Thomas Wesarg - Academia.edu (original) (raw)
Papers by Thomas Wesarg
Trends in Hearing, 2021
This study investigated the speech intelligibility benefit of using two different spatial noise r... more This study investigated the speech intelligibility benefit of using two different spatial noise reduction algorithms in cochlear implant (CI) users who use a hearing aid (HA) on the contralateral side (bimodal CI users). The study controlled for head movements by using head-related impulse responses to simulate a realistic cafeteria scenario and controlled for HA and CI manufacturer differences by using the master hearing aid platform (MHA) to apply both hearing loss compensation and the noise reduction algorithms (beamformers). Ten bimodal CI users with moderate to severe hearing loss contralateral to their CI participated in the study, and data from nine listeners were included in the data analysis. The beamformers evaluated were the adaptive differential microphones (ADM) implemented independently on each side of the listener and the (binaurally implemented) minimum variance distortionless response (MVDR). For frontal speech and stationary noise from either left or right, an impr...
Ear and Hearing, 2007
AutoNRT is the completely automatic electrically evoked compound action potential (ECAP) measurin... more AutoNRT is the completely automatic electrically evoked compound action potential (ECAP) measuring algorithm in the recently released Nucleus Freedom cochlear implant system. AutoNRT allows clinicians to automatically record T-NRT profiles that in turn can be used as a guide for initial fitting. The algorithm consists of a pattern recognition part that judges if the traces contain an ECAP and an intelligent flow that optimizes the measurement parameters and finds the ECAP threshold (T-NRT). The objective of this study was to determine how accurate, reliable, and fast the automatic measurements are. Data on more than 400 electrodes were collected as part of the multicenter clinical trial of the Nucleus Freedom cochlear implant system. T-NRT values determined by the algorithm were compared with T-NRT determinations on the same data by different human observers. Also, the time the measurements took was analyzed. In 90% of the cases, the absolute difference between the AutoNRT and the human observer determined T-NRT was less than 9 CL; the median absolute difference was 3 CL. A second experiment, in which a group of human observers were asked to analyze NRT data, showed high variability in T-NRT; in some cases, two experienced clinicians disagreed by more than 30 current levels. Compared with the group, AutoNRT performed as well as the "average" clinician, with the advantage that the AutoNRT threshold determinations are objective. Analysis of the timing data showed an average intraoperative measurement time of less than 20 sec per electrode with a standard deviation of 5 sec, suggesting that the total array of 22 electrodes can be measured intraoperatively in about 7 minutes on average. AutoNRT provides comparable accuracy to an average clinician but with the added benefit of significant time savings over manual recordings. This makes it a valuable tool for clinical measurement of ECAP threshold in cochlear implant recipients.
Einleitung: Einseitige Taubheit (Single Sided Deafness, SSD) führt u.a. zu einer Einschränkung de... more Einleitung: Einseitige Taubheit (Single Sided Deafness, SSD) führt u.a. zu einer Einschränkung des Lokalisationsvermögens sowie des Sprachverständnisses im Störlärm. In dieser Studie wird das Lateralisations- und Lokalisationsvermögen sowie das Sprachverständnis[for full text, please go to the a.m. URL]
The Journal of Laryngology & Otology, 2016
where the cell sheet were transplanted. No recurrence of choleateatomas were seen. Conclusion: Th... more where the cell sheet were transplanted. No recurrence of choleateatomas were seen. Conclusion: This is the first clinical study approved from the Ministry of Health, Labour and Welfare in Japan. Furthermore this is a first-in-man study in the world that the cultured cells were transplanted to the human ear. This novel technology of transplantation might be an effective alternative to the surgical operation on intractable otitis media in the near future.
Contralateral audiometric thresholds and speech intelligibility vary greatly across cochlear impl... more Contralateral audiometric thresholds and speech intelligibility vary greatly across cochlear implant (CI) users with acoustic hearing in the non-implanted ear. This study systematically compares spatial speech-in-noise performance in these (bimodal or single-sided deaf, SSD) CI users using three different paradigms, in order to reveal the influence of spatial scenario and contralateral audibility on speech intelligibility. The three paradigms include (1) measurements of 16 actual CI users with a mobile measurement platform, (2) vocoder simulations of electric and acoustic listening with normal hearing (NH) listeners, and (3) an "effective" model of electric, acoustic and bimodal electroacoustic speech-in-noise performance. All three paradigms controlled for secondary factors, e.g., head movements, room acoustics, and hearing aid signal processing (using the Master Hearing Aid). Eleven NH participants listening to unprocessed speech and noise were used as a reference group....
