OBJECTIVES.: Several studies have demonstrated the benefits of tonotopic fitting on speech-in-noise perception in new cochlear implant (CI) users. However, these studies used different coding strategies (CIS, HDCIS, FSP, FS4, or mixed) with different frequency spectra....
✦ The floor
Discussion
Signed responses from readers of the wire.
Audiologists fitting new cochlear implant users should watch for published results from this trial, as positive findings could support incorporating fine structure coding with tonotopic fitting into routine programming protocols for improved speech-in-noise performance.
Speech-in-noise performance remains one of the biggest unmet needs for cochlear implant users, and trials rigorously testing fine structure coding strategies could directly shape future device programming guidelines.
- 01Prospective, randomized, double-blind, cross-over RCT design — high internal validity for cochlear implant research.
- 02Evaluates fine structure coding (preserving detailed sound timing/pitch cues) paired with tonotopic fitting (matching sound to correct cochlear location).
- 03Primary outcome is speech-in-noise perception in new cochlear implant users.
- 04Published in Clinical and Experimental Otorhinolaryngology (PMID 42706938, DOI 10.21053/ceo.2026-00039).
- 05Cross-over design controls for individual variability, strengthening the comparison.
Fine structure coding with tonotopic fitting improves speech-in-noise perception in new cochlear implant users compared to standard coding.
studyunclear- PMID
- 42706938
- DOI
- 10.21053/ceo.2026-00039.
- Journal
- Clinical and Experimental Otorhinolaryngology
- Publication type
- research_article
- Evidence level
- 1b
- Population
- New cochlear implant users
- Intervention
- Fine structure coding with tonotopic fitting
- Comparator
- Standard cochlear implant sound coding (without fine structure coding)
Primary outcomes
Speech-in-noise perception