Head orientation benefit to speech intelligibility in noise for cochlear implant users and in realistic listening conditions

Cochlear implant (CI) users suffer from elevated speech-reception thresholds and may rely on lip reading. Traditional measures of spatial release from masking quantify speech-reception-threshold improvement with azimuthal separation of target speaker and interferers and with the listener facing the target speaker. Substantial benefits of orienting the head away from the target speaker were predicted by a model of spatial release from masking. Audio-only and audio-visual speech-reception thresholds in normal-hearing (NH) listeners and bilateral and unilateral CI users confirmed model predictions of this head-orientation benefit. The benefit ranged 2-5 dB for a modest 30° orientation that did not affect the lip-reading benefit. NH listeners' and CI users' lip-reading benefit measured 3 and 5 dB, respectively. A head-orientation benefit of ∼2 dB was also both predicted and observed in NH listeners in realistic simulations of a restaurant listening environment. Exploiting the benefit of head orientation is thus a robust hearing tactic that would benefit both NH listeners and CI users in noisy listening conditions.