International Journal of Audiology
Introduction: The Symposium was hosted by the University of Freiburg and we invited one of our re... more Introduction: The Symposium was hosted by the University of Freiburg and we invited one of our recipients to tell his own story about the impact of sudden SingleSided Deafness and how he is using a cochlear implant to remediate some of the problems he faces. He highlights many important issues including that motivation is essential. Background: I had a sudden hearing loss on the left side on the 2nd of October 2008. Before that day my left ear was absolutely normal. I know this exactly because I had had a partial hearing loss on the left side three weeks before, which resolved completely, and the audiogram showed 0–10 dB on both sides over the whole frequency range. All subsequent audiograms showed a complete loss on the left side. When tested with more than 120 dB, I felt the vibration, but absolutely no sound. As there was also a complete loss of the vestibular function (indeed this was more apparent during the first days), I am quite sure that the etiology was a thrombosis in or ...
European Archives of Oto-Rhino-Laryngology
Purpose The aim of the study was to compare long-term results after 1 year in patients with singl... more Purpose The aim of the study was to compare long-term results after 1 year in patients with single-sided deafness (SSD) who were fitted with different hearing aids. The participants tested contralateral routing of signals (CROS) hearing aids and bone-anchored hearing systems (BAHS). They were also informed about the possibility of a cochlear implant (CI) and chose one of the three devices. We also investigated which factors influenced the choice of device. Methods Prospective study with 89 SSD participants who were divided into three groups by choosing BAHS, CROS, or CI. All participants received test batteries with both objective hearing tests (speech perception in noise and sound localisation) and subjective questionnaires. Results 16 participants opted for BAHS-, 13 for CROS- and 30 for CI-treatment. The greater the subjective impairment caused by SSD, the more likely patients were to opt for surgical treatment (BAHS or CI). The best results in terms of speech perception in noise...
European Archives of Oto-Rhino-Laryngology
Purpose The new active transcutaneous partially implantable osseointegrated system Cochlear™ Osia... more Purpose The new active transcutaneous partially implantable osseointegrated system Cochlear™ Osia® System is indicated in case of conductive or mixed hearing loss (CHL/MHL) with a maximum average bone conduction hearing loss of 55 dB, or in single-sided deafness (SSD). The implant directly stimulates the bone via a piezoelectric transducer and is directed by an external sound processor. We conducted a monocentric retrospective longitudinal within-subject clinical study at our tertiary academic referral center. The aim was to investigate long-term data (2017–2021) on audiological outcomes and hearing-related quality of life for the Osia system. Methods Between 2017 and 2020, 22 adults (18: CHL/MHL; 3: SSD) were implanted with the Osia100 implant; seven received bilateral implants. As of 10/2020, the sound processor was upgraded to Osia 2. Results Mean Osia system use by 04/2021 was 30.9 ± 8.6 months (range 17–40 months). Unaided bone conduction thresholds were unchanged postoperative...
Scientific Reports
Positron emission tomography (PET) has been successfully used to investigate central nervous proc... more Positron emission tomography (PET) has been successfully used to investigate central nervous processes, including the central auditory pathway. Unlike early water-cooled PET-scanners, novel PET/CT scanners employ air cooling and include a CT system, both of which result in higher background noise levels. In the present study, we describe the background noise generated by two state-of-the-art air-cooled PET/CT scanners. We measured speech recognition in background noise: recorded PET noise and a speech-shaped noise applied in clinical routine to subjects with normal hearing. Background noise produced by air-cooled PET/CT is considerable: 75.1 dB SPL (64.5 dB(A)) for the Philips Gemini TF64 and 76.9 dB SPL (68.4 dB(A)) for the Philips Vereos PET/CT (Philips Healthcare, The Netherlands). Subjects with normal hearing exhibited better speech recognition in recorded PET background noise compared with clinically applied speech-shaped noise. Speech recognition in both background noises corr...
