Tonotopic versus conventional frequency mapping in adult cochlear implant recipients: a systematic review and meta-analysis of randomized trials.

Authors

Nourah Almarri, Fabian Peralta, Jorge Silva, Estelle Page-Taylor, Arijit Ganguly, Eman Khalid Hussain, Bertrand Cailliau, Jose Manuel Morales-Puebla, Luis Lassaletta

Published in

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. Jul 19, 2026. Epub Jul 19, 2026.

Abstract

In adult cochlear implant users, conventional frequency (CF) mapping is standard practice. Tonotopic fitting (TF) refers to a programming strategy in which the frequency allocation of the speech processor is matched as closely as possible to the natural tonotopic organization of the cochlea. Whether TF mapping improves outcomes over CF remains uncertain.
We searched PubMed, Embase, and Cochrane for randomized controlled trials comparing tonotopic versus conventional mapping in adult cochlear implant users. Random-effects meta-analysis was performed using RevMan 5.4. Continuous outcomes were analyzed using standardized mean difference (SMD) with 95% confidence intervals (CIs), and heterogeneity was assessed with I². A two-tailed P-value < 0.05 was considered statistically significant. We created an effect-direction plot for selected outcomes to provide a visual summary of the direction and consistency of effects across studies.
A total of five publications were included, representing four trials (n = 109). There was no significant difference between TF and CF mapping in speech understanding in quiet (SMD = -0.07; 95% CI -0.82, 0.68; P = 0.86; I² = 79%) and in noise (SMD = 0.51; 95% CI -0.44,1.46; P = 0.30; I² = 93%). The sensitivity analysis for speech understanding in noise favored TF. Also music perception favored TF on the effect direction plot, while sound quality showed variable outcomes.
TF mapping may have potential benefits over CF mapping for speech understanding in noise and music perception. Larger randomized trials are needed to establish the clinical significance of TF mapping.

PMID:
42472950
Bibliographic data and abstract were imported from PubMed on 20 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.