Cochlear implant combined with a linear frequency transposing hearing aid

J Am Acad Audiol. 2012 Oct;23(9):722-32. doi: 10.3766/jaaa.23.9.6.


Background: Adults with cochlear implants (CIs) are usually implanted unilaterally. To preserve binaural advantages, a noninvasive method involves maintaining the hearing aid (HA) on the contralateral ear; the choice of HA for this purpose is therefore crucial. In recent years, the use of frequency transposition has gained a renewed interest in clinical practice. This type of processing records information from the high-frequency region and conveys it to a low-frequency region where there is still some residual hearing.

Purpose: To conduct an investigation and examine whether adults with unilateral CI derive benefits from a HA utilizing linear frequency transposition (LFT) on the contralateral ear.

Research design: A two-period, single-blind, repeated-measures crossover design was conducted to examine the combination of LFT in conjunction with a CI. Speech recognition tests were performed in quiet and in noise with LFT either activated or deactivated. The Speech, Spatial and Qualities of Hearing Questionnaire (SSQ) was used to measure subjective benefit.

Study sample: The participants were nine frequent bimodal users, five males and four females, with a moderate to profound high-frequency sensorineural hearing loss in the nonimplanted ear.

Intervention: The current study was conducted using the Widex Mind440 power (m4-19) behind-the-ear HA. The participants acted as their own control in a total of seven conditions: (1) bimodal with own HA, (2) CI only, (3) own HA alone, (4) bimodal new HA LFT-off, (5) new HA LFT-off, (6) bimodal new HA LFT-on, and (7) new HA LFT-on.

Data collection and analysis: Monosyllabic words in quiet and the Swedish version of Hearing in Noise Test (HINT) were used as speech test materials. Stimuli were presented in sound field at a speech level of 65 dB sound pressure level (SPL) via a loudspeaker at a distance of 1 m from the participant in a sound-treated room. The SSQ was administered in each session evaluating the three bimodal conditions. SPSS software was used for statistical analyses. General linear model (GLM) analysis of variance for repeated measures was performed and followed with Bonferroni-adjusted post hoc pairwise comparisons.

Results: Participants performed better with CI only than with HA alone, and the bimodal conditions were superior to the CI alone. No significant differences (p > .05) were observed when comparing the LFT-on with LFT-off regardless of whether the use of CI was included in the different listening conditions in objective and subjective measurements.

Conclusions: The results suggest an advantage for CI patients with a HA in the opposite ear, and that the LFT neither degraded nor enhanced speech performance in conjunction with a CI in quiet or in noise in comparison to when it was deactivated.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Auditory Threshold
  • Cochlear Implantation / methods*
  • Combined Modality Therapy
  • Cross-Over Studies
  • Female
  • Hearing Aids*
  • Hearing Loss, Sensorineural / therapy*
  • Humans
  • Male
  • Middle Aged
  • Noise
  • Single-Blind Method
  • Sound Localization
  • Speech Perception*
  • Surveys and Questionnaires
  • Treatment Outcome