European Archives of Oto-Rhino-Laryngology
Purpose Hearing performance data was collected from a large heterogeneous group of subjects impla... more Purpose Hearing performance data was collected from a large heterogeneous group of subjects implanted with the Cochlear™ Nucleus® CI532 with Slim Modiolar Electrode, for the purposes of postmarket clinical follow-up. Data was analysed for factors which may predict postoperative speech recognition scores. Methods Data was collected retrospectively from five German clinics for 159 subjects from March 2017 to August 2018. Hearing thresholds and recognition scores for monosyllabic words in quiet and sentences in noise were measured preoperatively and at 3 and 6 months postoperatively. Results There was a mean gain of 44% points (95% CI 39–49%) at 6 months in monosyllable scores in quiet for implanted ears. Preoperative hearing thresholds in implant ears increased systematically with decreasing age; however, younger subjects had better baseline monosyllable scores with hearing aids compared with older subjects. Baseline performance alone explained 14% of the variation in postoperative sc...
Forschung heute – Zukunft morgen
Audiology and Neurotology
Access to full text and tables of contents, including tentative ones for forthcoming issues: www.... more Access to full text and tables of contents, including tentative ones for forthcoming issues: www.karger.com/aud_issues 172 Selecting Appropriate Dose Regimens for AM-101 in the Intratympanic Treatment of Acute Inner Ear Tinnitus
Forschung heute – Zukunft morgen
The Journal of the Acoustical Society of America
Journal of the American Academy of Audiology
Background Previous research showed benefits of remote wireless technology in bilaterally moderat... more Background Previous research showed benefits of remote wireless technology in bilaterally moderate-to-severe hearing-impaired participants provided with hearing aid(s), cochlear implant(s) (CIs), or bimodal devices as well as in single-sided deaf (SSD) cochlear implant recipients (with CI from Cochlear™) and normal-hearing (NH) participants. Purpose To evaluate the effect of the digital remote wireless microphone system, Roger™, on speech recognition at different levels of multisource noise in SSD CI recipients using MED-EL CI sound processor OPUS 2. Outcomes were assessed as a function of the listening condition (NH only, NH þ CI, NH þ CIRog, NHRog þ CI, and NHRog þ CIRog), Roger™ receiver type (Roger™ Focus for NH; Roger™ Xand Roger™ MyLink for CI) and accessory mixing ratio. Study Sample Eleven adult, SSD participants aided with CI from MED-EL. Data Collection and Analysis Speech recognition in noise was assessed in two no-Roger™ conditions, one Roger™ X condition, and two Roger™ MyLink conditions. For the Roger™ X and no-Roger™ conditions, speech recognition was tested at 60.3 dB(A) with the Oldenburg Sentence Test in classroom noise at levels of 55, 65, and 75 dB(A). For the two Roger™ MyLink conditions, speech recognition at 60.3 dB(A) was measured at a noise level of 75 dB(A). Roger™ X was assessed with an accessory mixing ratio of 1:1 (summation of unattenuated microphone and audio accessory input). For Roger™ MyLink, two accessory mixing ratios were investigated, MT (1:1, summation of unattenuated microphone and telecoil input) and T with maximum attenuation of microphone input. Results Speech recognition at higher noise levels (65 and 75 dB(A)) improved significantly with Roger™ in both unilateral use conditions (NH þ CIRog and NHRog þ CI) as well as bilateral use condition (NHRog þ CIRog). Both the bilateral application of Roger™ and the unilateral Roger™ application on the NH ear outperformed the Roger™ application on CI alone. There was no statistically significant
Audiology and Neurotology
Purpose: This study analyses data logs in order to investigate the usage pattern of cochlear impl... more Purpose: This study analyses data logs in order to investigate the usage pattern of cochlear implant (CI) recipients with single-sided deafness (SSD-CI) and bilaterally deaf, uni- or bilaterally implanted CI recipients (Uni-CI and Bil-CI). Data logging is available from SCAN, an automated auditory scene classifier which categorizes auditory input into 6 listening environments. Methods: CI usage data were retrospectively available from data logs of 206 CI recipients using the Nucleus 6 system obtained between January 2013 and June 2015. For all recipients, we analysed time on air and time spent in the listening environments. For statistical analysis, we matched the CI recipients according to age and duration of CI experience and classified them into 4 age groups. Results: SSD-CI showed a similar time on air compared to Uni- and Bil-CI. Usage behaviour of SSD-CI was comparable to Uni- and Bil-CI regarding exposure to music, speech in quiet and speech in noise. With increasing age, exp...
