OTOLOGY Fine structure processing improves telephone speech perception in cochlear implant users Javier Galindo • Luis Lassaletta • Rosa Pe ´rez Mora • Alejandro Castro • Marta Bastarrica • Javier Gavila ´n Received: 15 May 2012 / Accepted: 19 June 2012 / Published online: 6 July 2012 Ó Springer-Verlag 2012 Abstract The objective of this study was to compare telephone speech perception and subjective preferences in cochlear implant users with two different speech-processing strategies: high-definition continuous interleaved sampling (HDCIS) and fine structure processing (FSP). A randomized double-blind study was designed for intra-individual com- parison of HDCIS and FSP. Twenty-five post-lingually deafened patients with either the PulsarCI 100 or SonataTI 100 and Opus2 acoustic processor were tested consecutively with both coding strategies, assigned in a random order. Disyllabic word speech perception was tested 6 weeks after each fitting under the following conditions: landline use with (LWN) and without (LWoN) background noise, mobile use with (MWN), and without (MWoN) background noise and mobile use with a Bluetooth magnetic field transmitter necklace (MB). Changes in health-related quality of life (QoL) were assessed using the Glasgow Benefit Inventory (GBI) and Faber’s questionnaire. Personal preferences between strategies were surveyed upon completion of the study. All subjects included in this study performed better with FSP in the landline tests. There was an improvement of 11.5 % in LWN use (p = 0.014; CI 95 % = 3–20 %) and 10 % in LWoN use (p = 0.001; CI 95 % = 5–15 %). MWoN showed an improvement of 6.3 % with FSP (p = 0.03; CI 95 % = 0–13 %). MB tests showed an improvement of 11 % with FSP (p \ 0.05; CI 95 % = 1.5–22 %). Quality of life was significantly better using FSP. Eighty-four percent of participants preferred FSP. The FSP speech coding strategy improved the speech recognition of cochlear implant users when using the tele- phone compared to HDCIS. Cochlear implantation with FSP coding improved QoL. Keywords Cochlear implant Á Coding strategy Á Speech perception Á Telephone Á HDCIS Á FSP Á Quality of life Introduction Telecommunication plays an integral part in modern society. In particular, the telephone is relied upon heavily for communication at work and socially. Communication by telephone requires speech understanding without visual cues in an environment often inhibited by noise and voice distortion [1]. Consequently hearing impaired individuals, even with a hearing aids or cochlear implant (CI), encounter great difficulties in telephone communication, if telephone use is not precluded [2]. The lack of lip-reading and other contextual cues, a reduced bandwidth (220–3,300 Hz), distortion, or background noise often impairs effective sound transmission to the user [2, 3]. Several studies have investigated speech perception on the telephone in CI users [1, 4, 5]. In 1985, Brown and col- leagues [4] reported the first case of a woman showing acceptable discrimination on the telephone. More recently, the development of multichannel implants, speech pro- cessors with higher stimulation rates and enhanced speech coding strategies have improved speech perception on the J. Galindo (&) Á L. Lassaletta Á R. P. Mora Á A. Castro Á M. Bastarrica Á J. Gavila ´n Department of Otolaryngology-Head and Neck Surgery, University Hospital La Paz, Secretaria de Otorrinolaringologı ´a, 4th Floor, Paseo de la Castellana 261, 28046 Madrid, Spain e-mail: doctorgalindo@gmail.com J. Galindo Á L. Lassaletta Á R. P. Mora Á A. Castro Á M. Bastarrica Á J. Gavila ´n Hospital La Paz Institute for Health Research idiPAZ, Madrid, Spain 123 Eur Arch Otorhinolaryngol (2013) 270:1223–1229 DOI 10.1007/s00405-012-2101-9