Recognition of familiar melodies by adult cochlear implant recipients and normal-hearing adults

The purpose of this study was to compare melody recognition and pitch perception of adult cochlear implant recipients and normal-hearing adults and to identify factors that influence the ability of implant users to recognize familiar melodies. Forty-nine experienced cochlear implant recipients and 18 normal-hearing adults were tested on familiar melody recognition. The normal-hearing adults were significantly (p < 0.0001) more accurate than implant recipients. Implant recipients showed considerable variability in perception of complex tones and pure tones. There were significant negative correlations between melody recognition, age at the time of testing, length of profound deafness and complex-tone perception, and significant positive relations between melody recognition and speech recognition scores.     

成人人工耳蜗植入者音乐旋律和音色感知研究

目的评价成人人工耳蜗植入者对音乐旋律及音色的感知能力。方法对13例人工耳蜗植入者（男8例,女5例,平均年龄26．5±6．9岁）分别进行音乐聆听行为评估和旋律辨别、乐器辨别测试。实验使用慕尼黑音乐经验问卷MUMU（Munich music questionnaire）和人工耳蜗音乐评估软件Mu．S．I．C（musical sounds in cochlear implant）进行评估。对照组为40例听力正常受试者（男21例,女19例,平均年龄26．8±6．7岁）。结果①人工耳蜗组与听力正常组的年龄及音乐经验相互匹配。②人工耳蜗组旋律辨别平均正确率为69．3％,乐器辨别平均正确率为51．2％,听力正常组旋律辨别平均正确率为80．4％,乐器辨别平均正确率为85．3％。两组比较,差异存在统计学意义（P=0．000）。结论成人人工耳蜗植入者的旋律感知能力和音色感知能力明显落后于听力正常者。     

Recognition of "real-world" musical excerpts by cochlear implant recipients and normal-hearing adults

OBJECTIVE: The purposes of this study were (a) to compare recognition of "real-world" music excerpts by postlingually deafened adults using cochlear implants and normal-hearing adults; (b) to compare the performance of cochlear implant recipients using different devices and processing strategies; and (c) to examine the variability among implant recipients in recognition of musical selections in relation to performance on speech perception tests, performance on cognitive tests, and demographic variables. DESIGN: Seventy-nine cochlear implant users and 30 normal-hearing adults were tested on open-set recognition of systematically selected excerpts from musical recordings heard in real life. The recognition accuracy of the two groups was compared for three musical genre: classical, country, and pop. Recognition accuracy was correlated with speech recognition scores, cognitive measures, and demographic measures, including musical background. RESULTS: Cochlear implant recipients were significantly less accurate in recognition of previously familiar (known before hearing loss) musical excerpts than normal-hearing adults (p < 0.001) for all three genre. Implant recipients were most accurate in the recognition of country items and least accurate in the recognition of classical items. There were no significant differences among implant recipients due to implant type (Nucleus, Clarion, or Ineraid), or programming strategy (SPEAK, CIS, or ACE). For cochlear implant recipients, correlations between melody recognition and other measures were moderate to weak in strength; those with statistically significant correlations included age at time of testing (negatively correlated), performance on selected speech perception tests, and the amount of focused music listening following implantation. CONCLUSIONS: Current-day cochlear implants are not effective in transmitting several key structural features (i.e., pitch, harmony, timbral blends) of music essential to open-set recognition of well-known musical selections. Consequently, implant recipients must rely on extracting those musical features most accessible through the implant, such as song lyrics or a characteristic rhythm pattern, to identify the sorts of musical selections heard in everyday life.     

Contribution of hearing aids to music perception by cochlear implant users

Abstract

Objectives

Modern cochlear implant (CI) encoding strategies represent the temporal envelope of sounds well but provide limited spectral information. This deficit in spectral information has been implicated as a contributing factor to difficulty with speech perception in noisy conditions, discriminating between talkers and melody recognition. One way to supplement spectral information for CI users is by fitting a hearing aid (HA) to the non-implanted ear.

Methods

In this study 14 postlingually deaf adults (half with a unilateral CI and the other half with a CI and an HA (CI + HA)) were tested on measures of music perception and familiar melody recognition.

Results

CI + HA listeners performed significantly better than CI-only listeners on all pitch-based music perception tasks. The CI + HA group did not perform significantly better than the CI-only group in the two tasks that relied on duration cues. Recognition of familiar melodies was significantly enhanced for the group wearing an HA in addition to their CI. This advantage in melody recognition was increased when melodic sequences were presented with the addition of harmony.

