Download PDF
Semin Hear 2018; 39(04): 405-413
DOI: 10.1055/s-0038-1670706
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bimodal Hearing in Individuals with Severe-to-Profound Hearing Loss: Benefits, Challenges, and Management

Sarah E. Warren
1   School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
2   Department of Audiology and Speech Pathology, Arkansas Children's Hospital, Little Rock, Arkansas
,
M. Noelle Dunbar
3   Department of Otolaryngology/Head and Neck Surgery, Columbia University Medical Center, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
26 October 2018 (online)

Also available at
    Permissions and Reprints

Abstract

Binaural hearing offers numerous advantages over monaural hearing. While bilateral implants are a successful treatment option for some patients, many individuals choose to achieve binaural hearing by using a cochlear implant with a contralateral hearing aid. Compared with monaural hearing, benefits of bimodal hearing include improved speech perception in quiet and in noise, improved localization, and more natural sound quality. Despite the advantages, there exist disadvantages to bimodal hearing, primarily related to binaural integration. Management of these devices can be challenging in that the hearing aid and cochlear implant may be managed by different clinicians. When fitting devices, strategies are recommended to optimize the integration of input from both devices. In managing bimodal devices, recommended outcomes measures include those that would reflect bimodal benefit, such as speech understanding in noise and spatial sound quality perception.

