One Click Is Not Enough: Anatomy-Based Fitting in Experienced Cochlear Implant Users.

Area of Science:

• Audiology
• Medical Imaging
• Neurosurgery

Background:

• Cochlear implant (CI) technology offers significant auditory rehabilitation for individuals with severe to profound hearing loss.
• Current fitting methods may not fully optimize device performance for all users, necessitating advanced approaches.
• Anatomy-based fitting (ABF) presents a novel strategy to personalize CI audio processor settings.

Purpose of the Study:

• To evaluate a new methodological approach for applying anatomy-based fitting (ABF) in experienced cochlear implant (CI) users.
• To assess the impact of ABF on speech perception and user-reported auditory benefit.
• To determine the acceptance criteria for ABF in CI users with varying device configurations.

Main Methods:

• Three experienced unilateral and bilateral CI users with postlingual hearing loss participated.
• Postoperative imaging (Dyna CT) and precise electrode positions were integrated into fitting software.
• Individual frequency bandwidths were adapted within the audio processor using the new ABF procedure.

Main Results:

• ABF mapping resulted in superior speech perception in quiet and noise compared to standard clinical fitting.
• ABF was accepted by CI users even with unequal bilateral array insertion depths and lengths.
• Acceptance of ABF was contingent on the first electrode contact being below 230 Hz.

Conclusions:

• ABF mapping enhances speech understanding and auditory benefit in experienced CI users.
• This method improves device acceptance, especially for users with longer electrode arrays or previous dissatisfaction.
• Further large-scale randomized trials are warranted to confirm long-term outcomes of ABF mapping.