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1.
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。  相似文献   

2.
The present study investigated the ability of normal-hearing listeners and cochlear implant users to recognize vocal emotions. Sentences were produced by 1 male and 1 female talker according to 5 target emotions: angry, anxious, happy, sad, and neutral. Overall amplitude differences between the stimuli were either preserved or normalized. In experiment 1, vocal emotion recognition was measured in normal-hearing and cochlear implant listeners; cochlear implant subjects were tested using their clinically assigned processors. When overall amplitude cues were preserved, normal-hearing listeners achieved near-perfect performance, whereas listeners with cochlear implant recognized less than half of the target emotions. Removing the overall amplitude cues significantly worsened mean normal-hearing and cochlear implant performance. In experiment 2, vocal emotion recognition was measured in listeners with cochlear implant as a function of the number of channels (from 1 to 8) and envelope filter cutoff frequency (50 vs 400 Hz) in experimental speech processors. In experiment 3, vocal emotion recognition was measured in normal-hearing listeners as a function of the number of channels (from 1 to 16) and envelope filter cutoff frequency (50 vs 500 Hz) in acoustic cochlear implant simulations. Results from experiments 2 and 3 showed that both cochlear implant and normal-hearing performance significantly improved as the number of channels or the envelope filter cutoff frequency was increased. The results suggest that spectral, temporal, and overall amplitude cues each contribute to vocal emotion recognition. The poorer cochlear implant performance is most likely attributable to the lack of salient pitch cues and the limited functional spectral resolution.  相似文献   

3.
The present study investigated the relative importance of temporal and spectral cues in voice gender discrimination and vowel recognition by normal-hearing subjects listening to an acoustic simulation of cochlear implant speech processing and by cochlear implant users. In the simulation, the number of speech processing channels ranged from 4 to 32, thereby varying the spectral resolution; the cutoff frequencies of the channels envelope filters ranged from 20 to 320 Hz, thereby manipulating the available temporal cues. For normal-hearing subjects, results showed that both voice gender discrimination and vowel recognition scores improved as the number of spectral channels was increased. When only 4 spectral channels were available, voice gender discrimination significantly improved as the envelope filter cutoff frequency was increased from 20 to 320 Hz. For all spectral conditions, increasing the amount of temporal information had no significant effect on vowel recognition. Both voice gender discrimination and vowel recognition scores were highly variable among implant users. The performance of cochlear implant listeners was similar to that of normal-hearing subjects listening to comparable speech processing (4–8 spectral channels). The results suggest that both spectral and temporal cues contribute to voice gender discrimination and that temporal cues are especially important for cochlear implant users to identify the voice gender when there is reduced spectral resolution.  相似文献   

4.
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.  相似文献   

5.
Melodic contour identification by cochlear implant listeners   总被引:4,自引:0,他引:4  
Galvin JJ  Fu QJ  Nogaki G 《Ear and hearing》2007,28(3):302-319
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.  相似文献   

6.
Abstract

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.  相似文献   

7.
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.  相似文献   

8.
The latest-generation cochlear implant devices provide many deaf patients with good speech recognition in quiet listening conditions. However, speech recognition deteriorates rapidly as the level of background noise increases. Previous studies have shown that, for cochlear implant users, the absence of fine spectro-temporal cues may contribute to poorer performance in noise, especially when the noise is dynamic (e.g., competing speaker or modulated noise). Here we report on sentence recognition by cochlear implant users and by normal-hearing subjects listening to an acoustic simulation of a cochlear implant, in the presence of steady or square-wave modulated speech-shaped noise. Implant users were tested using their everyday, clinically assigned speech processors. In the acoustic simulation, normal-hearing listeners were tested for different degrees of spectral resolution (16, eight, or four channels) and spectral smearing (carrier filter slopes of –24 or –6 dB/octave). For modulated noise, normal-hearing listeners experienced significant release from masking when the original, unprocessed speech was presented (which preserved the spectro-temporal fine structure), while cochlear implant users experienced no release from masking. As the spectral resolution was reduced, normal-hearing listeners release from masking gradually diminished. Release from masking was further reduced as the degree of spectral smearing increased. Interestingly, the mean speech recognition thresholds of implant users were very close to those of normal-hearing subjects listening to four-channel spectrally smeared noise-band speech. Also, the best cochlear implant listeners performed like normal-hearing subjects listening to eight- to 16-channel spectrally smeared noise-band speech. These findings suggest that implant users susceptibility to noise may be caused by the reduced spectral resolution and the high degree of spectral smearing associated with channel interaction. Efforts to improve the effective number of spectral channels as well as reduce channel interactions may improve implant performance in noise, especially for temporally modulated noise.  相似文献   