Conclusion

These results show that, for CI recipients with aidable hearing in the non-implanted ear, using a HA in addition to their implant improves perception of musical pitch and recognition of real-world melodies.     

Accuracy of cochlear implant recipients on pitch perception, melody recognition, and speech reception in noise

OBJECTIVE: The purposes of this study were to (a) examine the accuracy of cochlear implant recipients who use different types of devices and signal processing strategies on pitch ranking as a function of size of interval and frequency range and (b) to examine the relations between this pitch perception measure and demographic variables, melody recognition, and speech reception in background noise. DESIGN: One hundred fourteen cochlear implant users and 21 normal-hearing adults were tested on a pitch discrimination task (pitch ranking) that required them to determine direction of pitch change as a function of base frequency and interval size. Three groups were tested: (a) long electrode cochlear implant users (N = 101); (b) short electrode users that received acoustic plus electrical stimulation (A+E) (N = 13); and (c) a normal-hearing (NH) comparison group (N = 21). Pitch ranking was tested at standard frequencies of 131 to 1048 Hz, and the size of the pitch-change intervals ranged from 1 to 4 semitones. A generalized linear mixed model (GLMM) was fit to predict pitch ranking and to determine if group differences exist as a function of base frequency and interval size. Overall significance effects were measured with Chi-square tests and individual effects were measured with t-tests. Pitch ranking accuracy was correlated with demographic measures (age at time of testing, length of profound deafness, months of implant use), frequency difference limens, familiar melody recognition, and two measures of speech reception in noise. RESULTS: The long electrode recipients performed significantly poorer on pitch discrimination than the NH and A+E group. The A+E users performed similarly to the NH listeners as a function of interval size in the lower base frequency range, but their pitch discrimination scores deteriorated slightly in the higher frequency range. The long electrode recipients, although less accurate than participants in the NH and A+E groups, tended to perform with greater accuracy within the higher frequency range. There were statistically significant correlations between pitch ranking and familiar melody recognition as well as with pure-tone frequency difference limens at 200 and 400 Hz. CONCLUSIONS: Low-frequency acoustic hearing improves pitch discrimination as compared with traditional, electric-only cochlear implants. These findings have implications for musical tasks such as familiar melody recognition.     

Music perception with temporal cues in acoustic and electric hearing

OBJECTIVE: The first specific aim of the present study is to compare the ability of normal-hearing and cochlear implant listeners to use temporal cues in three music perception tasks: tempo discrimination, rhythmic pattern identification, and melody identification. The second aim is to identify the relative contribution of temporal and spectral cues to melody recognition in acoustic and electric hearing. DESIGN: Both normal-hearing and cochlear implant listeners participated in the experiments. Tempo discrimination was measured in a two-interval forced-choice procedure in which subjects were asked to choose the faster tempo at four standard tempo conditions (60, 80, 100, and 120 beats per minute). For rhythmic pattern identification, seven different rhythmic patterns were created and subjects were asked to read and choose the musical notation displayed on the screen that corresponded to the rhythmic pattern presented. Melody identification was evaluated with two sets of 12 familiar melodies. One set contained both rhythm and melody information (rhythm condition), whereas the other set contained only melody information (no-rhythm condition). Melody stimuli were also processed to extract the slowly varying temporal envelope from 1, 2, 4, 8, 16, 32, and 64 frequency bands, to create cochlear implant simulations. Subjects listened to a melody and had to respond by choosing one of the 12 names corresponding to the melodies displayed on a computer screen. RESULTS: In tempo discrimination, the cochlear implant listeners performed similarly to the normal-hearing listeners with rate discrimination difference limens obtained at 4-6 beats per minute. In rhythmic pattern identification, the cochlear implant listeners performed 5-25 percentage points poorer than the normal-hearing listeners. The normal-hearing listeners achieved perfect scores in melody identification with and without the rhythmic cues. However, the cochlear implant listeners performed significantly poorer than the normal-hearing listeners in both rhythm and no-rhythm conditions. The simulation results from normal-hearing listeners showed a relatively high level of performance for all numbers of frequency bands in the rhythm condition but required as many as 32 bands in the no-rhythm condition. CONCLUSIONS: Cochlear-implant listeners performed normally in tempo discrimination, but significantly poorer than normal-hearing listeners in rhythmic pattern identification and melody recognition. While both temporal (rhythmic) and spectral (pitch) cues contribute to melody recognition, cochlear-implant listeners mostly relied on the rhythmic cues for melody recognition. Without the rhythmic cues, high spectral resolution with as many as 32 bands was needed for melody recognition for normal-hearing listeners. This result indicates that the present cochlear implants provide sufficient spectral cues to support speech recognition in quiet, but they are not adequate to support music perception. Increasing the number of functional channels and improved encoding of the fine structure information are necessary to improve music perception for cochlear implant listeners.     

