Effect of Speech Processor Program Modifications on Cochlear Implant Recipients’ Threshold and Maximum Acceptable Loudness Levels This study’s purpose was to determine whether or not modifications in speech processor electrical stimulation levels were associated with changes in five Nucleus 22 cochlear implant recipients’ thresholds or maximum acceptable loudness levels (MALs). These modifications in minimum and maximum stimulation levels were made to optimize hearing in everyday life. ... Research Article
Research Article  |   December 01, 1999
Effect of Speech Processor Program Modifications on Cochlear Implant Recipients’ Threshold and Maximum Acceptable Loudness Levels
 
Author Affiliations & Notes
  • John C. Sun
    Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8115, St. Louis, MO 63110
    MD
  • Margarate W. Skinner
    Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8115, St. Louis, MO 63110
  • S. Y. Liu
    Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
  • T. S. Huang
    Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
  • Corresponding author: e-mail: sunj@medicine.wustl.edu
Article Information
Hearing & Speech Perception / Acoustics / Hearing Aids, Cochlear Implants & Assistive Technology / Research Articles
Research Article   |   December 01, 1999
Effect of Speech Processor Program Modifications on Cochlear Implant Recipients’ Threshold and Maximum Acceptable Loudness Levels
American Journal of Audiology, December 1999, Vol. 8, 128-136. doi:10.1044/1059-0889(1999/015)
History: Received March 1, 1999 , Accepted June 9, 1999
 
American Journal of Audiology, December 1999, Vol. 8, 128-136. doi:10.1044/1059-0889(1999/015)
History: Received March 1, 1999; Accepted June 9, 1999

This study’s purpose was to determine whether or not modifications in speech processor electrical stimulation levels were associated with changes in five Nucleus 22 cochlear implant recipients’ thresholds or maximum acceptable loudness levels (MALs). These modifications in minimum and maximum stimulation levels were made to optimize hearing in everyday life. One threshold and one MAL were obtained on each active electrode during six, weekly test sessions, three before and three after program modification. Only one participant had a significant change in threshold after program modification; this participant and four others had significant changes in MAL. Participants’ threshold variability was the same, but MAL variability was higher than that observed in other studies. Because these participants had no experience making MAL judgments prior to this study, this result suggests that implant recipients should be given sufficient practice in making MAL judgments to provide a stable clinical estimate of the upper boundary of the electrical dynamic range.

Acknowledgments
The authors are grateful to the five participants who devoted so much of their time and effort to this study. We also are grateful to Laura and Timothy Holden as well as two anonymous reviewers for valuable suggestions on a previous draft of this paper and to Timothy Holden, who contributed to the analysis of data, and to Marilyn Demorest for advice on the statistical analysis. This research was supported by Grant R01-DC00581 from the National Institute on Deafness and Other Communication Disorders and from the American Bureau of Medical Advancement in China (ABMAC) Clerkship in Taiwan, Schmidt Scientific (Taiwan Ltd.). Portions of this paper were presented at the Chang Gung International Symposium on Cochlear Implant and Related Sciences, Taoyuan, Taiwan, November 23, 1996, and at the 21st Midwinter Research Meeting of the Association for Research in Otolaryngology, St. Petersburg Beach, Florida, February 15 through 19, 1998.
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