Comparison of Unilateral CI vs. Bimodal Stimulation in Prosodic Perception

Study Overview
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Brief Summary
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An observational study to determine and assess perception of prosodic information in adults who use bimodal stimulation (cochlear implant plus hearing aid) when using both devices vs. cochlear implant alone.

Detailed Description
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People with severe to profound hearing loss often do not get satisfactory benefit from their hearing aids. A cochlear implant (CI) is a prosthetic device for the inner ear which can directly stimulate the auditory nerve, bypassing damaged inner ear hair cells and thus provide audible sensations to profoundly deaf patients. Currently, one CI is funded by NHS England for adult patients and the eligibility criteria for implantation has been relaxed in recent years. As a result, there are now an increasing number of unilateral CI users who possess low-frequency residual hearing in their non-implanted ear. For many patients this residual hearing may still be usefully amplified by a HA. This configuration, consisting of a CI and a contralateral HA, is known as bimodal stimulation. The PEPS-C receptive test battery has been previously used to assess prosody perception in hearing loss. The current project will use selected tests from the PEPS-C prosodic test battery to assess intonation, emotion and phrase stress perception ability in adults with bimodal stimulation using both devices together and CI alone.

Official Title
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Comparison of Unilateral CI vs. Bimodal Stimulation in Prosodic Perception

Conditions
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Cochlear Hearing Loss

Intervention / Treatment
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* Device: Hearing Aid


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult Has unilateral Cochlear Implant Consistent use of Hearing Aid Obtains some benefit in speech discrimination from hearing aid (> 20% AB words) Post-lingually deafened Fluent English Exclusion Criteria: Longstanding significant asymmetry (> 20 dB HL 4 frequency average) in hearing where the unimplanted ear is the worse ear Inconsistent Hearing Aid use Significant conductive hearing loss (> 20 dB HL 4 frequency average) Using Electro-Acoustic stimulation Cochlear Implant Aetiology of hearing loss likely associated with auditory neuropathy Significantly abnormal appearance of cochlea or cochlear nerve

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Hearing Aid|Contralateral Hearing Aid to Cochlear Implant|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PEPS-C speech test battery | Test battery of 7 speech tests examining prosodic elements of speech, each section scored out of 16 (112 in total higher scores better outcome) | Tested at one time point at day 1 of study after recruitment in both Cochlear Implant Alone and Cochlear Implant and Hearing Aid Together conditions | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| AB words speech test | Word speech discrimination test in quiet, 30 words presented, scored as % correct, higher score better outcome | Tested at one time point at day 1 of study after recruitment in both Cochlear Implant Alone and Cochlear Implant and Hearing Aid Together conditions | 
| SSQ12 Questionnaire | Speech Spatial Qualities patient reported outcome measure, scored out of 120 higher scores better outcome | Tested at one time point at day 1 of study after recruitment in both Cochlear Implant Alone and Cochlear Implant and Hearing Aid Together conditions | 
| Unaided Soundfield Audiometry | Soundfield hearing test without Cochlear Implant or Hearing Aid | Tested at one time point at day 1 of study after recruitment | 
| BKB sentences speech test | Sentences speech discrimination test in quiet, 100 words presented, 50 male, 50 female voice, scored as % | Tested at one time point at day 1 of study after recruitment in both Cochlear Implant Alone and Cochlear Implant and Hearing Aid Together conditions |