Effects of frequency, instrumental family, and cochlear implant type on timbre recognition and appraisal

The purpose of this study was to compare postlingually deafened cochlear implant recipients and normal-hearing adults on timbre (tone quality) recognition and appraisal of 8 musical instruments representing 3 frequency ranges and 4 instrumental families. The implant recipients were significantly less accurate than the normal-hearing adults on timbre recognition. The implant recipients gave significantly poorer ratings than did the normal-hearing adults to those instruments played in the higher frequency range and to those from the string family. The timbre measures were weakly correlated with speech perception measures, but were significantly correlated with 3 cognitive measures of sequential processing.     

Music mixing preferences of cochlear implant recipients: A pilot study

Abstract

Objective: Music perception and appraisal are generally poor in cochlear implant recipients. Simple musical structures, lyrics that are easy to follow, and clear rhythm/beat have been reported among the top factors to enhance music enjoyment. The present study investigated the preference for modified relative instrument levels in music with normal-hearing and cochlear implant subjects. Design: In experiment 1, test subjects were given a mixing console and multi-track recordings to determine their most enjoyable audio mix. In experiment 2, a preference rating experiment based on the preferred relative level settings in experiment 1 was performed. Study sample: Experiment 1 was performed with four postlingually deafened cochlear implant subjects, experiment 2 with ten normal-hearing and ten cochlear implant subjects. Results: A significant difference in preference rating was found between normal-hearing and cochlear implant subjects. The latter preferred an audio mix with larger vocals-to-instruments ratio. In addition, given an audio mix with clear vocals and attenuated instruments, cochlear implant subjects preferred the bass/drum track to be louder than the other instrument tracks. Conclusions: The original audio mix in real-world music might not be suitable for cochlear implant recipients. Modifying the relative instrument level settings potentially improves music enjoyment.     

Familiar melody recognition by children and adults using cochlear implants and normal hearing children

This study investigated the effects of age at time of testing, hearing history (age at hearing loss) and hearing status on melody recognition. Four groups were compared: children with normal hearing thresholds, and three groups of cochlear implant recipients (children with prelingual deafness, children with postlingual deafness, adults with postlingual deafness). Participants were tested for recognition of familiar melodies (no lyrics) in a closed-set task. Groups differed in accuracy in the following rank order (most to least accurate): children with normal hearing thresholds, adult cochlear implant recipients, children with postlingual deafness, children with prelingual deafness. Melody recognition scores were correlated with age, variables regarding hearing history, musical background/experience and speech perception scores.     

A cochlear implant user with exceptional musical hearing ability

Abstract

Although the perception of music is generally poor in cochlear implant users, there are a few excellent performers. Objective: The aim of this study was the assessment of different aspects of music perception in one exceptional cochlear implant user. Design: The assessments included pitch direction discrimination, melody and timbre recognition, relative and absolute pitch judgment, and consonance rating of musical notes presented through the sound processor(s). Study sample: An adult cochlear implant user with musical background who lost her hearing postlingually, and five normally-hearing listeners with musical training participated in the study. Results: The CI user discriminated pitch direction for sounds differing by one semitone and recognized melody with nearly 100% accuracy. Her results in timbre recognition were better than average published data for cochlear implant users. Her consonance rating, and relative and absolute pitch perception were comparable to normally-hearing listeners with musical training. Conclusion: The results in this study showed that excellent performance is possible on musical perception tasks including pitch perception using present day cochlear implant technologies. Factors that may explain this user's exceptional performance are short duration of deafness, pre- and post-deafness musical training, and perfect pitch abilities before the onset of deafness.     