Trends in Hearing, 2021
This study investigated the speech intelligibility benefit of using two different spatial noise r... more This study investigated the speech intelligibility benefit of using two different spatial noise reduction algorithms in cochlear implant (CI) users who use a hearing aid (HA) on the contralateral side (bimodal CI users). The study controlled for head movements by using head-related impulse responses to simulate a realistic cafeteria scenario and controlled for HA and CI manufacturer differences by using the master hearing aid platform (MHA) to apply both hearing loss compensation and the noise reduction algorithms (beamformers). Ten bimodal CI users with moderate to severe hearing loss contralateral to their CI participated in the study, and data from nine listeners were included in the data analysis. The beamformers evaluated were the adaptive differential microphones (ADM) implemented independently on each side of the listener and the (binaurally implemented) minimum variance distortionless response (MVDR). For frontal speech and stationary noise from either left or right, an impr...
Ear and Hearing, 2007
AutoNRT is the completely automatic electrically evoked compound action potential (ECAP) measurin... more AutoNRT is the completely automatic electrically evoked compound action potential (ECAP) measuring algorithm in the recently released Nucleus Freedom cochlear implant system. AutoNRT allows clinicians to automatically record T-NRT profiles that in turn can be used as a guide for initial fitting. The algorithm consists of a pattern recognition part that judges if the traces contain an ECAP and an intelligent flow that optimizes the measurement parameters and finds the ECAP threshold (T-NRT). The objective of this study was to determine how accurate, reliable, and fast the automatic measurements are. Data on more than 400 electrodes were collected as part of the multicenter clinical trial of the Nucleus Freedom cochlear implant system. T-NRT values determined by the algorithm were compared with T-NRT determinations on the same data by different human observers. Also, the time the measurements took was analyzed. In 90% of the cases, the absolute difference between the AutoNRT and the human observer determined T-NRT was less than 9 CL; the median absolute difference was 3 CL. A second experiment, in which a group of human observers were asked to analyze NRT data, showed high variability in T-NRT; in some cases, two experienced clinicians disagreed by more than 30 current levels. Compared with the group, AutoNRT performed as well as the "average" clinician, with the advantage that the AutoNRT threshold determinations are objective. Analysis of the timing data showed an average intraoperative measurement time of less than 20 sec per electrode with a standard deviation of 5 sec, suggesting that the total array of 22 electrodes can be measured intraoperatively in about 7 minutes on average. AutoNRT provides comparable accuracy to an average clinician but with the added benefit of significant time savings over manual recordings. This makes it a valuable tool for clinical measurement of ECAP threshold in cochlear implant recipients.
Einleitung: Einseitige Taubheit (Single Sided Deafness, SSD) führt u.a. zu einer Einschränkung de... more Einleitung: Einseitige Taubheit (Single Sided Deafness, SSD) führt u.a. zu einer Einschränkung des Lokalisationsvermögens sowie des Sprachverständnisses im Störlärm. In dieser Studie wird das Lateralisations- und Lokalisationsvermögen sowie das Sprachverständnis[for full text, please go to the a.m. URL]
The Journal of Laryngology & Otology, 2016
where the cell sheet were transplanted. No recurrence of choleateatomas were seen. Conclusion: Th... more where the cell sheet were transplanted. No recurrence of choleateatomas were seen. Conclusion: This is the first clinical study approved from the Ministry of Health, Labour and Welfare in Japan. Furthermore this is a first-in-man study in the world that the cultured cells were transplanted to the human ear. This novel technology of transplantation might be an effective alternative to the surgical operation on intractable otitis media in the near future.
Contralateral audiometric thresholds and speech intelligibility vary greatly across cochlear impl... more Contralateral audiometric thresholds and speech intelligibility vary greatly across cochlear implant (CI) users with acoustic hearing in the non-implanted ear. This study systematically compares spatial speech-in-noise performance in these (bimodal or single-sided deaf, SSD) CI users using three different paradigms, in order to reveal the influence of spatial scenario and contralateral audibility on speech intelligibility. The three paradigms include (1) measurements of 16 actual CI users with a mobile measurement platform, (2) vocoder simulations of electric and acoustic listening with normal hearing (NH) listeners, and (3) an "effective" model of electric, acoustic and bimodal electroacoustic speech-in-noise performance. All three paradigms controlled for secondary factors, e.g., head movements, room acoustics, and hearing aid signal processing (using the Master Hearing Aid). Eleven NH participants listening to unprocessed speech and noise were used as a reference group....
