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Self-Adjustment of Upper Electrical Stimulation Levels in CI Programming and the Effect on Auditory Functioning.
Jantien L Vroegop1, J Gertjan Dingemanse, Marc P van der Schroeff
1Erasmus Medical Center, ENT Department, Rotterdam, the Netherlands.
Ear and Hearing
|January 27, 2017
Summary
Experienced cochlear implant (CI) users can successfully self-adjust their device settings using remote assistant fitting (RAF). This self-programming improved perceived sound quality and speech perception in quiet, without negatively impacting objective auditory performance.
Area of Science:
- Audiology
- Biomedical Engineering
- Rehabilitation Medicine
Background:
- Current cochlear implants (CIs) provide good speech perception in quiet but struggle in complex environments.
- Fine-tuning CI sound processors in a clinic setting is challenging for real-world acoustic conditions.
- Cochlear Ltd. introduced remote assistant fitting (RAF) for CI users to self-adjust upper stimulation levels.
Purpose of the Study:
- To evaluate how experienced CI recipients adjust settings using RAF in daily life.
- To assess the impact of self-adjusted CI settings on auditory functioning.
- To investigate changes in speech intelligibility, noise tolerance, and perceived sound quality.
Main Methods:
- A prospective clinical study with 22 experienced adult CI recipients using a within-subject repeated measures design.
- Participants used their existing CI program and were trained on RAF, then self-adjusted settings for 3 weeks.
- Auditory performance was measured using speech-in-quiet, speech-in-noise, acceptable noise level tests, and the SSQ-C questionnaire.
Main Results:
- 68% of participants adjusted their C-level frequency profile, with preferences for high- or low-frequency emphasis.
- Some users primarily adjusted overall volume.
- Significant improvements were reported in perceived auditory functioning (SSQ-C scores), but objective measures showed no significant changes.
Conclusions:
- The majority of experienced CI users made modest self-adjustments to their programs using RAF.
- Self-adjustment led to improved perceived speech perception in quiet and sound quality.
- RAF is a useful, clinically applicable tool for enhancing CI recipients' daily listening experience.
