LAUSR

BACKGROUND  Previous research has found that when the location of a talker was varied and an auditory prompt indicated the location of the talker, the addition of visual information produced a significant and large improvement in speech understanding for listeners with bilateral cochlear implants (CIs) but not with a unilateral CI. Presumably, the sound-source localization ability of the bilateral CI listeners allowed them to orient to the auditory prompt and benefit from visual information for the subsequent target sentence. PURPOSE  The goal of this project was to assess the robustness of previous research by using a different test environment, a different CI, different test material, and a different response measure. RESEARCH DESIGN  Nine listeners fit with bilateral CIs were tested in a simulation of a crowded restaurant. Auditory-visual (AV) sentence material was presented from loudspeakers and video monitors at 0, +90, and -90 degrees. Each trial started with the presentation of an auditory alerting phrase from one of the three target loudspeakers followed by an AV target sentence from that loudspeaker/monitor. On each trial, the two nontarget monitors showed the speaker mouthing a different sentence. Sentences were presented in noise in four test conditions: one CI, one CI plus vision, bilateral CIs, and bilateral CIs plus vision. RESULTS  Mean percent words correct for the four test conditions were: one CI, 43%; bilateral CI, 60%; one CI plus vision, 52%; and bilateral CI plus vision, 84%. Visual information did not significantly improve performance in the single CI conditions but did improve performance in the bilateral CI conditions. The magnitude of improvement for two CIs versus one CI in the AV condition was approximately twice that for two CIs versus one CI in the auditory condition. CONCLUSIONS  Our results are consistent with previous data showing the large value of bilateral implants in a complex AV listening environment. The results indicate that the value of bilateral CIs for speech understanding is significantly underestimated in standard, auditory-only, single-speaker, test environments.