Benefits of Anatomy-Based Cochlear Implant Fitting in Patients with Single-Sided Deafness

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Benefits of Anatomy-Based Cochlear Implant Fitting in Patients with Single-Sided Deafness

(Original title: Kurz A, et al. Anatomy-based fitting improves speech perception in noise for cochlear implant recipients with single-sided deafness. Eur Arch Otorhinolaryngol. 2025 Jan;282(1):467-479.)

Key Message

Anatomy-based CI fitting (ABF) shows advantages over conventional fitting in terms of speech understanding and more natural sound quality, and is well accepted by CI users with single-sided deafness.

Background

An increasing number of patients with single-sided deafness (SSD) are being treated with cochlear implants (CIs). However, conventional processor fitting does not always align with the cochlea’s natural frequency mapping (tonotopy), which can impair natural sound quality. Individualized, anatomy-based fitting (ABF) uses pre- and postoperative imaging to achieve the most natural tonotopic CI fitting possible.

Study Objective

This study investigated the hearing outcomes and sound quality experienced by SSD users with ABF compared to conventional fitting.

• Method:

– 12 postlingually deafened SSD users
– Minimum age: 18 years; average age: approx. 50 years
– Average CI experience: approx. 3 years
– Test 1: with existing processor settings using conventional fitting
– Test 2 (1 month later): with ABF fitting

Objective Measurements:

– Speech understanding in quiet (Freiburg monosyllabic word test)
– Speech understanding in noise (Oldenburg MATRIX sentence test, OLSA Noise)
– Binaural hearing effects (squelch effect and summation effect)

Subjective Sound Quality:

– HISQUI questionnaire

Results:

Significant improvement in speech understanding in noise with ABF compared to conventional fitting

Binaural hearing: better integration of sound information from both ears with ABF

Sound quality: Subjectively high satisfaction with both ABF and conventional fitting, but the majority preferred the ABF setting and chose to keep it.