9.
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.  相似文献   

10.
《Acta oto-laryngologica》2012,132(7):826-835
Objective --To evaluate musical perception in adult cochlear implant (CI) recipients, i.e. perceptual accuracy for pitch, timbre, rhythmic patterns and song identification. Material and Methods --Twenty-nine adult patients were included in this transverse single-center study. Evaluative measures included tests assessing ability to discriminate pitch, rhythm and timbre and to identify nursery songs with and without verbal cues. Performance scores were correlated with duration of deafness, duration of implantation, speech discrimination and musical perception skills. Results --A total of 38% of patients reported that they did not enjoy listening to music with their device and 86% presented lower scores of listening habits after implantation. We found positive correlations between musical background and pitch identification and identification of nursery songs played by piano. We also found positive correlations between speech discrimination and rhythm, timbre and identification of nursery songs with verbal cues. Conclusion --Trends in the patterns of correlation between speech and music perception suggest that music patterns are differentially accessible to CI users. New processing strategies may improve this.  相似文献   

11.
Santurette S  Dau T 《Hearing research》2007,223(1-2):29-47
The effects of hearing impairment on the perception of binaural-pitch stimuli were investigated. Several experiments were performed with normal-hearing and hearing-impaired listeners, including detection and discrimination of binaural pitch, and melody recognition using different types of binaural pitches. For the normal-hearing listeners, all types of binaural pitches could be perceived immediately and were musical. The hearing-impaired listeners could be divided into three groups based on their results: (a) some perceived all types of binaural pitches, but with decreased salience or musicality compared to normal-hearing listeners; (b) some could only perceive the strongest pitch types; (c) some were unable to perceive any binaural pitch at all. The performance of the listeners was not correlated with audibility. Additional experiments investigated the correlation between performance in binaural-pitch perception and performance in measures of spectral and temporal resolution. Reduced frequency discrimination appeared to be linked to poorer melody recognition skills. Reduced frequency selectivity was also found to impede the perception of binaural-pitch stimuli. Overall, binaural-pitch stimuli might be very useful tools within clinical diagnostics for detecting specific deficiencies in the auditory system.  相似文献   

12.
OBJECTIVE: Speech and other environmental sounds must be compressed to accommodate the small electric dynamic range in cochlear implant listeners. The objective of this paper is to study whether and how amplitude compression and dynamic range reduction affect phoneme recognition in quiet and in noise for cochlear implant listeners. DESIGN: Four implant listeners using the Nucleus-22 SPEAK speech processor participated in this study. The amount of compression was varied by manipulating the Q-value in the SPEAK processor. The size of the dynamic range was systematically reduced by increasing the threshold level and decreasing the comfortable level in the processor. Both female- and male-talker vowel and consonant materials were used to evaluate speech recognition performance in quiet and in noise. Speech-spectrum-shaped noise was mixed with the speech signal and presented continuously to the speech processor through a direct electric connection. Signal to noise ratios were changed over a 30 to 40 dB range, within which phoneme recognition increased from chance to asymptotic performance. Phoneme recognition scores were obtained as the number of active electrodes was reduced from 20 to 10 to 4. For purposes of comparison, phoneme recognition data also were collected in four normal-hearing listeners under comparable laboratory conditions. RESULTS: In both quiet and noise, the amount of amplitude compression did not significantly affect phoneme recognition. The reduction of dynamic range marginally affected phoneme recognition in quiet, but significantly degraded phoneme recognition in noise. Generally, the 20- and 10-electrode processors produced similar performance, whereas the 4-electrode processor produced significantly poorer performance. Compared with normal-hearing listeners, cochlear-implant listeners required higher signal to noise ratios to achieve comparable recognition performance and produced significantly lower recognition scores at the same signal to noise ratios. CONCLUSIONS: The amount of amplitude compression does not significantly affect phoneme recognition, whereas reducing dynamic range significantly lowers phoneme recognition, particularly in noise and for vowels. Because the SPEAK processor extracts mostly spectral peaks, the present conclusions may not be applied to other types of processors extracting temporal envelope cues. The present results also suggest that more than four electrodes are required to optimize speech recognition in multiple-talker and noise conditions. A significant performance gap in speech recognition still remains between cochlear implant and normal-hearing listeners at the same signal to noise ratios. Improved cochlear implant designs and fitting procedures are required to narrow and, hopefully, close this performance gap.  相似文献   

