Study of Music and Speech Perception in New Cochlear Implanted Subjects Using or Not a Tonotopy Based Fitting

NCT ID: NCT04922619

Last Updated: 2021-10-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-10

Study Completion Date

2021-09-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Main objective:

Show the superiority of tonotopy based fitting strategy compared to default fitting strategy on the perception speech in noise.

Secondary objectives:

Show the superiority of tonotopy based fitting strategy compared to default fitting strategy on the perception of musical elements (contour test).

Show the non inferiority of tonotopy based fitting strategy compared to default fitting strategy on the perception of speech elements in quiet.

Show the superiority of tonotopy based fitting strategy compared to default fitting strategy on the qualitative preference for the listening of musical pieces.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Introduction: Cochlear implantation allows the rehabilitation of profound bilateral deafness, restoring speech perception and verbal communication when the traditional hearing aid no longer provides satisfactory hearing gain (Nimmons et al.).

A cochlear implant includes an electrode array and its functioning is based on the principle of cochlear tonotopy: each electrode encodes a frequency spectrum according to its position in the cochlea (high frequencies are assigned to the basal electrodes and low frequencies to the apical electrodes).

The cochlear implant thus breaks down the frequency spectrum into a number of frequency bands via bandpass filters corresponding to the number of electrodes in the implant. During the fitting these bands can be modified by the audiologist.

The fitting software developed by the manufacturers proposed a default fitting with a lower limit between 100 and 250 Hz according to the brands and an upper limit of about 8500 Hz. The frequency bands assigned to each electrode follow a logarithmic scale with the high frequencies for the basal electrodes and the low frequencies for the apical electrodes. This distribution takes into account the number of active electrodes but does not take into account the anatomy and the natural cochlear tonotopy specific to each patient.

Several studies have analyzed the anatomical variations of the cochlear dimensions: size of the cochlea and the ratio between the contact surfaces of the electrodes with the cochlea are variable from one patient to another (Stakhovskaya O et al., P. Pelliccia et al.).

The insertion depth during surgery is also variable due to parameters related to the patients as well as to the operator, which seems to impact the understanding of speech in noise (Deep electrode insertion and sound coding in cochlear implants - Ingeborg Hochmair et al.).

Mathematical algorithms have recently been developed to estimate the cochlear tonotopy of each patient from a CT scan assessment (Jiam et al., Sridhar et al.). CT imaging of the implanted ear combined with 3D reconstruction software, provides cochlear length measurements (Cochlear length determination using Cone Beam Computed Tomography in a clinical setting - Würfel et al .) Using this approach it is possible to measure the position of each electrode relative to the cochlear apex. These measurements are applied to the modified Greenwood equation to obtain the tonotopic frequency for each electrode and to determine for each patient a fitting based on the tonotopy of each electrode.

Main objective:

Show the superiority of tonotopy based fitting strategy compared to default fitting strategy on the perception speech in noise.

Secondary objectives:

Show the superiority of tonotopy based fitting strategy compared to default fitting strategy on the perception of musical elements (contour test).

Show the non inferiority of tonotopy based fitting strategy compared to default fitting strategy on the perception of speech elements in quiet.

Show the superiority of tonotopy based fitting strategy compared to default fitting strategy on the qualitative preference for the listening of musical pieces.

Plan of the study:

It is a prospective open monocentric randomized crossover study: measures will be done on the patient at 6 weeks and 12 weeks post-activation.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Sensorineural Hearing Loss, Bilateral

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Two arms A and B:

Arm A: patient's fitting with default fitting --\> 6 weeks use --\> tests and patient's fitting with tonotopy based fitting --\> 6 weeks use --\> tests

Arm B: patient's fitting with tonotopy based fitting --\> 6 weeks use --\> tests and patient's fitting with default fitting --\> 6 weeks use --\> tests
Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Investigators
Double blind study: the patient and the investigator don't know the fitting.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Cochlear Implant (CI) with default fitting then tonotopy based fitting

Cochlear Implant with default fitting first during 6 weeks then with tonotopy based fitting during 6 weeks

Group Type ACTIVE_COMPARATOR

tonotopy based fitting then default fitting

Intervention Type DEVICE

Cochlear implant with default fitting then tonotopy based fitting

default fitting then tonotopy based fitting

Intervention Type DEVICE

Cochlear implant with tonotopy based fitting then default fitting

Cochlear Implant (CI) with tonotopy based fitting then default fitting

Cochlear Implant with tonotopy based fitting during 6 weeks then with default fitting during 6 weeks

Group Type ACTIVE_COMPARATOR

tonotopy based fitting then default fitting

Intervention Type DEVICE

Cochlear implant with default fitting then tonotopy based fitting

default fitting then tonotopy based fitting

Intervention Type DEVICE

Cochlear implant with tonotopy based fitting then default fitting

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

tonotopy based fitting then default fitting

Cochlear implant with default fitting then tonotopy based fitting

Intervention Type DEVICE

default fitting then tonotopy based fitting

Cochlear implant with tonotopy based fitting then default fitting

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Adult patient (\>= 18 years old) speaking French
* Patient who fulfils the criteria for cochlear implantation

Exclusion Criteria

* retro-cochlear pathology: auditory neuropathy, vestibular schwannoma
* patient with residual hearing \< 60 dB HL at 250 Hz and \< 80 dB HL at 500 Hz
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

MED-EL Elektromedizinische Geräte GesmbH

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Benoit Godey, Pr

Role: PRINCIPAL_INVESTIGATOR

Rennes University Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

CHU Rennes

Rennes, , France

Site Status

Countries

Review the countries where the study has at least one active or historical site.

France

References

Explore related publications, articles, or registry entries linked to this study.

Creff G, Bernard-Le Liboux N, Coudert P, Bourdon H, Pean V, Wallaert N, Lambert C, Godey B. Tonotopic and Default Frequency Fitting for Music Perception in Cochlear Implant Recipients: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2024 Nov 1;150(11):960-968. doi: 10.1001/jamaoto.2024.2895.

Reference Type DERIVED
PMID: 39264640 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

MED_EL_tonofit_Rennes_study

Identifier Type: -

Identifier Source: org_study_id