Learning to hear with bimodal hearing care

Making the most of the benefits of a cochlear implant and hearing aid

Listening with both ears enables optimal access to sound. There are different ways to achieve this.

Some cochlear implant users may still have usable hearing in the other ear, which together with the CI can help with hearing. Others are eligible for a bilateral CI, but are currently only fitted with one CI for various reasons.

Depending on the residual hearing and the efficiency of the hearing aid, users can often benefit from the advantages of binaural hearing. The most important of these are

Binaural loudness summation and redundancy

A sound heard by two ears is generally perceived as louder than a sound heard by one ear. This results in redundancy - a doubling of information that supports speech perception.

Head shadow effect

The head becomes an acoustic barrier when sound is presented. This is why the sound reaches both ears at different times and with different intensities.

Binaural squelch effect

The central auditory system processes the different stimuli that each ear receives by comparing the differences in time and intensity between the two sides. This results in a clearer difference between the desired auditory signal and the disturbing background noise or hiss.

You can also get to know these functions in the first three parts of the interactive game "Swith on Life".

This results in the following binaural advantages:

Localizing sounds
Better speech intelligibility in quiet and noisy situations
Improved ability to follow conversations
Reduced listening effort
Improved sense of balance.

Binaural functions must be learned

Like understanding speech, binaural functions also develop slowly. Therefore, hearing training for bimodal cochlear implant users should also include activities aimed at developing directional hearing and hearing in noise.

Suggestions and helpful materials for hearing training in general and for practicing directional hearing can be found on the MED-EL service page. In order to practise hearing in background noise, these exercises are carried out with appropriate, initially relatively quiet background noise: for example, with the window open or the radio playing. A special brochure provides tips on this.