Evaluation of NRT and behavioral measures for MAPping elderly cochlear implant users

Area of Science:

• Audiology
• Biomedical Engineering
• Gerontology

Background:

• Cochlear implants (CIs) are vital for hearing restoration in severe to profound hearing loss.
• Programming cochlear implant device maps (MAPs) is crucial for optimizing speech perception.
• Electrophysiological measures offer an objective method for MAP programming, particularly in challenging populations.

Purpose of the Study:

• To evaluate the acceptability and speech perception outcomes of electrophysiologically derived MAPs in elderly cochlear implant recipients.
• To compare the performance of neural response telemetry (NRT)-based MAPs with traditional behavioral MAPs.

Main Methods:

• Eight elderly participants (≥75 years) with Nucleus 24 cochlear implants used both NRT-derived and behavioral MAPs.
• MAPs were programmed using electrophysiological measures (thresholds, comfort levels, evoked compound action potentials) via NRT.
• Speech perception (word and sentence in noise) was assessed after 6 and 8 weeks of use.

Main Results:

• NRT-derived MAPs estimated behavioral T levels accurately but sometimes underestimated C levels for apical electrodes.
• Speech perception performance with NRT-derived MAPs was comparable to that achieved with behavioral MAPs.
• Elderly participants tolerated NRT-derived MAPs well and indicated MAP preference for various listening situations.

Conclusions:

• Electrophysiologically derived MAPs using NRT are a viable and well-tolerated alternative for programming cochlear implants in elderly adults.
• NRT-based MAPs can yield good speech perception outcomes, simplifying the programming process.
• This approach holds promise for enhancing CI rehabilitation in the geriatric population.