Melody identification for cochlear implant users and normal hearers using expanded pitch contours

Music perception is considered unsatisfactory for most cochlear implant (CI) users. Usually, rhythm identification is adequate while pitch and melody recognition are rather limited. The aim of this study was to investigate whether insufficient contour information in the low-frequency range is one cause that contributes to the poor melody recognition results in CI users. For this purpose, the recognition of familiar melodies was tested with three differently expanded pitch contours. Ten cochlear implant subjects and five normal-hearing (NH) volunteers were investigated. Each subject chose ten out of a possible set of 23 well-known nursery songs without verbal cues. The songs were played in the original version and with three different pitch-contour expansions. All versions were tested with and without rhythm and in random order. CI subjects exhibited best results when melodies were presented with expanded pitch contours, although no clear preference for a specific contour modification was observed. Normal-hearing subjects exhibited poorer results for expanded pitch contours, especially when testing without rhythm. Both NH and CI-user groups exhibited large inter-individual differences, and melody recognition with rhythm was always better than melody recognition without rhythm. Insufficient contour information in the low-frequency range is confirmed as one contributing cause for the poor melody recognition results in CI users. Therefore, other efforts to improve low-frequency pitch discrimination, e.g., a more sophisticated design of the electrode array, a focus of the electrical stimulation pattern or an improved signal processing scheme could potentially improve melody recognition as well.     

Perception of vowels and prosody by cochlear implant recipients in noise

The aim of the present study was to compare the ability of cochlear implant (CI) recipients to recognise speech prosody in the presence of speech-weighted noise to their ability to recognise vowels in the same test paradigm and listening condition. All test materials were recorded from four different speakers (two male, two female). Two prosody recognition tasks were developed, both using single words as stimuli. The first task involved a question/statement distinction, while the second task required listeners to make a judgement about the speaker's attitude. Vowel recognition tests were conducted using vowel pairs selected on the basis of specific acoustic cues (frequencies of the first two formants and duration). Ten CI users and ten normal-hearing controls were tested in both quiet and an adaptive noise condition, using a two-alternative forced-choice test paradigm for all the tests. Results indicated that vowel recognition was significantly better than prosody recognition in both listener groups in both quiet and noise, and that question/statement discrimination was the most difficult task for CI listeners in noise. Data from acoustic analyses were used to interpret differences in performance on different tasks and with different speakers.Learning outcomes: As a result of this activity, readers will be able to (1) describe suitable methods for comparing vowel and prosody perception in noise, (2) compare performance on vowel and prosody perception tasks in quiet in normal-hearing listeners and cochlear implant recipients, (3) compare performance on vowel and prosody perception tasks in noise in normal-hearing listeners and cochlear implant recipients and (4) relate performance on prosody tasks in quiet to performance on these tasks in noise.     

Cantonese tone perception ability of cochlear implant children in comparison with normal-hearing children

BACKGROUND AND OBJECTIVE: Cantonese is a tone language. A change in the fundamental frequency pattern within the same phonemic segment causes a change in the lexical meaning. The present study examined the Cantonese tone perception ability of cochlear implant children in comparison with normal-hearing children. It was hypothesized that cochlear implant children follow a similar pattern of tone perception development, as do normal children. METHOD: 225 normal-hearing and 15 hearing-impaired children with cochlear implants were recruited. The high level (tone 1), high rising (tone 2) and low falling (tone 4) were the target tones examined. The three tones were arranged into tone pairs for identification. Each pair shared exactly the same segmental information but differed only in tones (e.g. /sy/ in tones 1 and 2 meaning 'book' and 'mouse', respectively). Subjects were required to point to the corresponding pictures after the live voice presentations. RESULTS: for each tone pair, each subject was awarded a score representing the proportion of stimuli pairs that were correctly discriminated by the subject. The average scores in the normal-hearing and hearing-impaired groups were 0.92 and 0.64, respectively. The normal group had the lowest average score in tone 2/tone 4 (0.87) while the hearing-impaired group performed the worst in tone 1/tone 2 (0.53) perception between the three tone contrasts. CONCLUSIONS: the normal-hearing group performed significantly better than the hearing-impaired group in basic Cantonese tone perception. The pattern of tone perception development of cochlear implant children did not seem to follow that of normal children. Contributing factors on the tone perception performance of the cochlear implant children were subject's age, duration of special training, and durations of wearing the hearing aid and the cochlear implant.     

