gms | German Medical Science

Introduction: This study aimed to examine the influence of age, ForwardFocus, and the different numbers of maxima of the Nucleus ACE Coding strategy (Cochlear, Sydney, Australia) on the speech recognition threshold (SRT50) and listening effort in noise.

Methods: In a prospective study, 33 cochlear implant users were included. The Oldenburg Sentence Test (OLSA) was used to assess the SRT50 in fluctuating (icra5) and stationary noise (olnoise). The adaptive categorical listening effort scaling (ACALES) test was performed in the icra5 noise to measure listening effort.

A novel test setup with spatial conditions of S0N0, S0N0,45,-45, and S0N180,135,-135 was utilized for the measurements of two different age groups (≤40 years and >40 years) to evaluate the effects of aging compared to the previously published results of normal-hearing listeners [1].

Results: No age dependency of SRT50 in either stationary or fluctuating noise conditions was observed. However, SRT50 significantly improved in the S0N180,135,-135 condition when ForwardFocus was activated. Additionally, the number of ACE maxima enhanced speech recognition in the S0N0 condition. Contrasting with the findings from the normal hearing participants, the SRT50 was lower for all study groups when stationary noise was used compared to fluctuating noise.

The results of the listening effort showed a significant age dependency. Older patients have reached a significantly higher ESCU7 value, corresponding to the average listening effort. Furthermore, ForwardFocus reduced listening effort only in the older group.

Conclusions: Forward Focus can markedly increase speech recognition in noisy environments and enhance daily communication for numerous cochlear implant users. Moreover, it reduces listening effort, especially in older patients, for whom the listening effort increases compared to younger and normal-hearing listeners.