Optimal gain control step sizes for bimodal stimulation

Objective: Cochlear implants (CI) and hearing aids (HA) have a gain control that allows the bimodal user to change the loudness. Due to differences in dynamic range between CI and HA, an equal change of the gains of the two devices results in different changes in loudness. The objective was to relate and individualise the step sizes of the loudness controls to obtain a similar perceptual effect in the two ears. Design: We used loudness models parametrised for individual users to find a relation between the controls of the CI and the HA such that each step resulted in an equal change in loudness. We conducted loudness balancing experiments to validate the results. Study sample: Eleven bimodal users of whom six were tested in a prior study. Results: The difference between the optimal gain from the loudness balancing procedure and actual gain was 3.3 dB when the new relation was applied. In contrast, the difference was 8 dB if equal step sized were applied at both sides. Conclusion: We can relate the controls such that each step results in a similar loudness difference.status: accepte