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

Objective To evaluate a new methodological approach of applying anatomy-based fitting (ABF) in experienced cochlear implant (CI) users. Participants Three experienced unilateral and bilateral CI users with postlingual hearing loss. Intervention Postoperative imaging, via a high-volume Dyna computed tomography, and exact electrode measurement positions were integrated into the clinical fitting software following a new procedure, which adapted individual frequency bandwidths within the audio processor. Main Outcome Measures Speech perception in quiet and noise, clinical mapping, and self-perceived level of auditory benefit were assessed. Results For each CI user, ABF mapping provided better speech perception in quiet and in noise compared with the original clinical fitting mapping. In addition, ABF mapping was accepted in CI users despite unequal bilateral array insertion depths and lengths; however, acceptance was only established if the point of first electrode contact was less than 230 Hz. Conclusions ABF mapping increased the acceptance in CI users with longer electrode arrays and in bilateral CI users who were unsatisfied with their device experience. A larger prospective, randomized investigation is currently underway to assess longitudinal outcomes with ABF mapping.