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Articles

Comparisons of electrophysiological and psychophysical fitting methods for cochlear implants

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Pages 118-128 | Received 16 Jun 2021, Accepted 19 Nov 2021, Published online: 29 Dec 2021
 

Abstract

Objective

This study compared two different versions of an electrophysiology-based software-guided cochlear implant fitting method with a procedure employing standard clinical software. The two versions used electrically evoked compound action potential (ECAP) thresholds for either five or all twenty-two electrodes to determine sound processor stimulation level profiles. Objective and subjective performance results were compared between software-guided and clinical fittings.

Design

Prospective, double-blind, single-subject repeated-measures with permuted ABCA sequences.

Study sample

48 post linguistically deafened adults with ≤15 years of severe-to-profound deafness who were newly unilaterally implanted with a Nucleus device.

Results

Speech recognition in noise and quiet was not significantly different between software- guided and standard methods, but there was a visit/learning-effect. However, the 5-electrode method gave scores on the SSQ speech subscale 0.5 points lower than the standard method. Clinicians judged usability for all methods as acceptable, as did subjects for comfort. Analysis of stimulation levels and ECAP thresholds suggested that the 5-electrode method could be refined.

Conclusions

Speech recognition was not inferior using either version of the electrophysiology-based software-guided fitting method compared with the standard method. Subject-reported speech perception was slightly inferior with the five-electrode method. Software-guided methods saved about 10 min of clinician’s time versus standard fittings.

Acknowledgments

Statistical analysis was performed by Dominik H. Pfluger (Zurich, Switzerland). Chris James of Cochlear France provided additional analysis of map levels and edited the manuscript.

Disclosure statement

Authors N. Neben and F. Junge are employees of Cochlear Deutschland GmbH & Co. KG; manufacturer of Nucleus cochlear implants. The other authors declare no conflict of interest.

Additional information

Funding

The work was funded by Cochlear AG (Basel, Switzerland).