Comparison of continuous interleaved sampling and simultaneous analog stimulation speech processing strategies in newly implanted adults with a clarion 1.2 cochlear implant

Terry A. Zwolan, Paul R. Kileny, Sharon Smith, Susan Waltzman, Pat Chute, Elizabeth Domico, Jill Firszt, Annelle Hodges, Dawna Mills, Maggie Whearty, Mary Joe Osberger, Laurel Fisher

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: This study consisted of a within-subjects comparison of speech recognition and patient preference when subjects used two different cochlear implant speech processing strategies with a Clarion 1.2 (enhanced bipolar) device: Simultaneous Analog Stimulation (SAS), and Continuous Interleaved Sampling (CIS). These two strategies used two different electrode configurations: the SAS strategy used bipolar stimulation, whereas the CIS strategy used monopolar stimulation. Study Design: This was a multicenter study that used a within-subjects balanced crossover design. Experience with the two strategies was replicated in each subject using an ABAB design. Order of strategy use was balanced across all subjects. Setting: The study was carried out at several cochlear implant centers affiliated with tertiary medical centers. Patients: Subjects consisted of 25 postlingually deafened adults who received a Clarion cochlear implant. Interventions: Total involvement by each subject was 14 weeks. Speech perception testing and sound quality assessments were performed after use with each strategy. Main Outcome Measures: Primary outcome measures include speech perception data and patient responses to questionnaires regarding speech and sound quality. Results: Analyses revealed that performance did not differ significantly by the strategy encountered first as relative to the strategy encountered second and that the order in which a strategy was used did not appear to affect subjects' eventual preference for a particular strategy. Although speech recognition scores tended to be higher for CIS for most of the test measures at most of the test intervals, the analysis of variance to evaluate differences in strategy did not reveal a significant effect of strategy. Further analysis of scores obtained at the replication interval, however, revealed that scores obtained with CIS were significantly higher than scores obtained with SAS on the Hearing in Noise Test sentences in quiet and noise. In addition, significantly more patients indicated a final preference for the CIS strategy than for the SAS strategy. Importantly, both the analysis evaluating order and the analysis evaluating strategy revealed significant effects of evaluation period, indicating that time/experience with the implant had a significant effect on scores for each strategy, regardless of the order in which it was used (first or second). Conclusions: This study demonstrates that important learning occurs during the first several weeks of cochlear implant use, making it difficult to adequately compare performance with different speech processing strategies. However, the finding that patients often prefer the strategy they understand speech the best with supports the clinical practice of letting adult patients select their preferred strategy without formally evaluating speech perception with each available strategy.

Original languageEnglish
Pages (from-to)455-465
Number of pages11
JournalOtology and Neurotology
Volume26
Issue number3
DOIs
StatePublished - May 1 2005

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Cochlear Implants
Speech Perception
Phonetics
Noise
Outcome Assessment (Health Care)
Patient Preference
Cross-Over Studies
Hearing
Multicenter Studies
Analysis of Variance
Electrodes
Learning
Equipment and Supplies

Keywords

  • Clarion 1.2 enhanced bipolar device
  • Cochlear implants
  • Continous Interleaved Sampling (CIS)
  • Simultaneous Analog Stimulation (SAS)
  • Speech recognition

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Neuroscience(all)

Cite this

Comparison of continuous interleaved sampling and simultaneous analog stimulation speech processing strategies in newly implanted adults with a clarion 1.2 cochlear implant. / Zwolan, Terry A.; Kileny, Paul R.; Smith, Sharon; Waltzman, Susan; Chute, Pat; Domico, Elizabeth; Firszt, Jill; Hodges, Annelle; Mills, Dawna; Whearty, Maggie; Osberger, Mary Joe; Fisher, Laurel.

In: Otology and Neurotology, Vol. 26, No. 3, 01.05.2005, p. 455-465.

Research output: Contribution to journalArticle

Zwolan, TA, Kileny, PR, Smith, S, Waltzman, S, Chute, P, Domico, E, Firszt, J, Hodges, A, Mills, D, Whearty, M, Osberger, MJ & Fisher, L 2005, 'Comparison of continuous interleaved sampling and simultaneous analog stimulation speech processing strategies in newly implanted adults with a clarion 1.2 cochlear implant', Otology and Neurotology, vol. 26, no. 3, pp. 455-465. https://doi.org/10.1097/01.mao.0000169794.76072.16
Zwolan, Terry A. ; Kileny, Paul R. ; Smith, Sharon ; Waltzman, Susan ; Chute, Pat ; Domico, Elizabeth ; Firszt, Jill ; Hodges, Annelle ; Mills, Dawna ; Whearty, Maggie ; Osberger, Mary Joe ; Fisher, Laurel. / Comparison of continuous interleaved sampling and simultaneous analog stimulation speech processing strategies in newly implanted adults with a clarion 1.2 cochlear implant. In: Otology and Neurotology. 2005 ; Vol. 26, No. 3. pp. 455-465.
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AU - Waltzman, Susan

AU - Chute, Pat

AU - Domico, Elizabeth

AU - Firszt, Jill

AU - Hodges, Annelle

AU - Mills, Dawna

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AU - Osberger, Mary Joe

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