Keywords

cochlear implant - hearing aid - bimodal - binaural - asymmetric
 

  • References

  • 1 Ching TYC, Incerti P, Hill M. Binaural benefits for adults who use hearing aids and cochlear implants in opposite ears. Ear Hear 2004; 25 (01) 9-21
    CrossrefPubMedGoogle Scholar
  • 2 Kong YY, Stickney GS, Zeng FG. Speech and melody recognition in binaurally combined acoustic and electric hearing. J Acoust Soc Am 2005; 117 (3, Pt 1): 1351-1361
    CrossrefPubMedGoogle Scholar
  • 3 Choi JE, Moon IJ, Kim EY. , et al. Sound localization and speech perception in noise of pediatric cochlear implant recipients: Bimodal fitting versus bilateral cochlear implants. Ear Hear 2017; 38 (04) 426-440
    CrossrefPubMedGoogle Scholar
  • 4 Firszt JB, Holden LK, Reeder RM, Cowdrey L, King S. Cochlear implantation in adults with asymmetric hearing loss. Ear Hear 2012; 33 (04) 521-533
    CrossrefPubMedGoogle Scholar
  • 5 Ching TYC, van Wanrooy E, Dillon H. Binaural-bimodal fitting or bilateral implantation for managing severe to profound deafness: a review. Trends Amplif 2007; 11 (03) 161-192
    CrossrefPubMedGoogle Scholar
  • 6 Gfeller KE, Olszewski C, Turner C, Gantz B, Oleson J. Music perception with cochlear implants and residual hearing. Audiol Neurootol 2006; 11 (01) (Suppl. 01) 12-15
    CrossrefPubMedGoogle Scholar
  • 7 Vlastarakos PV, Nazos K, Tavoulari EF, Nikolopoulos TP. Cochlear implantation for single-sided deafness: the outcomes. An evidence-based approach. Eur Arch Otorhinolaryngol 2014; 271 (08) 2119-2126
    CrossrefPubMedGoogle Scholar
  • 8 Carlson ML, Sladen DP, Haynes DS. , et al. Evidence for the expansion of pediatric cochlear implant candidacy. Otol Neurotol 2015; 36 (01) 43-50
    PubMedGoogle Scholar
  • 9 Potts LG, Skinner MW, Litovsky RA, Strube MJ, Kuk F. Recognition and localization of speech by adult cochlear implant recipients wearing a digital hearing aid in the nonimplanted ear (bimodal hearing). J Am Acad Audiol 2009; 20 (06) 353-373
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Ching TY, Incerti P, Hill M, van Wanrooy E. An overview of binaural advantages for children and adults who use binaural/bimodal hearing devices. Audiol Neurootol 2006; 11 (01) (Suppl. 01) 6-11
    CrossrefPubMedGoogle Scholar
  • 11 Pyschny V, Landwehr M, Hahn M, Walger M, von Wedel H, Meister H. Bimodal hearing and speech perception with a competing talker. J Speech Lang Hear Res 2011; 54 (05) 1400-1415
    CrossrefPubMedGoogle Scholar
  • 12 Zhang T, Dorman MF, Spahr AJ. Information from the voice fundamental frequency (F0) region accounts for the majority of the benefit when acoustic stimulation is added to electric stimulation. Ear Hear 2010; 31 (01) 63-69
    CrossrefPubMedGoogle Scholar
  • 13 Mok M, Grayden D, Dowell RC, Lawrence D. Speech perception for adults who use hearing aids in conjunction with cochlear implants in opposite ears. J Speech Lang Hear Res 2006; 49 (02) 338-351
    CrossrefPubMedGoogle Scholar
  • 14 Dorman MF, Gifford RH, Spahr AJ, McKarns SA. The benefits of combining acoustic and electric stimulation for the recognition of speech, voice and melodies. Audiol Neurootol 2008; 13 (02) 105-112
    CrossrefPubMedGoogle Scholar
  • 15 Dorman MF, Cook S, Spahr A. , et al. Factors constraining the benefit to speech understanding of combining information from low-frequency hearing and a cochlear implant. Hear Res 2015; 322: 107-111
    CrossrefPubMedGoogle Scholar
  • 16 El Fata F, James CJ, Laborde ML, Fraysse B. How much residual hearing is ‘useful’ for music perception with cochlear implants?. Audiol Neurootol 2009; 14 (Suppl. 01) 14-21
    CrossrefPubMedGoogle Scholar
  • 17 Gfeller K, Turner C, Oleson J, Kliethermes S, Driscoll V. Accuracy of cochlear implant recipients in speech reception in the presence of background music. Ann Otol Rhinol Laryngol 2012; 121 (12) 782-791
    CrossrefPubMedGoogle Scholar
  • 18 Gfeller K, Turner C, Oleson J. , et al. Accuracy of cochlear implant recipients on pitch perception, melody recognition, and speech reception in noise. Ear Hear 2007; 28 (03) 412-423
    CrossrefPubMedGoogle Scholar
  • 19 Sucher CM, McDermott HJ. Bimodal stimulation: benefits for music perception and sound quality. Cochlear Implants Int 2009; 10 (01) (Suppl. 01) 96-99
    CrossrefPubMedGoogle Scholar
  • 20 Devocht EMJ, Janssen AML, Chalupper J, Stokroos RJ, George ELJ. The benefits of bimodal aiding on extended dimensions of speech perception: intelligibility, listening effort, and sound quality. Trends Hear 2017; 21: 1-20 . Doi: 10.1177/2331216517727900
    PubMedGoogle Scholar
  • 21 Scherf FWA, Arnold LP. ; Poster Presentation at the 12th International Conference on Cochlear Implants and Other Implantable Auditory Technologies, ESPO 2012, Amsterdam, the Netherlands, SFORL 2012, Paris, France. Exploring the clinical approach to the bimodal fitting of hearing aids and cochlear implants: results of an international survey. Acta Otolaryngol 2014; 134 (11) 1151-1157
    CrossrefPubMedGoogle Scholar
  • 22 Sheffield SW, Gifford RH. The benefits of bimodal hearing: effect of frequency region and acoustic bandwidth. Audiol Neurootol 2014; 19 (03) 151-163
    CrossrefPubMedGoogle Scholar
  • 23 Hurley RM. Onset of auditory deprivation. J Am Acad Audiol 1999; 10 (10) 529-534
    PubMedGoogle Scholar
  • 24 Gelfand SA, Silman S. Apparent auditory deprivation in children: implications of monaural versus binaural amplification. J Am Acad Audiol 1993; 4 (05) 313-318
    PubMedGoogle Scholar
  • 25 Crew JD, Galvin III JJ, Landsberger DM, Fu QJ. Contributions of electric and acoustic hearing to bimodal speech and music perception. PLoS One 2015; 10 (03) e0120279
    CrossrefPubMedGoogle Scholar
