Cochlear Implant Patient Preference for Program Mapping with Anatomy Based Fitting Using Post Operative Imaging

Introduction: Anatomy Based Fitting (ABF) uses post operative images to specify the location of each cochlear implant (CI) electrode in order to tailor frequency programming. This MED-EL CI programming method is hypothesized to decrease pitch mismatch so sound is perceived as more natural to the user. Herein we report rates of patient preference for ABF versus conventional programming, as well as analyze for factors predictive of this preference.

Methods: After IRB exemption, we conducted a retrospective chart review of all adult CI recipients for sensorineural hearing loss receiving ABF programming (1/2024-12/2024) in a private neurotology practice. The primary outcome was patient preference for their ABF program versus their conventional program. Demographic and pre-operative audiometric data were then analyzed to assess for variables associated with preference for or against ABF programming. Univariate and multivariate analyses were run using JMP Pro 16.

Results: 26 patients received ABF programming, with 14 (54%) preferring their ABF program for daily use. The median age was 73, with 42% of participants female, and median time after CI to receiving ABF programming was 7.5 months. No demographic factors were significantly associated with ABF preference (age, gender, time from surgery to ABF programming, electrode length, surgeon). On univariate analysis, higher Speech Reception Threshold (SRT) and lower Word Recognition Score (WRS) were associated with preferring the ABF program (p=0.03 for both). Follow up multivariate analysis for SRT and WRS demonstrated a significant whole model test of the two variables (p=0.02) with covariance of estimates demonstrating no significance (p=0.06 for SRT and p=0.16 for WRS). This suggests an overall relationship with neither of the two having individual significance in this small sample size.

Conclusions: This study reports real world preference rates for using ABF programming, with just over 50% of patients preferring their ABF map to conventional mapping. It is possible that higher SRT and lower WRS during pre-CI evaluation could be predictors of ABF preference.