13.
Music perception in adult cochlear implant recipients   总被引:1,自引:0,他引:1  
OBJECTIVE: To evaluate musical perception in adult cochlear implant (CI) recipients, i.e. perceptual accuracy for pitch, timbre, rhythmic patterns and song identification. MATERIAL AND METHODS: Twenty-nine adult patients were included in this transverse single-center study. Evaluative measures included tests assessing ability to discriminate pitch, rhythm and timbre and to identify nursery songs with and without verbal cues. Performance scores were correlated with duration of deafness, duration of implantation, speech discrimination and musical perception skills. RESULTS: A total of 38% of patients reported that they did not enjoy listening to music with their device and 86% presented lower scores of listening habits after implantation. We found positive correlations between musical background and pitch identification and identification of nursery songs played by piano. We also found positive correlations between speech discrimination and rhythm, timbre and identification of nursery songs with verbal cues. CONCLUSION: Trends in the patterns of correlation between speech and music perception suggest that music patterns are differentially accessible to CI users. New processing strategies may improve this.  相似文献   

14.
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.  相似文献   

15.
Vowel identification is largely dependent on listeners’ access to the frequency of two or three peaks in the amplitude spectrum. Earlier work has demonstrated that, whereas normal-hearing listeners can identify harmonic complexes with vowel-like spectral shapes even with very little amplitude contrast between “formant” components and remaining harmonic components, listeners with hearing loss require greater amplitude differences. This is likely the result of the poor frequency resolution that often accompanies hearing loss. Here, we describe an additional acoustic dimension for emphasizing formant versus non-formant harmonics that may supplement amplitude contrast information. The purpose of this study was to determine whether listeners were able to identify “vowel-like” sounds using temporal (component phase) contrast, which may be less affected by cochlear loss than spectral cues, and whether overall identification improves when congruent temporal and spectral information are provided together. Five normal-hearing and five hearing-impaired listeners identified three vowels over many presentations. Harmonics representing formant peaks were varied in amplitude, phase, or a combination of both. In addition to requiring less amplitude contrast, normal-hearing listeners could accurately identify the sounds with less phase contrast than required by people with hearing loss. However, both normal-hearing and hearing-impaired groups demonstrated the ability to identify vowel-like sounds based solely on component phase shifts, with no amplitude contrast information, and they also showed improved performance when congruent phase and amplitude cues were combined. For nearly all listeners, the combination of spectral and temporal information improved identification in comparison to either dimension alone.  相似文献   

16.
PURPOSE OF REVIEW: This paper examines and consolidates recent advances in cochlear implant sound processing from the perspective of music perception, which is increasingly viewed as one of the most difficult of all listening conditions. RECENT FINDINGS: Music is an essentially abstract, complex form of sound composed of multiple layers of sounds that vary in temporal presentation, frequency distribution, and harmonic content. As a result, music perception is perhaps the most challenging aspect of implant-mediated listening. Thus far, implant performance has shown poor performance overall during perception of musical pitches, melodies, and timbre while perception of rhythm is relatively good. Recent advances in implant sound processing strategies, particularly the use of current distribution along adjacent electrodes, have promising early results in terms of improving the number of pitch percepts available to cochlear implant listeners. SUMMARY: Music perception poses auditory challenges that can exceed those of language perception during cochlear implant-mediated listening. These challenges should be emphasized to patients prior to implantation. Although rhythm perception via cochlear implants is reasonably good using simple test paradigms, significant work remains to improve critically important aspects of music perception, including melody and timbre. New implant processing strategies are encouraging and should lead to improved music perception in the near future.  相似文献   

