Remote versus in-clinic cochlear implant programming during rehabilitation: clinical outcomes and patient perspectives

N C Homans; M Hussain; H F E van der Toom; J L Vroegop

doi:10.1080/17483107.2026.2626470

Remote versus in-clinic cochlear implant programming during rehabilitation: clinical outcomes and patient perspectives

Disabil Rehabil Assist Technol. 2026 Feb 5:1-15. doi: 10.1080/17483107.2026.2626470. Online ahead of print.

Authors

N C Homans¹, M Hussain¹, H F E van der Toom¹, J L Vroegop¹

Affiliation

¹ Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, The Netherlands.

PMID: 41641882
DOI: 10.1080/17483107.2026.2626470

Abstract

Purpose: Increasing cochlear implant (CI) demand due to broader candidacy and an ageing population challenges in-clinic rehabilitation. Remote programming offers a promising alternative to improve accessibility. This study evaluates its non-inferiority and optimal timing during rehabilitation.

Materials and methods: Forty-three postlingually deafened adults were divided into three groups: standard in-clinic fitting (n = 21), remote fitting during the second session (n = 12), and remote fitting during the third session (n = 10). Auditory outcomes at the fourth session were assessed using speech perception phoneme score at 65 dB SPL (primary outcome measure), free-field tone audiometry and programming parameters (M- and T-levels). Patient experiences with remote programming were evaluated via a dedicated questionnaire. Non-inferiority of remote versus in-clinic fitting was assessed.

Results: Speech perception phoneme score at 65 dB SPL was 73% (SD = 11) in the remote group and 76% (SD = 11) in the in-clinic group, with a mean difference of -3% (95% CI: -9.4 to 3.9), meeting the pre-specified non-inferiority margin. Free-field tone audiometry thresholds were not significantly different (remote: 24 ± 5 dB HL; in-clinic: 25 ± 5 dB HL). Patients without remote experience expressed more negative perceptions about the concept, whereas those with firsthand experience reported high satisfaction, ease of use, and willingness to continue remote sessions.

Conclusions: Replacing one rehabilitation appointment with a remote fitting is non-inferior to standard in-clinic fitting for speech perception outcomes. Most patients reported high satisfaction, supporting its feasibility and accessibility.

Keywords: Cochlear implants; health innovation; hearing loss; rehabilitation; remote care; telehealth.

Plain language summary

Remote fitting sessions can reduce travel burden and improve accessibility for patients with mobility or logistical challenges.One in-clinic rehabilitation appointment can be replaced with a remote cochlear implant fitting without compromising speech perception outcomes.Combining in-clinic and remote sessions in a hybrid rehabilitation model may increase efficiency and allow more patient-centered care.