الفهرس 
Title: Input Dynamic Range Changes versus Cochlear Implant Performance
AbstractOnly 14 pages are availabe for public view
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Abstract
Introduction: As the cochlear implant (CI) population grows, guidelines to optimize patient benefit from a CI are valuable to audiologists as well as to CI users.If optimizing patient performance in daily life is the goal, then clinical fitting should improve the ability of CI users to understand soft speech as well as speech in noise. It is important to change the input dynamic range (IDR) characteristics in order to optimize the CI performance in everyday life. Aim of the work: To evaluate the effect of different IDR characteristics on CI performance. Subjects and Methods:Fourteen postlingual CI adults who were implanted and used their device for at least 6 months were studied. Programs were adjusted for four input sensitivity settings differing in T&C levels, microphone sensitivity (MS) and volume sensitivity. Subjects were tested using each sensitivity program with Arabic monosyllabic word lists presented at 50 dB SPL (30 dB HL) and 70 dB SPL (50 dB HL) both in quiet and in noise (SNR 0,+10, {u0336} 10) with and without visual cues (VC). In addition, aided hearing threshold level was tested. They were asked to complete COSI questionnaire 2 weeks after each setting. Results:The highest word recognition score (WRS) at 50 dB SPL without VC in quiet was obtained when T level was set behaviorally followed by maximum MS. The highest score at 70 dB SPL in quiet was obtained with maximum MS. Patients preferred programs with maximum MS and C level below MCL. There was a negative correlation between duration of hearing loss and WRS. Our study revealed a positive correlation between final ability-COSI and WRS in subjects who suffered in quiet. However, it revealed a negative correlation in those suffering in noise. Conclusions:Behavioral measuring of T levels results in maximized perception of soft sounds. High MS setting makes low-level sounds more audible. Duration of hearing loss has great impact on cochlear performance. COSI-questionnaire is reliable in patients suffering of speech difficulties of speech discrimination during conversation in quiet rather than in noise. Recommendations: Based on the results of the study, it is better to determine CI program on an individual basis