Can anatomy-based fitting improve musical perception in adult cochlear implant users?

•Music represents one of the biggest challenges for cochlear implant users.•Anatomy-based fitting is a new step regarding personalized medicine in the field of CIs.•Anatomy-based fitting may be beneficial for improving certain musical skills in CI users To compare Anatomy-Based Fitting (ABF) vs. Default Fitting (DF) in terms of music perception and music enjoyment in CI users. CI users ≥ 18 years implanted with a Synchrony ST Flex28 (MEDEL) with at least 12 months of experience with either ABF or DF, with good speech tests outcomes (≥ 65% disyllables) were enrolled. Music tasks were assessed with “Discovery” level of Meludia online interactive music tool, which includes Rhythm (beat count), Spatialization (differentiating between lower and higher notes), Stable/unstable (perception of stability or instability), Melody (ascendant or descendant), and Density (presence of one or multiple simultaneous sounds). Each task consists of five levels of difficulty. Participants were allowed a maximum of 4 attempts to complete a level. The Music-Related Quality of Life (MuRQoL) and the Munich Music (MUMU) questionnaires evaluated music background. Twenty CI users took part: 10 using ABF and 10 DF. There were no significant differences in age at implantation (53.2 ± 15.0 vs. 53.8 ± 14.5y), time since surgery (1.8 ± 0.5 vs. 2.4 ± 1.5y), or the percentage of disyllables in silence (68.0 ± 8.0 vs. 77.3 ± 11.5%) between groups. Regarding Meludia scores, differences were observed between both groups in Density: ABF had better mean scores when completing the level in only one attempt (8.7 ± 2.5 vs. 4.6 ± 3.1, p = 0.016) and required fewer restarts to complete the five levels (6.6 ± 1.6 vs. 9.3 ± 2.3; p = 0.009). Furthermore, the fifth level of Density was successfully completed by 60% of patients with ABF, while none of the patients with DF achieved this (p = 0.003). The scores obtained in MuRQoL were similar between ABF and DF groups. In a similar way, the MUMU showed no differences in terms of frequency and music importance. ABF demonstrates specific advantages in certain musical tasks, specifically in processing multiple sounds simultaneously. Further studies are necessary to explore additional benefits of ABF in musical skills in CI users. NCT05319678. Level 3.