Abstract
OBJECTIVE: Rising cochlear implant (CI) candidate numbers and limited clinic resources challenge high-quality care. Remote programming via telemedicine offers a solution to enhance efficiency while maintaining patient satisfaction and outcomes. This study examined the feasibility of replacing an in-clinic fitting with a remote one during the rehabilitation phase. PATIENTS: This study included 31 postlingually deafened adult CI users implanted at Erasmus Medical Center, Rotterdam, The Netherlands. INTERVENTIONS: Recently, a new remote programming system allowed audiologists to program implants via the CI user's smartphone app using Bluetooth connectivity. Twenty-one participants received standard in-clinic rehabilitation of 4 fitting appointments, while 10 patients underwent remote fitting for their third appointment. MAIN OUTCOME MEASURES: Auditory functioning and patient satisfaction was evaluated at 3 months postimplantation. RESULTS: Participants in the remote group expressed high satisfaction with the process, with most of them recommending remote fitting to others. Most participants found the setup easy and appreciated the convenience of skipping an in-clinic visit. Technical performance was stable, with the exception of one CI user for whom it was not possible to establish the connection. No significant differences were observed between groups in free-field PTA thresholds, speech perception scores, or perceived auditory functioning (SSQ). CONCLUSIONS: Remote fitting proves to be a feasible alternative to in-clinic programming, yielding high patient satisfaction and similar auditory outcomes. It could optimize CI care by reducing clinic burden and improving accessibility, advancing future-proof CI health care. Further research with larger samples is needed to validate these findings and explore long-term effects. Incorporating streaming options and/or subtitles would enhance communication during the process.