New Methodology for Fitting Cochlear Implants

Sound coding strategies for cochlear implants have evolved over the past 30 years with advances in research and technology. Processing schemes have transitioned from the delivery of a diffuse, broad signal in single channel devices to the transmission of detailed sound information to multi-channel devices. This evolution has involved the addition of more channels and more parameter options for adjustment during programming, often adding to the complexity and duration of a programming session. Therefore, most clinician-patient contact time is spent programming and tweaking the processing parameters. Significantly less time is spent counseling or on rehabilitation due to reimbursement constraints (Garber et al., 2002) despite their positive impact on patient outcomes (Sherbourne et al., 2002; Gordon et al., 2000; Bray et al., 1997). Recently, the U.S. Food and Drug Administration approved the latest advancement in cochlear implant processing, HiResolution Sound (HiRes). HiRes processing strategies represent an advanced method of capturing, composing, detailing and delivering sound for hearing via a cochlear implant. This advancement in sound technology necessitated parallel advancements in the fitting paradigm that are respectful of the patient programming needs as well as the reimbursement of clinician’s time. The new software platform used to fit HiResolution Sound, SoundWave Professional Suite, introduces a new fitting methodology that includes innovative features for psychophysics and automated parameter management. The software is designed to simplify the fitting process and reduce fitting time while simultaneously optimizing patient outcomes. This paper will explore the new fitting methodology introduced in the SoundWave software for programming HiRes. The new methodology will be compared with the traditional methodology for fitting previous generation processing strategies. In order to assess the clinical viability and clinician acceptance of the new fitting methodology, a field trial was conducted at several centers in North America. This paper will also review the clinician feedback on the new fitting procedure.