Koklear İmplant Kullanıcılarında Farklı Konuşma İşlemci Modellerinin Lokalizasyon ve Gürültüde Konuşmayı Anlama Becerileri Üzerine Etkisinin Değerlendirilmesi

Abstract

A cochlear implant (CI) is an electronic system used for individuals with severe/profound sensorineural hearing loss who can not benefit from hearing aids. CI consists of two parts, internal and external. The inner components include the inner receiver located under the skin and the intracochlear electrode bundle surrounding the cochlea, while the outer components include the speech processor, microphone, and transmitting coil part, which are located on the speech processor. Speech processors in terms of external components vary in many aspects, such as shape, size, and directionality, depending on different brands and models. Behind-the-ear (BTE) speech processors, which have been used as the only option in CI systems for many years, have added a different speech processor option suggested as wireless (off-the-ear; OTE) with the advancement in current technology. Although these processors have similar features in terms of usage purpose, considering the difference in the head placement of the outer part, it can be seen that the microphone positions are quite different. In the literature, using different variables in cochlear implant users who have difficulties in localizing the sound source, particularly in speech perception in noisy environments, compared to individuals with normal hearing, these skills have been evaluated. The present study aimed to investigate the effect of microphone position differences in BTE and OTE speech processors on localization and speech understanding in noise in CI users. Individuals with unilateral cochlear implants between the ages of 20 and 50 who had undergone cochlear implantation surgery in Hacettepe University Hospital, Department of Otorhinolaryngology, were involved in routine controls in the Audiology unit were included in the study voluntarily. Two research groups were created based on the participants' BTE and OTE model processors. Auditory Speech Sounds Evaluation (A§E) localization tests in the Audiqueen program were used to evaluate the localization skills of the participants with their speech processors that they are currently using, and the Turkish Hearing in Noise Test (T-HINT) was used to assess speech perception in noise skills. While there was no significant difference between the two groups in localization tests (p>0.05), a significant difference was observed between the groups in NFrontSFront (p=0.014) and NİLSFront (p=0.005) conditions in HINT results (p<0.05), it was found that BTE model speech processor users performed better. While there was no significant difference in the NKLSFront condition, it was found that BTE model users performed much better (p=0.09). Variables such as pre-op hearing loss and duration of hearing aid use, duration of CI use, and age at CI were evaluated. According to the results obtained, it was concluded that the difference in microphone position did not affect the localization test results, but the BTE users performed better according to the HINT results.