title: Exploring the clinical approach to the bimodal fitting of hearing aids and cochlear implants: results of an international survey.
abstract: CONCLUSIONS
  The results show that the fitting of a contralateral hearing aid (HA) in the non-implanted ear of cochlear implant (CI) recipients is now well established as standard clinical practice. However, there is a lack of experience in HA fitting within the CI centres and the use of published bimodal fitting procedures is poor. The HA is often not refitted after CI switch-on and this may contribute to rejection. Including a bimodal fitting prescription and process in the CI fitting software would make applying a balancing procedure easier and may increase its implementation in routine clinical practice.
  
  
  OBJECTIVE
  This survey was designed to investigate and understand the current approach to bimodal fitting of HAs and CIs across different countries and the recommendations made to recipients.
  
  
  METHODS
  Clinicians working with HAs and/or CIs were invited to participate in an international multicentre clinical survey, designed to obtain information on the various approaches towards bimodal hearing and CI and HA device fitting. Forty-one questions were presented to clinicians in experienced CI centres across a range of countries and answers were collected via an online survey.
  
  
  RESULTS
  In all, 65 responses were obtained from 12 different countries. All clinicians said they would advise a CI user to wear a contralateral HA if indicated. However, a significant number (45%) had either never fitted HAs before or had less than 1 year of experience. In general, there were no specific criteria for selecting candidates to fit with an HA. A strategy to balance the HA with the CI was not used as a standard practice for any of the adults and was used in only 12% of the children. Only half the respondents were aware of the bimodal literature. The majority of professionals (18/30) did not refit the HA after CI switch-on. However, if users complained of sound quality or loudness issues or had poor test results, a follow-up session was provided. The main benefit reported by recipients was improvement in overall sound quality.
authors.affiliation: Advanced Bionics Clinical Research Department International , Stäfa , Switzerland.
authors.forename: Fanny W A C
authors.initials: FW
authors.lastname: Scherf
authors.forename: Laure P
authors.initials: LP
authors.lastname: Arnold
mesh_terms: D000328:Adult; D002648:Child; D003625:Data Collection; D006310:Hearing Aids / Q000706:statistics & numerical data*; D034381:Hearing Loss / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D055815:Young Adult
keywords: Cochlear implant fitting; binaural hearing; clinical practice; contralateral ear; hearing aid fitting; loudness balancing; residual hearing