  • 26 Reiss LA, Ito RA, Eggleston JL, Wozny DR. Abnormal binaural spectral integration in cochlear implant users. J Assoc Res Otolaryngol 2014; 15 (02) 235-248
    CrossrefPubMedGoogle Scholar
  • 27 Blamey PJ, Dooley GJ, James CJ, Parisi ES. Monaural and binaural loudness measures in cochlear implant users with contralateral residual hearing. Ear Hear 2000; 21 (01) 6-17
    CrossrefPubMedGoogle Scholar
  • 28 Tan CT, Martin B, Svirsky MA. Pitch matching between electrical stimulation of a cochlear implant and acoustic stimuli presented to a contralateral ear with residual hearing. J Am Acad Audiol 2017; 28 (03) 187-199
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Schafer EC, Amlani AM, Paiva D, Nozari L, Verret S. A meta-analysis to compare speech recognition in noise with bilateral cochlear implants and bimodal stimulation. Int J Audiol 2011; 50 (12) 871-880
    CrossrefPubMedGoogle Scholar
  • 30 Gifford RH, Driscoll CL, Davis TJ, Fiebig P, Micco A, Dorman MF. A within-subjects comparison of bimodal hearing, bilateral cochlear implantation, and bilateral cochlear implantation with bilateral hearing preservation: high-performing patients. Otol Neurotol 2015; 36 (08) 1331-1337
    CrossrefPubMedGoogle Scholar
  • 31 Scollie S, Glista D. The Ling-6(HL): Instructions. Manual, The University of Western Ontario; 2012
    Google Scholar
  • 32 Uhler K, Warner-Czyz A, Gifford R, Working Group P. Pediatric minimum speech test battery. J Am Acad Audiol 2017; 28 (03) 232-247
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Nilsson M, Soli SD, Sullivan JA. Development of the Hearing in Noise Test for the measurement of speech reception thresholds in quiet and in noise. J Acoust Soc Am 1994; 95 (02) 1085-1099
    CrossrefPubMedGoogle Scholar
  • 34 Nilsson MJ, McCaw VM, Soli SD. Minimum Speech Test Battery for Adult Cochlear Implant Users: User Manual. Los Angeles, CA: House Ear Institute; 1996
    Google Scholar
  • 35 Weichbold V, Tsiakpini L, Coninx F, D'Haese P. Development of a parent questionnaire for assessment of auditory behaviour of infants up to two years of age [in German]. Laryngorhinootologie 2005; 84 (05) 328-334
    Article in Thieme ConnectPubMedGoogle Scholar
  • 36 Robbins AM, Renshaw JJ, Berry SW. Evaluating meaningful auditory integration in profoundly deaf children. Am J Otol 1991; 12: 14-50
    PubMedGoogle Scholar
  • 37 Zimmerman-Phillips S, Robbins AM, Osberger MJ. Assessing cochlear implant benefit in very young children. Ann Otol Rhinol Laryngol Suppl 2000; 185: 42-43
    PubMedGoogle Scholar
  • 38 Newman CW, Weinstein BE, Jacobson GP, Hug GA. The Hearing Handicap Inventory for Adults: psychometric adequacy and audiometric correlates. Ear Hear 1990; 11 (06) 430-433
    CrossrefPubMedGoogle Scholar
  • 39 Ventry IM, Weinstein BE. The hearing handicap inventory for the elderly: a new tool. Ear Hear 1982; 3 (03) 128-134
    CrossrefPubMedGoogle Scholar
  • 40 Tyler RS, Perreau AE, Ji H. The validation of the spatial hearing questionnaire. Ear Hear 2009; 30 (04) 466-474
    CrossrefPubMedGoogle Scholar
  • 41 Gatehouse S, Noble W. The speech, spatial, and qualities of hearing scale (SSQ). Int J Audiol 2004; 43 (02) 85-99
    CrossrefPubMedGoogle Scholar
  • 42 Siburt HW, Holmes AE. Bimodal programming: a survey of current clinical practice. Am J Audiol 2015; 24 (02) 243-249
    CrossrefPubMedGoogle Scholar
  • 43 Yehudai N, Shpak T, Most T, Luntz M. Functional status of hearing aids in bilateral-bimodal users. Otol Neurotol 2013; 34 (04) 675-681
    CrossrefPubMedGoogle Scholar
  • 44 Guidelines for the audiologic management of adult hearing impairment. American Academy of Audiology. Audiology Today. 2006; 18: 6-10
    PubMedGoogle Scholar
  • 45 Ching TYC, Psarros C, Hill M, Dillon H, Incerti P. Should children who use cochlear implants wear hearing aids in the opposite ear?. Ear Hear 2001; 22 (05) 365-380
    CrossrefPubMedGoogle Scholar
  • 46 Neuman AC, Svirsky MA. Effect of hearing aid bandwidth on speech recognition performance of listeners using a cochlear implant and contralateral hearing aid (bimodal hearing). Ear Hear 2013; 34 (05) 553-561
    CrossrefPubMedGoogle Scholar
  • 47 Moore BCJ. Dead regions in the cochlea: diagnosis, perceptual consequences, and implications for the fitting of hearing aids. Trends Amplif 2001; 5 (01) 1-34
    CrossrefPubMedGoogle Scholar
  • 48 Moore BCJ, Glasberg BR, Stone MA. New version of the TEN test with calibrations in dB HL. Ear Hear 2004; 25 (05) 478-487
    CrossrefPubMedGoogle Scholar
  • 49 Zhang T, Dorman MF, Gifford R, Moore BCJ. Cochlear dead regions constrain the benefit of combining acoustic stimulation with electric stimulation. Ear Hear 2014; 35 (04) 410-417
    PubMedGoogle Scholar
  • 50 Veugen LCE, Chalupper J, Snik AFM, Opstal AJ, Mens LHM. Matching automatic gain control across devices in cochlear implant users. Ear Hear 2016; 37 (03) 260-270
    CrossrefPubMedGoogle Scholar
  • 51 Chalupper J, Agrawal S, Fredelake S, Spahr T. Rationale and implementation of a bimodal fitting formula. Presented at the Conference on Implantable Auditory Prostheses, Lake Tahoe, CA; July 14-19, 2013
    PubMedGoogle Scholar
  • 52 Allen S, Sheetal A, Archbold S. , et al. Choosing and using bimodal hearing: the experiences of adults with a cochlear implant and audiologists working in hearing aid clinics. 2017 . Available at: http://www.earfoundation.org.uk/research/research-categories/current-research/choosing-and-using-bimodal-hearing . Accessed January 22, 2018
    PubMedGoogle Scholar
  • 53 Trinidade A, Page JC, Kennett SW, Cox MD, Dornhoffer JL. Simultaneous versus sequential bilateral cochlear implants in adults: cost analysis in a US setting. Laryngoscope 2017; 127 (11) 2615-2618
    CrossrefPubMedGoogle Scholar