Improvement of perceived cochlear implant sound quality through individualized psychoacoustic-based frequency fitting.

Objective: In recent years, there has been a trend toward more individualization in the fitting of cochlear implants (CI). Here, a new individualized approach to frequency band allocation was used. This approach is based on binaural perceptual pitch matching.

Patient: The patient had congenital bilateral progressive sensorineural hearing loss due to Usher Syndrome. He had used hearing aids in both ears since the age of 4 years. In his mid-40s, he received a CI on his right ear and, ten months later, a second CI on the left ear.

Intervention: Adjustments to the frequency band allocations were made, guided by the binaural perceptual pitch matching of piano notes. For the first CI, pitch matching was performed using the contralateral ear as the reference, which had preserved low-frequency residual hearing (bimodal pitch matching). For the second CI, pitch matching was performed using the first implanted side as the reference (bilateral electrical pitch matching).

Results: The final frequency band allocation adjustments were always shifted toward lower frequencies relative to the default band allocations. The adjustments were larger in magnitude for the second CI compared to the first CI. Speech perception scores generally increased over the course of rehabilitation and were higher with the individualized fitting compared to the default fitting. The subjective sound quality was reportedly greatly improved with the individualized fitting.

Conclusions: Individualized psychoacoustic frequency-based fitting can yield improvements in the perceived sound quality with a CI. However, this method requires significant residual hearing in at least one ear, and the patient must have relatively fine pitch discrimination abilities.