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Related Experiment Video

Updated: Feb 10, 2026

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Comparing Two Hearing Aid Fitting Algorithms for Bimodal Cochlear Implant Users.

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Summary

Experienced bimodal cochlear implant (CI) users benefit from bimodal stimulation regardless of the hearing aid fitting formula used. Both the Adaptive Phonak Digital Bimodal (APDB) and NAL-NL2 formulas showed no significant differences in auditory performance for CI users.

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Area of Science:

  • Audiology
  • Hearing Science
  • Biomedical Engineering

Background:

  • Bimodal hearing, combining a cochlear implant (CI) with a hearing aid in the contralateral ear, offers potential benefits for individuals with unilateral hearing loss.
  • Selecting the optimal hearing aid fitting formula for bimodal configurations is crucial for maximizing auditory performance.
  • Existing standard formulas like NAL-NL2 may not be specifically optimized for the unique acoustic demands of bimodal CI use.

Purpose of the Study:

  • To compare the efficacy of a dedicated bimodal hearing aid fitting formula, Adaptive Phonak Digital Bimodal (APDB), against the standard NAL-NL2 formula.
  • To evaluate the impact of these formulas on hearing aid gain and bimodal auditory functioning in experienced CI users.
  • To assess the effect of broadband loudness balancing on prescribed gain within both fitting formulas.

Main Methods:

  • A prospective, crossover study design involving 19 postlingually deafened, experienced bimodal CI users.
  • Comparison of two fitting methods: NAL-NL2 and APDB, with a 3-week interval between sessions.
  • Auditory functioning assessed via speech in quiet, speech in noise tests, and a subjective auditory performance questionnaire.

Main Results:

  • The APDB formula provided less gain at frequencies of 2000 Hz and above compared to NAL-NL2.
  • APDB exhibited a higher compression ratio for frequencies of 1000 Hz and above than NAL-NL2.
  • No significant differences in auditory performance were observed between the APDB and NAL-NL2 fitting formulas across all tested conditions.

Conclusions:

  • Bimodal stimulation provides significant benefits for CI users with residual contralateral hearing, irrespective of the fitting formula employed.
  • Despite measurable differences in gain and compression between APDB and NAL-NL2, neither formula demonstrated superior auditory performance.
  • Both NAL-NL2 and APDB appear suitable for bimodal fitting, with loudness balancing having a minimal impact on hearing aid output.