Transmission of Binaural Cues by Bilateral Cochlear Implants: Examining the Impacts of Bilaterally Independent Spectral Peak-Picking, Pulse Timing, and Compression.

Acoustic hearing listeners use binaural cues-interaural time differences (ITDs) and interaural level differences (ILDs)-for localization and segregation of sound sources in the horizontal plane. Cochlear implant users now often receive two implants (bilateral cochlear implants [BiCIs]) rather than one, with the goal to provide access to these cues. However, BiCI listeners often experience difficulty with binaural tasks. Most BiCIs use independent sound processors at each ear; it has often been suggested that such independence may degrade the transmission of binaural cues, particularly ITDs. Here, we report empirical measurements of binaural cue transmission via BiCIs implementing a common "n-of-m" spectral peak-picking stimulation strategy. Measurements were completed for speech and nonspeech stimuli presented to an acoustic manikin "fitted" with BiCI sound processors. Electric outputs from the BiCIs and acoustic outputs from the manikin's in-ear microphones were recorded simultaneously, enabling comparison of electric and acoustic binaural cues. For source locations away from the midline, BiCI binaural cues, particularly envelope ITD cues, were found to be degraded by asymmetric spectral peak-picking. In addition, pulse amplitude saturation due to nonlinear level mapping yielded smaller ILDs at higher presentation levels. Finally, while individual pulses conveyed a spurious "drifting" ITD, consistent with independent left and right processor clocks, such variation was not evident in transmitted envelope ITDs. Results point to avenues for improvement of BiCI technology and may prove useful in the interpretation of BiCI spatial hearing outcomes reported in prior and future studies.