Results using the OPAL strategy in Mandarin speaking cochlear implant recipients

Abstract

Objective: To evaluate the effectiveness of an experimental pitch-coding strategy for improving recognition of Mandarin lexical tone in cochlear implant (CI) recipients. Design: Adult CI recipients were tested on recognition of Mandarin tones in quiet and speech-shaped noise at a signal-to-noise ratio of?+10?dB; Mandarin sentence speech-reception threshold (SRT) in speech-shaped noise; and pitch discrimination of synthetic complex-harmonic tones in quiet. Two versions of the experimental strategy were examined: (OPAL) linear (1:1) mapping of fundamental frequency (F0) to the coded modulation rate; and (OPAL+) transposed mapping of high F0s to a lower coded rate. Outcomes were compared to results using the clinical ACE? strategy. Study sample: Five Mandarin speaking users of Nucleus® cochlear implants. Results: A small but significant benefit in recognition of lexical tones was observed using OPAL compared to ACE in noise, but not in quiet, and not for OPAL+?compared to ACE or OPAL in quiet or noise. Sentence SRTs were significantly better using OPAL+?and comparable using OPAL to those using ACE. No differences in pitch discrimination thresholds were observed across strategies. Conclusions: OPAL can provide benefits to Mandarin lexical tone recognition in moderately noisy conditions and preserve perception of Mandarin sentences in challenging noise conditions.     

Auditory Cortical Activity During Cochlear Implant-Mediated Perception of Spoken Language, Melody, and Rhythm

Despite the significant advances in language perception for cochlear implant (CI) recipients, music perception continues to be a major challenge for implant-mediated listening. Our understanding of the neural mechanisms that underlie successful implant listening remains limited. To our knowledge, this study represents the first neuroimaging investigation of music perception in CI users, with the hypothesis that CI subjects would demonstrate greater auditory cortical activation than normal hearing controls. H₂ ¹⁵O positron emission tomography (PET) was used here to assess auditory cortical activation patterns in ten postlingually deafened CI patients and ten normal hearing control subjects. Subjects were presented with language, melody, and rhythm tasks during scanning. Our results show significant auditory cortical activation in implant subjects in comparison to control subjects for language, melody, and rhythm. The greatest activity in CI users compared to controls was seen for language tasks, which is thought to reflect both implant and neural specializations for language processing. For musical stimuli, PET scanning revealed significantly greater activation during rhythm perception in CI subjects (compared to control subjects), and the least activation during melody perception, which was the most difficult task for CI users. These results may suggest a possible relationship between auditory performance and degree of auditory cortical activation in implant recipients that deserves further study.     

Speech perception in elderly patients following cochlear implantation

Conclusions. Elderly patients benefit from cochlear implantation in terms of speech perception and quality of life. Age alone should be no contraindication for implantation. Objective. There have been concerns whether elderly patients may perform poorly after cochlear implantation due to degenerative processes in the central and peripheral auditory systems. The purpose of this study was to analyze the benefits of cochlear implantation in elderly patients in comparison to younger recipients. Material and methods. We examined 26 postlingually deafened adults aged?>?65 years who received a cochlear implant at our center regarding preoperative findings, comorbidities, postoperative complications and quality of life. Speech perception was assessed by means of multi- and monosyllabic word recognition and compared to the results obtained by younger patients. Results. The surgical procedure was well tolerated by all patients without notable perioperative complications. In terms of speech perception, no significant differences between the elderly patients and younger recipients were noted. All patients found that cochlear implantation had a positive impact on their quality of life.     

Melodic contour identification by cochlear implant listeners

OBJECTIVE: While the cochlear implant provides many deaf patients with good speech understanding in quiet, music perception and appreciation with the cochlear implant remains a major challenge for most cochlear implant users. The present study investigated whether a closed-set melodic contour identification (MCI) task could be used to quantify cochlear implant users' ability to recognize musical melodies and whether MCI performance could be improved with moderate auditory training. The present study also compared MCI performance with familiar melody identification (FMI) performance, with and without MCI training. METHODS: For the MCI task, test stimuli were melodic contours composed of 5 notes of equal duration whose frequencies corresponded to musical intervals. The interval between successive notes in each contour was varied between 1 and 5 semitones; the "root note" of the contours was also varied (A3, A4, and A5). Nine distinct musical patterns were generated for each interval and root note condition, resulting in a total of 135 musical contours. The identification of these melodic contours was measured in 11 cochlear implant users. FMI was also evaluated in the same subjects; recognition of 12 familiar melodies was tested with and without rhythm cues. MCI was also trained in 6 subjects, using custom software and melodic contours presented in a different frequency range from that used for testing. RESULTS: Results showed that MCI recognition performance was highly variable among cochlear implant users, ranging from 14% to 91% correct. For most subjects, MCI performance improved as the number of semitones between successive notes was increased; performance was slightly lower for the A3 root note condition. Mean FMI performance was 58% correct when rhythm cues were preserved and 29% correct when rhythm cues were removed. Statistical analyses revealed no significant correlation between MCI performance and FMI performance (with or without rhythmic cues). However, MCI performance was significantly correlated with vowel recognition performance; FMI performance was not correlated with cochlear implant subjects' phoneme recognition performance. Preliminary results also showed that the MCI training improved all subjects' MCI performance; the improved MCI performance also generalized to improved FMI performance. CONCLUSIONS: Preliminary data indicate that the closed-set MCI task is a viable approach toward quantifying an important component of cochlear implant users' music perception. The improvement in MCI performance and generalization to FMI performance with training suggests that MCI training may be useful for improving cochlear implant users' music perception and appreciation; such training may be necessary to properly evaluate patient performance, as acute measures may underestimate the amount of musical information transmitted by the cochlear implant device and received by cochlear implant listeners.     

