanced speech understanding in difficult listening environments through the use of remote microphone technology.
authors: Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. elizabeth.fitzpatrick@uottawa.ca
authors: Elizabeth M
authors: EM
authors: Fitzpatrick
authors: Christiane
authors: C
authors: Séguin
authors: David R
authors: DR
authors: Schramm
authors: Shelly
authors: S
authors: Armstrong
authors: Josée
authors: J
authors: Chénier
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D003054:Cochlear Implants; D003638:Deafness / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010470:Perceptual Masking; D011474:Prosthesis Design; D012931:Social Environment; D013067:Speech Perception; D013069:Speech Reception Threshold Test