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Introduction: Cochlear implant (CI) users frequently receive audio processor upgrades, and performance improvements are typically assessed using speech perception measures. However, aspects of everyday listening situations – such as different background noises, listening effort, and overall user satisfaction – are often not taken into account. Billinger-Finke et al. [1] developed a questionnaire to evaluate user satisfaction in hearing implant users and demonstrated that such tools can reliably compare different audio processors. By applying questionnaires in real-life situations, it is possible to capture the perception of specific listening contexts. The here presented ongoing multicentric study investigates the effects of upgrading from the Cochlear Nucleus 6/7 audio processor to the Nucleus 8 processor using ecological momentary assessment (EMA), along with speech perception and listening effort measurements.

Methods: So far, nine adult CI users participated. Each participant completed three appointments: screening, pre-upgrade, and post-upgrade measurements. During the intervals between two appointments, participants answered digitized standard questionnaires (APHAB, SSQ, RHHI) and additional hearing-related questions regarding predefined EMA scenarios such as restaurant visits (see Meis et al. [2]) on a smartphone to assess subjective performance and satisfaction in everyday situations. Speech reception thresholds (SRTs) were measured monaurally using the Oldenburg Sentence Test with Olnoise and ICRA5_250 maskers, presenting speech from the front and noise from the CI side. Listening effort was evaluated using adaptive categorical loudness scaling with ICRA5_250, in the same spatial configuration as the SRT measurements.

Results: The pre- and post-upgrade SRTs did not differ significantly, whereas a significant effect of masker type on SRTs was observed. Similarly, listening effort did not differ significantly between pre- and post-upgrade measurements. Although ratings on the APHAB and RHHI questionnaires remained almost unchanged, some trends were observed across all EMA scenarios and in the SSQ ratings.

Conclusions: While standard clinical procedures did not reveal an improvement following the audio processor upgrade, current results of subjective ratings (SSQ, EMA scenarios) indicated a potential benefit reported by the participants. These results highlight the importance of using more ecologically valid measures to assess the performance of CI users. Ongoing data collection shall clarify whether these preliminary trends reflect true effects of the processor upgrade.

Literatur

[1] Billinger-Finke M, Bräcker T, Weber A, Amann E, Anderson I, Batsoulis C. Development and validation of the audio processor satisfaction questionnaire (APSQ) for hearing implant users. Int J Audiol. 2020 May;59(5):392-397. DOI: 10.1080/14992027.2019.1697830
[2] Meis M, Krueger M, Radeloff A, Grundmann M, Buschermöhle M, Holube I, von Gablenz P, Wortmann R, Hessel H. Hearing in Daily Life (HearDL): Die Entwicklung einer Applikation zur Erfassung alltagsnaher Patientendaten im Bereich der CI- und Hörgeräteversorgung. GMS Z Audiol (Audiol Acoust). 2024;6:Doc03. DOI: 10.3205/zaud000038