Interfacing FM Systems with Implantable Hearing Devices

ABSTRACT

Cochlear implant recipients can reduce the challenges they encounter in noisy environments through the use of a remote microphone. Although there are numerous options for delivering the signal from the frequency modulated (FM) transmitter worn by the speaker to the FM receiver coupled to the implant, several have now been verified through research as viable, beneficial arrangements. Recommendations for the settings on the implant include mixing ratio and settings on the FM receivers (i.e., FM advantage). Because coupling of the FM system with the implant cannot be tested with traditional electroacoustic methods, behavioral verification using speech recognition in noise with the implant alone and with the implant plus the FM system is necessary. A variety of resources are available for the audiologist to consult for the specific components, start sequence of switches, and verification protocols. Resources can be found through manufacturer and professional association Web sites.

KEYWORDS

Cochlear implants - FM systems - verification

REFERENCES

• 1 Thibodeau L M. Systems: terminology and standardization. In: Fabry DA, Johnson CD ACCESS: Achieving Clear Communication Employing Sound Solutions. Proceedings of the First International FM Conference. Warrenville, IL; Phonak AG 2004: 1-12
• 2 American Speech-Language-Hearing Association . Position Statement and Guidelines for Addressing Acoustics in Educational Settings.  ASHA Desk Reference  2005;  http://Available at: www.asha.org/pdf
• 3 Knecht H, Nelson P, Whitelaw G, Feth L. Background noise levels and reverberation times in unoccupied classrooms: predictions and measurements.  Am J Audiol. 2002;  11 65-71
• 4 Hamzavi J, Franz P, Baumgartner W, Gstoettner W. Hearing performance in noise of cochlear implant patients versus severely-profoundly hearing-impaired patients with hearing aids.  Audiology. 2001;  40 26-31
• 5 Fetterman B, Domico E. Speech recognition in background noise of cochlear implant patients.  Otolaryngol Head Neck Surg. 2002;  126 257-263
• 6 Lewis M S, Crandell C C, Valente M, Horn J E. Speech perception in noise: directional microphones versus frequency modulation (FM) systems.  J Am Acad Audiol. 2004;  6 426-439
• 7 Ludena L, Thibodeau L. Evaluation of the benefits of FM systems with cochlear implants. Presented at: Meeting of the American Speech-Language-Hearing Association Nov. 18–22, 1993 Anaheim, CA;
• 8 Davies M, Yellon L, Purdy S. Speech-in-noise perception of children using cochlear implants and FM systems.  Aust N Z J Audiol. 2001;  23 52-62
• 9 Hanin L, Adams S. Use of sound-field FM systems with multi-channel cochlear implants. Paper presented at: American Academy of Audiology Convention April 20–22, 1996 Salt Lake City, UT;
• 10 Crandell C, Holmes A, Flexer C, Payne M. Effects of soundfield FM amplification on the speech recognition of listeners with cochlear implants.  Journal of Educational Audiology. 1998;  6 21-27
• 11 Anderson K, Goldstein H, Colodzin L, Iglehart F. Benefit of S/N enhancing devices to speech perception of children listening in a typical classroom with hearing aids or a cochlear implant.  Journal of Educational Audiology. 2005;  12 14-28
• 12 Iglehart F. Speech perception by students with cochlear implants using sound-field systems in classrooms.  Am J Audiol. 2004;  13 62-72
• 13 Schafer E, Thibodeau L. Speech recognition abilities of adults using cochlear implants interfaced with FM systems.  J Am Acad Audiol. 2004;  15 678-691
• 14 Aaron R, Sonneveldt V, Arcaroli J, Holstad B. Optimizing microphone sensitivity settings of pediatric Nucleus 24 cochlear implant patients using Phonak MicroLink CI + FM system. Poster presented at: ACCESS: Achieving Clear Communication Employing Sound Solutions - Proceedings of the First International Conference Nov. 4–6, 2003 Chicago, IL;
• 15 Schafer E, Thibodeau L. Speech recognition performance of children using cochlear implants and FM systems.  Journal of Educational Audiology. 2003;  11 15-26
• 16 Schafer E, Thibodeau L. Speech recognition in noise in children with bilateral cochlear implants while listening in bilateral, bimodal input, and FM-system arrangements.  Am J Audiol. 2006;  15 114-126
• 17 Schafer E, Kleineck M. Improvements in speech-recognition performance using cochlear implants and three types of FM systems: A meta-analytic approach.  Journal of Educational Audiology. 2009;  , In press
• 18 Schafer E, Wolfe J. Effects of FM receiver gain on performance with cochlear implants. Paper presented at: First Virtual FM Conference: ACCESS 2-Achieving Clear Communication Employing Sound Solution Jan. 30–Feb. 6, 2008 Murten, Switzerland;
• 19 Schafer E, Wolfe J, Lawless T, Stout B. Effects of FM-receiver gain on speech-recognition performance of adults with cochlear implants.  Int J Audiol. 2009;  48 196-203
• 20 Wolfe J, Schafer E. Optimizing the benefits of sound processors coupled to personal FM systems.  J Am Acad Audiol. 2008;  19 585-594
• 21 Wolfe J, Schafer E, Heldner B, Mulder H, Ward E, Vincent B. Evaluation of speech recognition in noise with cochlear implants and Dynamic FM.  J Am Acad Audiol. 2009;  , In press
• 22 American Speech-Language-Hearing Association .ASHA cochlear implants IDEA issues brief. Available at: http://www.asha.org/NR/rdonlyres/71772E44-FCCE-4FCB-8A8C-0788D698B03C/0/CochlearImplantsBrief.pdf Accessed July 24, 2009
• 23 American Academy of Audiology .AAA clinical practice guidelines: remote microphone hearing assistance technologies for children and youth birth–21 years. Available at: http://www.audiology.org/resources/documentlibrary/Documents/HATGuidelinezasha%22.pdf Accessed July 24, 2009
• 24 Thibodeau L, Schafer E, Overson G, Whalen H, Sullivan J. Clinical evaluation of the benefits provided by FM systems directly connected to cochlear implants. Paper presented at: 10th Symposium on Cochlear Implants in Children March 15–19, 2005 Dallas, TX;
• 25 ASHA .American Speech Language Hearing Association Guidelines for fitting and monitoring of FM systems. ASHA Desk Reference 2002 http://Available at: www.asha.org/policy
• 26 Thornton A, Raffin M. Speech discrimination scores modified as a binomial variable.  J Speech Hear Res. 1978;  21 507-518