International Journal of Audiology
Introduction: The Symposium was hosted by the University of Freiburg and we invited one of our re... more Introduction: The Symposium was hosted by the University of Freiburg and we invited one of our recipients to tell his own story about the impact of sudden SingleSided Deafness and how he is using a cochlear implant to remediate some of the problems he faces. He highlights many important issues including that motivation is essential. Background: I had a sudden hearing loss on the left side on the 2nd of October 2008. Before that day my left ear was absolutely normal. I know this exactly because I had had a partial hearing loss on the left side three weeks before, which resolved completely, and the audiogram showed 0–10 dB on both sides over the whole frequency range. All subsequent audiograms showed a complete loss on the left side. When tested with more than 120 dB, I felt the vibration, but absolutely no sound. As there was also a complete loss of the vestibular function (indeed this was more apparent during the first days), I am quite sure that the etiology was a thrombosis in or ...
European Archives of Oto-Rhino-Laryngology
Purpose The aim of the study was to compare long-term results after 1 year in patients with singl... more Purpose The aim of the study was to compare long-term results after 1 year in patients with single-sided deafness (SSD) who were fitted with different hearing aids. The participants tested contralateral routing of signals (CROS) hearing aids and bone-anchored hearing systems (BAHS). They were also informed about the possibility of a cochlear implant (CI) and chose one of the three devices. We also investigated which factors influenced the choice of device. Methods Prospective study with 89 SSD participants who were divided into three groups by choosing BAHS, CROS, or CI. All participants received test batteries with both objective hearing tests (speech perception in noise and sound localisation) and subjective questionnaires. Results 16 participants opted for BAHS-, 13 for CROS- and 30 for CI-treatment. The greater the subjective impairment caused by SSD, the more likely patients were to opt for surgical treatment (BAHS or CI). The best results in terms of speech perception in noise...
European Archives of Oto-Rhino-Laryngology
Purpose The new active transcutaneous partially implantable osseointegrated system Cochlear™ Osia... more Purpose The new active transcutaneous partially implantable osseointegrated system Cochlear™ Osia® System is indicated in case of conductive or mixed hearing loss (CHL/MHL) with a maximum average bone conduction hearing loss of 55 dB, or in single-sided deafness (SSD). The implant directly stimulates the bone via a piezoelectric transducer and is directed by an external sound processor. We conducted a monocentric retrospective longitudinal within-subject clinical study at our tertiary academic referral center. The aim was to investigate long-term data (2017–2021) on audiological outcomes and hearing-related quality of life for the Osia system. Methods Between 2017 and 2020, 22 adults (18: CHL/MHL; 3: SSD) were implanted with the Osia100 implant; seven received bilateral implants. As of 10/2020, the sound processor was upgraded to Osia 2. Results Mean Osia system use by 04/2021 was 30.9 ± 8.6 months (range 17–40 months). Unaided bone conduction thresholds were unchanged postoperative...
Scientific Reports
Positron emission tomography (PET) has been successfully used to investigate central nervous proc... more Positron emission tomography (PET) has been successfully used to investigate central nervous processes, including the central auditory pathway. Unlike early water-cooled PET-scanners, novel PET/CT scanners employ air cooling and include a CT system, both of which result in higher background noise levels. In the present study, we describe the background noise generated by two state-of-the-art air-cooled PET/CT scanners. We measured speech recognition in background noise: recorded PET noise and a speech-shaped noise applied in clinical routine to subjects with normal hearing. Background noise produced by air-cooled PET/CT is considerable: 75.1 dB SPL (64.5 dB(A)) for the Philips Gemini TF64 and 76.9 dB SPL (68.4 dB(A)) for the Philips Vereos PET/CT (Philips Healthcare, The Netherlands). Subjects with normal hearing exhibited better speech recognition in recorded PET background noise compared with clinically applied speech-shaped noise. Speech recognition in both background noises corr...
