The future of cochlear implant MAPping: customized MAPping

[Mary Beth]

There are several approaches to customized CI MAPping which use CT imaging post surgery to make MAPping determinations based on how the electrode array is actually positioned in our specific ears.  Here are some of the approaches being used or under clinical study at this time.  We have HP members who have mentioned participating in several of these studies/approaches. This definitely seems to be the future of CI MAPping:  an individualized approach based on the electrode array’s position in our unique cochleas.  Exciting times!

USING CT IMAGING POST SURGERY TO SET FREQUENCY BANDS FOR EACH ELECTRODE BASED ON THE POSITION IN THE COCHLEA:

1) Med-El’s Anatomy Based Fitting as part of OTOPLAN for Sonnet2 and Rondo3 processors @John R shared his experience with anatomy based fitting.  Has anyone else experienced it yet? (It requires a post operative CT scan.)

2) Meg Dillon at the University of North Carolina presented this week on a place based MAPping approach also using post operative CT scan.  @Roy Louis Smith shared his experience with this approach.  Has anyone else experienced it yet? 
 

3). There is a new clinical trial for new implants led by Western Canada in cooperation with the University of North Carolina that will compare music, speech in quiet and speech in noise of a place based MAPping versus a standard MAP.  Info here;

https://clinicaltrials.gov/ct2/show/NCT05558514?term=Med-el&draw=6&rank=44
 

4). Charles Limb’s research lab at the University of San Francisco with Melanie Gilbert, AuD has been working on musical pitch with a customized MAP based on CT scans.  @Justin has shared his experience with this approach.  (NOTE: this study is no longer enrolling already implanted CI users)

5). Charles Limb’s research lab is now enrolling people planning to be implanted with Med-El and activating those people using the above approach.  Info available here:

https://ohns.ucsf.edu/limb-lab
 

USING CT IMAGING POST SURGERY TO DETERMINE ELECTRODES THAT ARE OVERLAPPING IN STIMULATION AND THEN TURNING OFF TARGETED ELECTRODES:

Vanderbilt has a long running series of studies using post operative CT scans to determine electrodes that are overlapping in their stimulation areas and then turning off targeted electrodes.  I have shared my experience with this approach.  Information can be found here:

https://www.vanderbilt.edu/vise/viseprojects/computer-assisted-image-guided-programming-of-cochlear-implants/

[pdk]

I wonder if it would be able to decide which frequency band sounds best on each electrode. 

[Mary Beth]

@pdk theoretically it makes sense based on the regions of a healthy cochlea that are designed to focus on specific pitch ranges.  But we all know that our cochleas are not typical.  Many of us may have neural dead zones or at least an uneven amount of neural survival throughout our cochleas.  Time will tell.

All of the research I have read and presentations I have listened to so far have mixed results.  Some users reporting a significant improvement, others a more limited improvement and some no improvement.  It’s a work in progress.

Even the much longer ongoing studies from Vanderbilt on deactivating electrodes that are overlapping in stimulation areas do not show improvement in every user- but it does in a high majority.  My right ear had a slight improvement in sound quality.  My left ear had a significant improvement in sound quality.  And musical pitch improved as well.

[pdk]

Nice reply Mary Beth.

I'll check with my audiologist. I guess it's a given it will not work for everyone like all things cochlear. I think it's definitely worth following up.. 

I wish we could do our own mapping. 

 

[Dianna]

I was not offered a post surgry scan. My research project is regarding how ci can help delay age related dimentia. I wish! 

Im going to call today on one that uses a pet scan to measure things...sounded interesting

Ive had multiple eeg's .... like hyper rehab with frankenstein helmet no results tho...study just ended but may continue

I dont think my audi has time to view scans for placement...they do all three mfrs cis and very busy, havnt heard any rumbles about placement researches recently, but i know they had one in the past on the effects of cross over or perforation.

[Dianna]

Oooh, im not sure about that cuz you have to make the map, then listen, then make a new map, listen, lol....i just want a program that magically knows what cochlear hairs need stimulation for music lol.

Currently its rehab like mad lol 😠 🗯 😡 

[Mary Beth]

@Dianna

check this out.  Med-El US will do it for our doctors if they request it.

https://hearlife.medel.com/en-us/local/us-pages/otoplan-on-demand
 

 

[pdk]

My audiologist was present at both my ops to check electrode placement. Incidently the surgeon dug hollows in my skull for the magnets. They will stay put. 

Meantime lots of audio books 

[Lauren]

Interesting. I’m wondering I would benefit from this. Interesting stuff!

Ive gone through lots of testing but nothing like that. 

[Dianna]

Hmm 😒,   excellent idea!  well things are going good for now, i am still in training for things, and continuing with ha mappings..its helping the ci ear, at least the parts of speech and sound that it lacks.

Perhaps i can chat up the research team first. 

Worth keeping the post, thanks mary beth!

[Dianna]

Lauren, maybe after both ears done???

[Lauren]

I’ll ask if they’ve heard of that. Doubtful it would be up here. Pretty lonely and quiet as there’s no studies or groups lol. All the interesting stuff is in the lower 48 (we call it  Outside, as in going Outside)