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Updated: Sep 10, 2025

Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Bimodal fitting benefits emotional responses to music following unilateral cochlear implantation
Isaac L Alter1, Alexander Chern1,2, Megan E Kuhlmey1
1Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.
Objectives:
Investigate contributions of cochlear implants (CIs) and hearing aids (HAs) towards musical emotion in bimodal (CI and HA together) users.
Design:
Bimodal implantees and normal-hearing (NH) controls were recruited from a tertiary academic centre and via community outreach. Participants listened to ten musical clips and rated on scales of valence (happiness vs. sadness) and arousal (excitement vs. calm). Primary outcome measures included discrepancy - difference from validated normative ratings for each stimulus - and range - difference between each participant's maximum and minimum rating - of both valence and arousal.
Study Sample:
27 bimodal implantees and 21 NH controls.
Results:
Compared with bimodal listening, participants experienced increased valence discrepancy with CI alone (2.07 vs. 1.86, p = 0.027) and increased arousal discrepancy with HA alone (1.84 vs. 1.60, p = 0.029). Similarly, valence range was lower in the CI-only condition (4.57 vs. 5.40, p = 0.011), and arousal range was lower via HA (4.84 vs. 5.68, p = 0.013). CI listening alone was not significantly different from HA alone for any measured outcome. Bimodal participants performed worse than NH controls.
Conclusions:
Bimodal listening has diminished emotional responses to music compared to NH controls, but is superior to HA or CI alone. Our findings support bimodal fitting to enhance musical experience.

