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I participated in research at Vanderbilt in 2016. I was in three studies.  One of the studies was a version of their image guided CI programming where they use CT images of the electrode arrays in your cochleas and run it through their software to determine the areas of your cochleas that are receiving overlapping stimulation from adjacent electrodes.  Then they use their software to determine which electrodes if any should be turned off.  When electrodes are turned off, we do not miss any frequencies as all frequencies are redistributed to the electrodes that remain active.  These Image Guided CI Programming studies at Vanderbilt (there are several different studies in this group) are including people with all 3 FDA approved CI brands.  

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Hi Mary Beth.

Thanks for this. Yeah, I sorta thought that programming was a lot more systematic than seems to be the case. “Guess-and-check approach based on subjective patient feedback”!??? Yikes. “Guess” is not a word that you want to hear (no pun intended) when you are talking about medical care. Well, good luck to the Vanderbilt team...  

By the way, I took your advice and asked to see a different team of audiologists here in Tokyo. The new team seemed to think my most recent mapping was a disaster, so they recommended that we start over from the beginning and re-set everything to basic “activation” levels. So that’s where I’m at now. I’m supposed to go back next week and do a little fine-tuning. I don’t suppose the new Vanderbilt study will be done by then, so I guess we’ll use the ”guess and check approach”! :)  Look forward to seeing you and the gang on Sunday.  

Best,

Kirk

 

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@Kirk S.

I am glad you are working with a new team.  Keep us posted.

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Thank you @Mary Beth for posting this article. This research addresses the problem that carries over from what I viewed as the biggest in programming hearing aids. After the audiologist have made their best guess and the quality is not good, it is very difficult for a patient to explain what they are hearing in a way that the audiologist can understand the description and make correct adjustments. I am experiencing some of this with ci mapping as well. Overall my progress has been exceptionality good but television continues to be a struggle for me. The phone was very good on an early mapping but degraded on later mappings. Most people sound great, but some dont. I could understand my daughter almost perfect on an early mapping but can hardly carry on a conversation now. The problem now is I dont remember which was the good mapping, SHOULD HAVE KEPT NOTES. Maybe we will find it and the audiologist can setup a program for phone use. Maybe the audiologist can listen to my daughter on the phone and make adjustments from what she hears. I hope that this research at Vanderbilt will benefit all of us. 

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@Tommy C

I realized early on that there is quite a limitation to the information from sound booth testing after reaching a stable MAP. The sound booth testing could show great access across frequencies yet I knew there was a definite problem with certain voices, certain phoneme confusion or sound quality.

 

This is when I realized that CI MAPping is both an art and a science.

 

Keep a list of problem areas.  Be as specific as you can.  Keep discussing it with your audiologist.

 

I hope you find a fabulous MAP soon.

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  • 4 weeks later...

For me it's no good remembering a good mapping because your perception has already changed. Each new mapping is a new learning curve.. The audiologist is chasing a moving target. 

The cochlear method of mapping is to set the response of each electrode to the lowest volume a certain tone gives. 

Then for groups of 3 tones in a select frequency range, each tone is adjusted to sound the same volume. If any electrode gives a bad sound it is switched off. So you end up with the same volume for each frequency. 

The whole process is subjective. 

I have 3 programs. 

A fancy scan program that cuts out noise, probably cost millions in research. 

Then a straight program no fancy enhancements. 

A third program for music that has a larger dynamic range and no fancy enhancements.

The last one I use all the time. The magic scan program gathers dust. 

16 months down the line and it's still getting better. 

Still lots of challenges and still smiling 😊

Every morning when I put on my CI the world of sound bursts into my head. 

Peter 

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@pdk

Thanks for the link to the article.  I had not seen that.

Each brand of CI has a different way of MAPping AND each CI audiologist also has a different approach.

For my Med-El CIs I have found this helpful :

 

-test each threshold instead of using defaults (My left ear has interesting thresholds and did not hear well using defaults.  My right ear did fine with defaults but has improved sound quality with tested thresholds.). Testing thresholds involves listening to each electrode until the electrode’s beeps are too quiet to hear.  Then threshold is set right below that.  It is kind of the loudest setting that we can not detect.

-balancing electrode volumes using MCL (most comfortable loudness)

-balancing electrode volumes between right and left sides. 

-testing new MAPs using the IOWA phoneme test that I posted on here before And having my audiologist work her magic on phonemes that I get incorrect

-I like @Joan’s experience of using YouTube videos for restaurant noise

-Listening to speech with the new MAP and having my audiologist adjust it based on subjective reporting.

@Kylie’s shared an interesting way her audiologist is measuring her MAP objectively.

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