Audiovisual sentence recognition in bimodal and bilateral cochlear implant users

The present study describes audiovisual sentence recognition in normal hearing listeners, bimodal cochlear implant (CI) listeners and bilateral CI listeners. This study explores a new set of sentences (the AzAV sentences) that were created to have equal auditory intelligibility and equal gain from visual information.

The aims of Experiment I were to (i) compare the lip reading difficulty of the AzAV sentences to that of other sentence materials, (ii) compare the speech-reading ability of CI listeners to that of normal-hearing listeners and (iii) assess the gain in speech understanding when listeners have both auditory and visual information from easy-to-lip-read and difficult-to-lip read sentences. In addition, the sentence lists were subjected to a multi-level text analysis to determine the factors that make sentences easy or difficult to speech read.

The results of Experiment I showed that (i) the AzAV sentences were relatively difficult to lip read, (ii) that CI listeners and normal-hearing listeners did not differ in lip reading ability and (iii) that sentences with low lip-reading intelligibility (10-15 % correct) provide about a 30 percentage point improvement in speech understanding when added to the acoustic stimulus, while sentences with high lip-reading intelligibility (30-60 % correct) provide about a 50 percentage point improvement in the same comparison. The multi-level text analyses showed that the familiarity of phrases in the sentences was the primary driving factor that affects the lip reading difficulty.

The aim of Experiment II was to investigate the value, when visual information is present, of bimodal hearing and bilateral cochlear implants. The results of Experiment II showed that when visual information is present, low-frequency acoustic hearing can be of value to speech understanding for patients fit with a single CI. However, when visual information was available no gain was seen from the provision of a second CI, i.e., bilateral CIs. As was the case in Experiment I, visual information provided about a 30 percentage point improvement in speech understanding.