Music appreciation and music listening in prelingual and postlingually deaf adult cochlear implant recipients

Abstract

Objective: To explore the music appreciation of prelingually deaf adults using cochlear implants (CIs). Design: Cohort study. Adult CI recipients were recruited based on hearing history and asked to complete the University of Canterbury Music Listening Questionnaire (UCMLQ) to assess each individual’s music listening and appreciation. Results were compared to previous responses to the UCMLQ from a large cohort of postlingually deaf CI recipients. Study sample: Fifteen prelingually deaf and 15 postlingually deaf adult cochlear implant recipients. Results: No significant differences were found between the prelingual and postlingual participants for amount of music listening or music listening enjoyment with their CI. Sound quality of common instruments was favourable for both groups, with no significant difference in the pleasantness/naturalness of instrument sounds between the groups. Prelingually deaf CI recipients rated themselves as significantly less able to follow a melody line and identify instrument styles compared to their postlingual peers. Conclusions: The results suggest that the pre- and postlingually deaf CI recipients demonstrate equivalent levels of music appreciation. This finding is of clinical importance, as CI clinicians should be actively encouraging all of their recipients to explore music listening as a part of their rehabilitation.     

Tone perception in Mandarin-speaking children with cochlear implants

Abstract

Objective: To evaluate the effects of implant age and duration of implantation on development of Mandarin tone perception in paediatric cochlear implant recipients. Design: Retrospective cross-sectional evaluation of tone perception, as assessed with the Mandarin Early Speech Perception test at 3, 6, 12, 24, 36 and 48 months after activation. Study sample: A total of 143 subjects, 60 girls and 83 boys unilaterally implanted at 1–4 years of age comprised the sample. All the subjects were implanted with devices from one of three manufacturers. Results: Regardless of implant age, approximately 80% of the subjects obtained overall tone discrimination scores significantly above chance by 4 years after implantation, and average discrimination accuracy increased from approximately 68% to 79%. Acoustically distinct tones 1 and 4 were discriminated and recognised more accurately, while less distinct tones 2 and 3 were discriminated and recognised less accurately. Large individual differences in performance were evident. Conclusions: Most Mandarin-speaking paediatric CI recipients discriminate tones above chance at 5 years of age with accuracy comparable to that of children with normal hearing at 2 years of age. Modest benefits of early implantation are evident.     

Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults

Abstract

Objective: Adult selection criteria for cochlear implantation have been developed based on analysis of the post-operative performance of a large group of postlingually deafened adults. Original criteria published in 2004 were reviewed and amended to reflect outcomes currently being achieved by implant recipients. Design: Retrospective review of 12-month post-operative speech perception performance of adults implanted at the Eye and Ear Hospital, Melbourne, Australia. Study sample: A total of 382 postlingually deafened adults, using a Freedom, Nucleus 5, or CI422 Slim Straight cochlear implant were used to create a comparative set of data. Results: Revised guidelines suggest that adults with postlingual hearing loss can now be considered cochlear implant candidates if they obtain scores of up to 55% for open-set phonemes in quiet in the ear to be implanted. Functional benefit may vary depending on the recipients’ contralateral hearing. Conclusions: This study supports the provision of cochlear implants to candidates with significant residual hearing when at least one ear meets the criterion outlined above. Patient-specific counseling is required to ensure the potential to benefit predicted by the current model is acceptable to the individual patient and their family. Counseling regarding functional benefit must take into consideration hearing in the contralateral ear.