European Archives of Oto-Rhino-Laryngology
Purpose Hearing performance data was collected from a large heterogeneous group of subjects impla... more Purpose Hearing performance data was collected from a large heterogeneous group of subjects implanted with the Cochlear™ Nucleus® CI532 with Slim Modiolar Electrode, for the purposes of postmarket clinical follow-up. Data was analysed for factors which may predict postoperative speech recognition scores. Methods Data was collected retrospectively from five German clinics for 159 subjects from March 2017 to August 2018. Hearing thresholds and recognition scores for monosyllabic words in quiet and sentences in noise were measured preoperatively and at 3 and 6 months postoperatively. Results There was a mean gain of 44% points (95% CI 39–49%) at 6 months in monosyllable scores in quiet for implanted ears. Preoperative hearing thresholds in implant ears increased systematically with decreasing age; however, younger subjects had better baseline monosyllable scores with hearing aids compared with older subjects. Baseline performance alone explained 14% of the variation in postoperative sc...
Forschung heute – Zukunft morgen
Audiology and Neurotology
Access to full text and tables of contents, including tentative ones for forthcoming issues: www.... more Access to full text and tables of contents, including tentative ones for forthcoming issues: www.karger.com/aud_issues 172 Selecting Appropriate Dose Regimens for AM-101 in the Intratympanic Treatment of Acute Inner Ear Tinnitus
Forschung heute – Zukunft morgen
The Journal of the Acoustical Society of America
Journal of the American Academy of Audiology
Background Previous research showed benefits of remote wireless technology in bilaterally moderat... more Background Previous research showed benefits of remote wireless technology in bilaterally moderate-to-severe hearing-impaired participants provided with hearing aid(s), cochlear implant(s) (CIs), or bimodal devices as well as in single-sided deaf (SSD) cochlear implant recipients (with CI from Cochlear™) and normal-hearing (NH) participants. Purpose To evaluate the effect of the digital remote wireless microphone system, Roger™, on speech recognition at different levels of multisource noise in SSD CI recipients using MED-EL CI sound processor OPUS 2. Outcomes were assessed as a function of the listening condition (NH only, NH þ CI, NH þ CIRog, NHRog þ CI, and NHRog þ CIRog), Roger™ receiver type (Roger™ Focus for NH; Roger™ Xand Roger™ MyLink for CI) and accessory mixing ratio. Study Sample Eleven adult, SSD participants aided with CI from MED-EL. Data Collection and Analysis Speech recognition in noise was assessed in two no-Roger™ conditions, one Roger™ X condition, and two Roger™ MyLink conditions. For the Roger™ X and no-Roger™ conditions, speech recognition was tested at 60.3 dB(A) with the Oldenburg Sentence Test in classroom noise at levels of 55, 65, and 75 dB(A). For the two Roger™ MyLink conditions, speech recognition at 60.3 dB(A) was measured at a noise level of 75 dB(A). Roger™ X was assessed with an accessory mixing ratio of 1:1 (summation of unattenuated microphone and audio accessory input). For Roger™ MyLink, two accessory mixing ratios were investigated, MT (1:1, summation of unattenuated microphone and telecoil input) and T with maximum attenuation of microphone input. Results Speech recognition at higher noise levels (65 and 75 dB(A)) improved significantly with Roger™ in both unilateral use conditions (NH þ CIRog and NHRog þ CI) as well as bilateral use condition (NHRog þ CIRog). Both the bilateral application of Roger™ and the unilateral Roger™ application on the NH ear outperformed the Roger™ application on CI alone. There was no statistically significant
Audiology and Neurotology
Purpose: This study analyses data logs in order to investigate the usage pattern of cochlear impl... more Purpose: This study analyses data logs in order to investigate the usage pattern of cochlear implant (CI) recipients with single-sided deafness (SSD-CI) and bilaterally deaf, uni- or bilaterally implanted CI recipients (Uni-CI and Bil-CI). Data logging is available from SCAN, an automated auditory scene classifier which categorizes auditory input into 6 listening environments. Methods: CI usage data were retrospectively available from data logs of 206 CI recipients using the Nucleus 6 system obtained between January 2013 and June 2015. For all recipients, we analysed time on air and time spent in the listening environments. For statistical analysis, we matched the CI recipients according to age and duration of CI experience and classified them into 4 age groups. Results: SSD-CI showed a similar time on air compared to Uni- and Bil-CI. Usage behaviour of SSD-CI was comparable to Uni- and Bil-CI regarding exposure to music, speech in quiet and speech in noise. With increasing age, exp...