17.
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.  相似文献   

18.
Recent studies suggest that normal-hearing listeners maintain robust speech intelligibility despite severe degradations of amplitude-modulation (AM) cues, by using temporal-envelope information recovered from broadband frequency-modulation (FM) speech cues at the output of cochlear filters. This study aimed to assess whether cochlear damage affects this capacity to reconstruct temporal-envelope information from FM. This was achieved by measuring the ability of 40 normal-hearing listeners and 41 listeners with mild-to-moderate hearing loss to identify syllables processed to degrade AM cues while leaving FM cues intact within three broad frequency bands spanning the range 65–3,645 Hz. Stimuli were presented at 65 dB SPL for both normal-hearing listeners and hearing-impaired listeners. They were presented as such or amplified using a modified half-gain rule for hearing-impaired listeners. Hearing-impaired listeners showed significantly poorer identification scores than normal-hearing listeners at both presentation levels. However, the deficit shown by hearing-impaired listeners for amplified stimuli was relatively modest. Overall, hearing-impaired data and the results of a simulation study were consistent with a poorer-than-normal ability to reconstruct temporal-envelope information resulting from a broadening of cochlear filters by a factor ranging from 2 to 4. These results suggest that mild-to-moderate cochlear hearing loss has only a modest detrimental effect on peripheral, temporal-envelope reconstruction mechanisms.  相似文献   

19.
The purpose of this study was to investigate the effect of the limited-frequency bandwidth employed by telephones (300-3400 Hz) on speech recognition in adult cochlear implant users. The Four Alternative Auditory Feature (FAAF) test was used in four conditions: unfiltered and in three filtered conditions of 300-4500 Hz, 300-3400 Hz and 300-2500 Hz. Ten subjects implanted with the Nucleus CI24M device and 10 normal-hearing listeners were assessed to examine differences between word discrimination scores in each condition. Scores obtained from the 300-3400-Hz and 300-2500-Hz filtered conditions were significantly worse than those with unfiltered speech for the cochlear implant subjects, decreasing by 17.7% and 21.4%, respectively, from scores with unfiltered speech. By contrast, the normal-hearing listeners did not experience difficulties in discriminating between words in any of the conditions. Analysis of the word errors demonstrated that the reduction in implant subject scores with bandwidth arose from errors in place of articulation. Filtering speech in this way has a significant effect on speech recognition for cochlear implant subjects but not normal-hearing listeners. Hence, the limitations of the normal telephone bandwidth can be expected to have a negative effect on speech recognition for cochlear implant users using the telephone.  相似文献   

20.
The purpose of this study was to investigate the effect of the limited-frequency bandwidth employed by telephones (300-3400Hz) on speech recognition in adult cochlear implant users. The Four Alternative Auditory Feature (FAAF) test was used in four conditions: unfiltered and in three filtered conditions of 300-4500Hz, 300-3400Hz and 300-2500Hz. Ten subjects implanted with the Nucleus C124M device and 10 normal-hearing listeners were assessed to examine differences between word discrimination scores in each condition. Scores obtained from the 300-3400-Hz and 300-2500-Hz filtered conditions were significantly worse than those with unfiltered speech for the cochlear implant subjects, decreasing by 17.7% and 21.4%, respectively, from scores with unfiltered speech. By contrast, the normal-hearing listeners did not experience difficulties in discriminating between words in any of the conditions. Analysis of the word errors demonstrated that the reduction in implant subject scores with bandwidth arose from errors in place of articulation. Filtering speech in this way has a significant effect on speech recognition for cochlear implant subjects but not normal-hearing listeners. Hence, the limitations of the normal telephone bandwidth can be expected to have a negative effect on speech recognition for cochlear implant users using the telephone.  相似文献   

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