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The digits-in-noise test in audiological cochlear implant aftercare

HNO. 2026 Jul 3. doi: 10.1007/s00106-026-01784-8. Online ahead of print.

ABSTRACT

BACKGROUND: A wide range of methods for speech audiometry to evaluate the outcome after cochlear implant (CI) fitting exist in German-speaking countries. Various procedures are used to determine the speech recognition threshold in noise (SRT). As an adaptive test with a simple lexical structure, the digits-in-noise (DiN) test offers an alternative to list-based speech tests or matrix tests. The aim of this study was to evaluate the clinical relevance of DiN in postoperative follow-up, particularly in comparison to the Freiburg speech test (FBS) and the Oldenburg sentence test (OlSa), as well as for supporting individualized CI settings.

MATERIALS AND METHODS: In a prospective study, 73 adult CI users were examined. Speech comprehension was assessed monaurally in a free field using the FBS, OlSa, and DiN. The participants were divided into three groups based on their hearing loss for numbers (HVZ). The OlSa in noise was only performed if speech comprehension was sufficient. The evaluation was carried out using descriptive statistics, the Kruskal-Wallis test, and Bland-Altman analysis.

RESULTS: The test-retest reliability of the DiN was high and independent of the time of measurement. The SRTs differed significantly between groups, with better audibility showing lower thresholds. Speech tests in quiet and noise confirmed these differences. The DiN could be performed in all participants.

CONCLUSION: The DiN can be used in all phases of audiological CI follow-up care and enables early differentiation and progress monitoring, provides information on audibility, complements the FBS, and may be used in future studies on optimal fitting of CI systems.

PMID:42397601 | DOI:10.1007/s00106-026-01784-8

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