Binaural masking level differences in actual and simulated bilateral cochlear implant listeners.

At present commercially available bilateral cochlear implants (CIs) improve their users' speech understanding in noise but they employ two independent speech processors that cannot provide accurate and appropriate interaural level and time differences as seen binaurally in normal hearing (NH) listeners. Previous work suggests that binaural cues are accessible to bilateral CI users when presented to single pairs of pitch-matched electrodes, but the scope was limited and the mechanisms remained unclear. In this study, binaural masking level differences (BMLDs) were measured in five bilateral Nucleus-24 CI users over multiple pairs of pitch-matched electrodes. Average BMLD was 4.6+/-4.9 dB, but large individual variability prevented significance (p=0.09). Considering just the 125 Hz condition, as in previous work, phase (N0S0 vs N0Spi) and electrode effects were significant. Compared with simulated bilateral CI users, actual bilateral CI users had proportionally higher thresholds for N0Spi than N0S0. Together the present results suggest that the performance gap in BMLDs between CI and NH listeners is not due to a lack of sufficient acoustic cues in the temporal envelope domain but to a true binaural deficit related to a central mechanism in deprived binaural processing.